Transcript for
Helping children to live their ‘best life’ – part two
Narrator (00:02): Welcome to the Emerging Minds podcast.
Dan Moss (00:08): Hello, everyone. My name’s Dan Moss, and this is episode two in a series of two podcasts with psychologist Penny Sih. Penny will be continuing her description today of practice strategies for work with children and families. For those of you who listened to part one, you will know that Penny supports children to walk towards their best life, by discussing the relationships, routines, and activities that sustain and energise them.
(00:34): Penny has been integral to the development of the Emerging Minds e-learning course: Practice srategies for assessment and engagement. Within this course, there is a fictional demonstration of a psychologist, Cassie, working with Zoe, an eight-year-old girl, and her mum, Bridget. Zoe has been referred to Cassie because she’s experiencing significant anxiety, and this is causing her to miss lots of school. Bridget and Matt, Zoe’s dad, are currently going through separation that has brought tension and conflict into the house, particularly when Matt comes over to visit or comes around for dinner. Penny will refer occasionally to the case study during this podcast, and if you’d like to know more about the course, please log into our website on www.emergingminds.com.au.
(01:24): So Penny, welcome back, and welcome to episode two. So great to have you back with us. When we last spoke to you, you were describing how you would set up engagement with children like Zoe. Could you tell us a bit about how you would involve active participation from parents like Bridget, when they’re involved in therapy sessions? Particularly where they might be feeling a little unsure about their role or a lack of confidence about what they might have to offer to the sessions?
Penny Sih (01:51): Well, so first and foremost, if I’ve got both of them in the room, it is that kind of tricky balance between keeping age-appropriate sort of fun, kid-type language, but also making sure that parents, right from the outset, are really involved and included and engaged in that process. So that’s why one of the ways I do rules of therapy is actually covering both of these key issues.
(02:14): So rule number one, we have a bit of fun. Rule number two, we need to know who’s in charge in this room. So I always say to kids, “Okay, so it’s really important, so that everyone can be safe and we can have a really good time. We need to know who’s in charge of therapy. Who do you think is in charge?” I’ll address this to the child. Now, 99% of the time, because they’re in my room and I’m the professional, and they think that’s the answer, is kids will say, “Well, it’s you.” Looking at me.
(02:40): And I’ll be like, “Ah, you think I’m in charge? Thank you so much. I would love to be in charge, and you’re right; I am in charge of some things. This is my room, so it is my job to make sure that everyone in this room, during this time, is safe, and all of my things are safe. So if anything’s ever happening, I will step in to make sure that everybody here and everything here is safe. So you’re right; I’m in charge of that. But no, I’m not actually in charge of therapy. So I’ll give you another guess. Who’s in charge?” And at this point, the kid will be a bit hesitant or sort of be looking at their mum and dad, and their mum’s usually going, “You,” pointing at the child. And the child goes, “Okay,” because they thought that was the answer, but now they’re confident, and they’ll look at me and they’ll be like, “Oh, it’s me.”
(03:21): At which point I go, “Nah, good try. Good guess. Glad you thought that, and you’re right. You are in charge of lots of things. So you are in charge of your feelings. You can be the boss of your feelings. You can have lots of say in what we focus on here, because it’s your life. So I’m going to say you are like the team captain. You’re Team Captain Zoe, and this is your life that we are sort of working on, so yes, it’s really important that what we’re talking about matters to you. But you are not quite right. You’re not actually in charge. So who do you think is in charge?”
(03:55): And they’re thinking, “Well, there’s only one person left in the room.” And they’re looking at Mum and Dad, by this time, are looking really shocked. They’re like, “What?” Suddenly, they’re like, “Oh, hang on a second. I have to be what?” And everyone looks at them, and the kid will be like, “Mum or Dad?” I’ll be like, “Yes, just like at home.”
(04:13): And then I might say, “Because Mum and Dad know you the best. And even though it’s a bit annoying, sometimes, that mums and dads get to make rules about things like bedtime and sleep time and what you eat for dinner, mums and dads are the ones who know you best. They know that they want to get your best life for you, and so just like at home, everything we do here is going to depend on whether Mum or Dad think that’s going to work for you, whether that’s going to work for your family. And if you are the team captain, Mum and Dad and I, we’re the coaches. We’re going to all work together as a team, and Mum and Dad are going to keep helping you practise at home all the things you need to learn. I might have some suggestions and ideas, but it’s Mum and Dad’s job to say: That won’t work for us, because of this, this and this, or that will work for us.”
(05:02): At this point, I’m involving Bridget a lot more. I’m saying, “Hey, just like at home, I’m going to be helping you to do this. We, of course, will come up with some ideas, but ultimately, Mum and Dad are the ones who care about and are most responsible for your wellbeing. And they’re the ones who are going to be helping you do the work.”
Dan Moss (05:20): So when you’re making a decision around who’s in the room, it sounds like it’s really important for you, as much as possible, to be including a parent or both parents or caregiver.
Penny Sih (05:29): Absolutely. Obviously, the complexity of the situation is a whole range of factors about who might be able to be at the first session, things like that. And different clinicians do that different ways. But for the most part, well, we do have an expectation that a parent is available and engaging and in the therapy room, at least every session, if they’re under about the age of 12, for at least some of the time. You can’t just send your kid along and hope we’ll fix them. That’s set up.
(05:55): Some clinicians will work more with kids alone. Some clinicians will work more with both the parent and kid together. But all of that is about if we’re working with a kid alone, how do we then feedback to whoever’s going to be your key coaches? And we’ll work with the family to work out who the most important or who the most helpful people are to be involved in that process, making sure we’re including as much of the parenting team as we can, given the situation. So that everyone who’s a coach in Zoe’s life can be on Team Zoe.
Dan Moss (06:27): Yeah, and I suppose within that, there are certain challenges, where a parent thinks your role is to fix the child, or where a parent might be perhaps articulating some negative views around the child. So how do you negotiate that within a therapeutic setting?
Penny Sih (06:42): I mean, I think one of my big roles is to actually support the parent to have the confidence to be the parent that they want to be. And I believe that parents who bring their kids to therapy want life to be better for their kids. They want to know how to support their kids better. They may be overwhelmed by their own struggles, absolutely, so it is my job to support them to either get more support for themselves or to support them to be in that role.
(07:08): I guess I do that through also really engaging and connecting with parents, acknowledging their concerns, but also building them up, I guess, one-on-one, but also in front of their child. I think that stuff I was saying before, about how I might say, “Oh, Zoe, you’re really lucky. You’ve got a mum who’s been so worried about you and so wants you to have a good life that she’s brought you along, even though she wasn’t quite sure how to help you. It sounds like you and Mum and Dad really want things to be going better for you.”
(07:34): And I’ll be looking for those moments where I can notice parents’ strengths and their good intention, as well. And name that for the parent, name that for the child. It’s not my job to be better with their kid than they are, and in fact, I think that really gets in the way of therapy. I need to connect with the kid, but I also need them to connect with their kid, more than anything. That’s the sweet spot.
Dan Moss (07:57): So you talked about noticing some of the strengths, and it’s highly likely that a kid like Zoe might be coming to see you with almost wholly deficit-based sense of themselves. And they can’t get out of bed, can’t go to school. There’s a lot wrong with her. How do you work with Zoe, for example, to notice some of the ways or the strategies she’s used in the past, or even presently, to overcome some of her difficulties?
Penny Sih (08:25): Yeah, I think that that idea of identifying strengths or noticing times when she’s she’s achieved something in the past. So I might ask parents again. Bring them in right from the outset to change and shift the dialogue a little bit, by asking a question like, “Tell me three things that make you really proud of Zoe.” Or “What are some things she’s done lately, that you were like, Wow, that was really tough, but she really had a go at it?” So I’ll be looking for specific examples. I’ll be naming the ones that I can see even immediately, like, “Hey, I can kind of get a sense that you weren’t sure about being here today. You didn’t really even want to come and see this strange lady and talk about your life, but here you are. And you’re telling me things. You’re joking around with me. You’re a really brave kid. I can see that you are going to do well.”
(09:10): So I’m sort of looking for little moments where we’re already noticing examples of that. I might be looking for something where they’ve indicated, maybe in the Best Life Work, something that they have achieved, and talking about how did they get better at that? Particularly with an emphasis of: To learn a new skill, we’ve got to practise it and really work at it.
(09:30): So if a kid’s got a piano, I would say to them, “Okay, so have you ever had a piano piece which was just really complicated? And the first time you played it, you were all fingers and thumbs, and it was going really badly, and it was really frustrating, and you just got up and stormed away and left the piano? But then you came back, and bit by bit, you got better at it, until you mastered it. Have you ever had a tough piece that you didn’t think you’d ever get, and then you’ve actually completed?”
Dan Moss (09:57): But then there’s some stumbling blocks, and sometimes, when you might bring something up, where a child becomes a bit more reluctant or worried, how, as a therapist, do you pick up on those cues with Zoe, or between Zoe and Bridget?
Penny Sih (10:11): I think you pay attention. So I think one of the things that I’m hoping to coach in parents is … We talk about validating kids, which is … One of the things we do is help them make sense of themselves. That’s what validation means. It means someone sees you. Someone’s helping you understand what’s going on outside of you, understand what’s happening in your internal world. And we can do that simply by naming what we see, or having a guess at what we think, based on our adult theories, of what’s going on in a kid’s mind and checking that with them.
(10:46): So as I said, if a kid is saying, “I really love soccer,” and then their face drops, I might just notice that. I might say, “Oh, I noticed your face lit up when you talked about soccer, but then it kind of dropped.” And I will model that for them, so they see what I mean. There’s no judgement there. It’s just, “I just noticed that. Did you notice that?” And sometimes kids will speak to it. Sometimes they’ll just move on. But I’m modelling to Mum and Dad: “We should be noticing that.” And I’m also modelling to the child: “I saw you. I saw you, and I noticed that something shifted. You might not yet have the skills or the words to even talk about or say what shifted, but I saw you, and it’s okay. It’s okay that that shifted for you.”
(11:27): So I might just notice, or I might have a guess. “I notice that your face just dropped. I’m wondering. Is there a bit of a worry about soccer? Has something also been tricky about soccer for you? Did a worry just pop into your head? Or is it something else?” And giving that checking-out sort of idea. And sometimes kids will be able to put it into words, and sometimes they won’t.
Dan Moss (11:49): So Penny, by noticing children’s cues, you are also actively noticing their preferences, their hopes, or even their strengths.
Penny Sih (11:57): So if I’m looking to build up kids’ ability to talk about their strengths or their best life, sometimes I might do an activity where we’re trying to identify key words to go with the strengths they want to build up or the strengths they already have. So I might do a strengths card sort, or I might be talking about some times in their lives when they’re showing their strengths or doing well. I might talk to them about what sort of a kid they want to be in different situations, and we’re pulling out these words that capture what is for them, the most important words for the type of kid they want to be. Even if they’re not always acting like that at the moment. So we might be looking for a word like, “I want to be calmer.” Or “I want to be more confident. I want to be friendly. I want to be more caring.”
(12:45): And we’re pulling out these words about what their family values are, but also what their values are for themselves. And I try and narrow it down, so there’s not too many words. I think kids might come up with lots of words, and I’ll be like, “Oh, great. You’re good at lots of things, but let’s just, for now, focus on one or two, maybe three really important ones.” And once we’ve kind of narrowed down those words, with the help of other people who might want to contribute to that, or if I know what they’re struggling with, I might help them choose a word that’s something they want to work towards. So if they’re maybe struggling with big feelings, it might be calm. It’s a word we might be looking for. Or kind or caring.
(13:22): And we maybe make a poster. We might get a visual or an image. I would ideally get a photo of the actual kid looking calm or looking confident or engaging in an activity where they’ve tried a new skill and have that as our image. That’s like, “This is the kid I want to be more like, more often, in my life.” And we’ll have the “I’m a calm kid.” Says that at the top, and we’ll create a poster. And then we might talk about specific examples, so that their brains can’t refute it. Especially if they’ve got a brain that says, “Well, you’re not a calm kid. You’re a kid who loses your temper all the time.”
(13:54): We wanted them to those examples. So I’ll say, “Okay, so let’s talk about times when I’ve seen you be calm. For example, right now. You’re in a tough situation, meeting a new person, and you seem like you are really calm. I meet new people, and I stayed calm when I met Penny. I’ll write it down on my poster.” And then I’ll get kids and their parents and their teachers or whoever they want to recruit to spend the week or the next couple of weeks looking for examples, like catching that kid when they’re calm. Catching that kid when they’re confident and collecting evidence that this is a kid who can already do these things. No, they’re not doing it all the time, but they are using these skills. And we’re going to build on that. And it gives these kids this new sense of, “This is something I could achieve. I’m already doing it; I just need to build it up from there.”
Dan Moss (14:41): And in a sense, again, you are kind of acting as a facilitator for a child to be really examining critically their own day-to-day lives.
Penny Sih (14:50): Yeah, absolutely. They’re working out: In which situations do I want to be a certain way? It also gives them this sense of, “Actually, I do have some control. I might be feeling really upset, but I can act calm.” And that’s a really important distinction. I’m not here to get rid of feelings and thoughts. We’re here to go, “Even in a tough situation, even if I’m having a big feeling, I am getting better at responding in a way that creates my best life.”
Dan Moss (15:19): What I really love about what you’re talking about, too, Penny, is that idea of the children’s voices coming through so richly in what you describe, about having them describe their best life, rather than you or their mum or dad. Having them do the work, but then also giving them really strong guidelines for them to be able to do that work.
Penny Sih (15:39): Yeah, yeah. It’s really hard for us. I mean, I think if someone asks me, “What does my best life look like as an adult?” that’s a hard question to answer. So there’s a scaffolding that needs to happen, and I think we do need to bring in the other players who know this kid well and have their best intention at heart, to contribute to that picture. But led by the captain of the team, who’s the kid, yeah.
Dan Moss (16:01): So in that kind of recruiting allies type of idea that you’re talking about, how do you make decisions about who you physically bring into the room? And then who you might just mention about what they might know about you, whether that’s a soccer teacher or a school teacher or an uncle or whatever?
Penny Sih (16:17): I mean, that’s where it gets complex and depends on your system. Depends on whether there’s legal things in place or separated families, other complexities, kids in care. It gets very complex, but I think including the child’s opinion in that is really crucial. So having a chat about who they would see as people who could support them in that process. But not just taking that as the only guidance, because a kid might be hesitant to involve a certain person in their life who’s actually a really important person in their life. And it would be the job of the adults in that child’s life, including me and perhaps the parent who’s brought them along, or the person who’s most responsible for them, to have those discussions about in the situation that they’re in, who actually do make up a really core part of this child’s parenting team or carer team? And how do we appropriately have at least communication with them, so that they know what’s going on? So that they’ve got a shot at actually contributing or improving this kid’s life.
(17:18): That might not mean they’re in every session. It might not mean they come to any sessions, but we’ve got to make sure we’re not just hearing one point of view or just the child’s voice, because sometimes, children don’t know what’s best for them, either. They’re kids. We have to support them as well to find out that.
Dan Moss (17:34): And so in this striving to have a child realise or experience their best life more often, I imagine for someone like Zoe, she might have an idea of success being the time where anxiety never comes to visit her, where she never has a day where she wants to stay in bed or can’t go to school. How do you see success, as her therapist?
Penny Sih (17:57): Well, probably completely the opposite. No, not quite. I mean, I would like, over time, for kids to have, in their lives, experiences when they’re not feeling sad or anxious or worried or angry all of the time. That does indicate to me that we need to still put support in place, if they’re feeling that way for most of the time. But success, for me, would be that Zoe and her family have an experience in therapy that any experience that Zoe has makes sense. That feelings come and feelings go. They don’t last forever. They can feel good. They can feel bad.
(18:41): That we experience tough situations in life, and part of life is actually getting good at knowing that, “When something tough happens, I feel pretty rotten for a while, and I’ve got a way to cope. I’ve got people who support me. We’re doing this together. I don’t have to feel happy. I can feel anxious, but I’m going to get on and do what matters, and the people in my life are going to be with me in that journey and support me to do what matters, even if we all feel bad while we do that.”
(19:15): Zoe’s family is potentially breaking down. There’s going to be inevitable pain and grief and loss for all of her family, as part of that shift and change. But that doesn’t mean that they can’t all live their best life within that, if they can find a way to get support, name their feelings, say, “Hey, I feel sad, but so does Mum, and so does Dad, and we’re okay with being sad, because we’re also looking after each other. We’re also getting on and going to school and playing piano and getting out of bed and doing things that actually make our life rich and meaningful, too.” So life doesn’t mean not feeling sad or bad or worried or scared. It means having those experiences and ideally, not doing them alone. And getting on and doing what matters. That’s success, to me.
Dan Moss (20:01): Thank you so much, Penny. I’m sure our listeners have been fascinated and enlightened by that conversation, as I have been. Just a reminder to you that if you are interested in knowing about Penny’s best life work, it does feature in the Emerging Minds: Practice strategies assessment and engagement course. As does practice demonstration, featuring Zoe and Bridget, as they do some work on understanding Zoe’s best life with the psychologist. That course, as with all our e-learning courses and other content, can be found on our website: www.emergingminds.com.au. So that completes the second and final episode with psychologist Penny Sih. Penny, thank you again for your amazing insight and practise wisdom. And thank you to all of you for your continued support of our podcast series.
Narrator (20:53): Visit our website at www.emergingminds.com.au to access a range of resources to assist your practice. Brought to you by the National Workforce Centre for Child Mental Health, led by Emerging Minds. The National Workforce Centre for Child Mental Health is funded by the Australian Government Department of Health, under the National Support for Child and Youth Mental Health Program.