Felicity Tyson, child and adolescent psychotherapist and spokesperson for the Association of Child Psychotherapists (ACP), describes the value of her job and the rewards she finds in helping families opening up dialogue and connection.
My day begins speaking to a parent, Magda (pseudonym). Her voice falters as she tells me that her son called her ‘mummy’ for the first time last week. She tells me she has waited nine years for this. A large smile deepens across my face, and tears form in my own eyes. Her son was born prematurely, has a diagnosis of autism, and until recently, was non-verbal.
Over the past 18 months, this mother, her son, and I have worked hard to try to understand his communications, to try to understand what he feels, to know more about how she feels about his difficulties. We have asked questions and observed and wondered what helps him to feel understood. We have looked at the challenges the family and he has faced in the past and present. We have made links with many different professionals to advocate for support around him. But, most of all, we have looked to him. We have asked: ‘how does he experience the world? What does he feel and think and want us to know?’
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The role of the child psychotherapist in working with children with autism and their families is often about encouraging parents to listen to and observe their children. To come to know and trust their instincts and feelings about their children, however painful this can be, and to fight for their and their children's right to be understood, to develop and live full lives.
Adapting during lockdown to the needs of autistic children
The pandemic and lockdown have been particularly tough on families with children with learning difficulties, disabilities, or are neurodiverse. They have been cut off physically from the very lifelines and hubs of support that schools, community services, and activities provide. We have all adapted child psychotherapists and families alike.
Therapists meet families online; we attune our observation skills and capacities for wonder and curiosity to therapy on screen. We continue to provide vital therapeutic spaces for the pain, challenges, connections, and wonder that parents and children who are neurodivergent live through.
And there have been gains. Some families of autistic children or developmental delays report that the lockdown has given them time together, time for their children to feel more secure – time for them to become closer. For some, bonds have grown, anxiety has reduced, communication has improved, but they have also been afraid; of financial insecurity, and a common profound fear I often hear: what will happen to my child if I get Covid and I become very unwell?
Being understood has never felt more important
The position of the child psychotherapist in NHS services, supporting autistic children or with neurodevelopmental difficulties, is a vital one. In assessments for autism, child psychotherapists hold the role of encouraging careful observation, gathering a detailed developmental history, and providing support and understanding for parents and children adapting to their diagnoses.
We hold carefully and encourage thinking about how autism impacts attachment relationships and provide therapeutic space for children on their own or parents and their children to understand and adapt to their experiences of the world.
One of the first things Magda had told me was that her son wailed every morning. She heard such sadness in this sound. Two of her son’s first words were ‘sad’ and ‘angry’. They came before his favourite ‘spaghetti’. Helping parents find the words for their and their children’s feelings, especially where communication is challenged, is at the heart of helping families and is essential to a child psychotherapist’s work. Being understood has never felt more important.