Parents must be included in the therapeutic process

Without parental and family involvement in the process, progress is hampered and undoubtedly takes much longer.

Depressed girl gets counseling and comfort from a caring therapist (photo credit: INGIMAGE)
Depressed girl gets counseling and comfort from a caring therapist
(photo credit: INGIMAGE)
One of the most frustrating complaints that I have heard from parents is about therapists and other professionals meeting with their kids without including them in the process. The parents are generally not allowed to attend the sessions, are not party to the content of the conversations and are not guided as to how to help the situation.
While it is important for your kids to feel safe with their counselors – knowing that the information they share is confidential between the two of them – there must also be a way to allow the parents to participate in the process.
In the case of children under the age of 18, it is the parents’ right to know what is happening with their kids in therapy, whereas over the age of 18 there needs to be consent by the young adults to share the information. What is always allowed is communication between the parents and the therapist about what is happening at home and in other situations, which the child in treatment may not be sharing with the therapist.
Every successful program I have ever encountered for teens and young adults has included not only parents but siblings and even extended family as well as significant others, with the understanding that change can occur only when the entire support system is a part of the therapeutic process.
This phenomenon of parents paying high-priced professionals to work with their kids while they themselves are excluded from the process is often self-defeating. How are families to know how to support their child if they have no guidance? How do professionals believe that they can help their young clients once a week for an hour, then send them home to their families to deal with them for the rest of the time? Whereas parents should receive guidance from their own counselors as to how to create healthy boundaries that allow them to support their children without becoming enmeshed, it is imperative for parents to hear from the therapist or counselor actually working with their children about how they feel at home and what support they need to get healthy.
Our kids need a support system, but no parent has all of the answers. Professionals are needed to be objective observers of the process, make suggestions, and provide tools and encouragement.
Leaving their offices, our youth are expected to have a clearer insight into their issues and to continue their introspection process between sessions.
Without parental and family involvement in this process, progress is hampered and undoubtedly takes much longer.
Who is responsible for helping the families support their loved one, to help them understand what to say or what to do? Should they sympathize with their child, avoid asking pointed questions and tiptoe around their children in crisis out of fear of upsetting them? Should they tough-love them? Enable them? Ignore their self-destructive behaviors and allow them to take their own journey? What messages should we be giving our kids? All of these questions need to be answered by the professionals working with our kids. Who would know better than them? If they indeed have the trust of our children, then our kids have opened up to them and told them what they need. If they haven’t, then they are certainly not the professionals we want working with our kids.
At-risk youth centers in Jerusalem, which otherwise do wonderful work with teens and young adults, generally do not include the parents unless the kids ask them to, or agree to without encouragement.
Years ago I approached a number of these centers in downtown Jerusalem with an idea that I believed would help them better help our kids. I asked them to hold family support groups once a week, each week hosted by another atrisk center and run by the social workers and counselors who were actually working with their kids.
The counselors could share with the parents the issues most seen and heard from the kids visiting their centers, in particular the things that drove their kids away from them and to high-risk behaviors. They could show the families the best way to restore open communication in their households, and be proactive in creating the meaningful relationships that their kids need more than anything else. I still hope that one day we can organize such a badly needed service.
Organizations such as Milam have been created to assist parents and loved ones in dealing with various forms of mental illness (bipolar syndrome, schizophrenia, depression, suicidal tendencies), whether genetic or caused or exacerbated by drug use or traumatic events.
The Milam program is under the umbrella of Enosh, a parent- and community- created nonprofit set up to meet the needs of the mentally ill and their families.
Milam provides seminars and lectures on many issues of concern to parents, such as medication, how to communicate with their loved ones and how to encourage them to get the help they need. When necessary, the staff intervenes to acquire information about how their loved ones are progressing during their stay in the hospital, and advocate for the family and their need to be more involved in the process.
Milam provides individual and family support groups, lectures on the rights of parents and families to get the services they need, and counsels parents about protected living arrangements such as hostels, in-patient programs, appropriate employment frameworks and extracurricular activities. All of the services provided by Enosh and Milam are free of charge.
Mental health hospitals often provide sessions and support for parents as well, an acknowledgment that the chances of successful treatment are almost impossible when the patient has no support system.
Without guidance from the health professionals who are best positioned to help the child transition back to a healthier home environment, parents are likely to continue old and unproductive parenting behaviors.
As one mother commented, the law apparently considers the patients’ confidentiality more important than the overall quality of treatment they receive. By protecting the patient in this manner, it increases the distance between the child and the parent, making it difficult to create a healing environment at home. In a sense, it is validating the child’s perception that the parent is part of the problem and not a viable source of emotional support and guidance.
It is time for parents to take control and insist on being included in their children’s therapeutic process.
The writer counsels families and their troubled youth. An addiction counselor, she is the founder of the Sobar alcohol-free live music bar project for teens and young adults.;