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From: Ellen-Marie Silverman
Date: 10 Oct 2012
Time: 11:58:52 -0500
Remote Name: 76.228.192.184
[[I really like the "Taking Charge" attitude at the end of your paper...whether the choice is therapy or not, the decision comes back to the individual. Sometimes I feel that creating awareness for the client can be the most motivating piece, but this feels trickier to accomplish when working with younger clients. Have you ever found this? When the choice of therapy is out of the hands of the young child (who doesn't want it) and parents/schools/doctors/etc. are favoring therapy, it seems harder initially to "convince" them to buy in to it. Do you find that, as well? ]] /// Kelly, thanks for raising these very real and consequential issues. There is a line in the powerful almost spell-binding movie, "The Prime of Miss Jean Brodie," stated with frightening conviction by the lead character, Jean Brodie, a middle grade classroom teacher in a private school in Scotland who presented herself to "her girls" as a charming, alluring, magetic despot. (Brodie, incidentaly, was portayed by Maggie Smith, who won an Oscar for playing that role.) That line, paraphrased, is, "Give me a child when they are seven, and they will be mine for life." /// The reason I started out responding to your musings and questions by referring to that fictional character that, for some of us, may depict someone we have known personally, is because we always need to remember that when we touch the life of another we set into motion a casacade of conditions we can not even begin to recognize let alone imagine, and all the more so when we work with children. /// As an undergraduate speech clinician preparing to work in the profession, I witnessed what I considered appalling situations where school children had been required to attend therapy that did little to change the speaking behavior that they had been told repeatedly was unacceptable. After years of unsuccessful therapy, some I observed had been convinced that they were speaking incorrectly and were incapable of speaking acceptably. In fact, a colleague scornfully explained he had litle respect for speech pathology because his wife, when she was an elementary school student was required to attend speech therapy to remedy a lateral lisp which she failed to benefit after years of therapy. All she received from the time spent apparently was an inferiority complex. Before she entered therapy she did not know she had a problem speaking. After therapy, she knew she had a problem, one she wasn't able to resolve. When I met her she was working as an elementary school counselor who lisped slightly and spoke little. /// So, if we choose to work to motivate children to participate in speech therapy, we ought to first know we can help them; otherwise, we may only add to their problem. And I have had any number of teenages referred to me for help managing their stuttering problem after years of therapy that did not reduce their problem speaking but magnified feelings of "otherness" in those teens. They were angry and sad and, not surprisingly, unmotivated to engage in more therapy. Of course, therapy now is different in some ways from therapy provided earlier, but the impetus to be certain that we can, through therapy, help resolve a problem for which we are recommending therapy should be in the forefront of our planning before we set out to motivate a child to enter therapy. Of course, we can't be certain we will provide the instruction and guidance needed for the child to speak without struggle or shame, but we need to be quite sure there is a good likelihood we can before we enroll a child in face-to-face, or direct, therapy. There may be other options to provide help, such as indirect therapy, more effective for very young children, and which may be part of a program for older children. This approach focuses on helping caregivers learn to communicate with their child in helpful ways that encourage communication of thoughts and feelings rather than performance and begins with honing, as needed, their listening skills. /// I am so happy, Kelly, that you are giving careful thought to how to motivate clients. And, as you do and have more experience doing so, you may find that, for children especially, capitalizing on their usually abundant curiosity, can be helpful and for individuals of all ages, validating their feelings, mutually examining their beliefs, incorporating their stated goals into a treatment plan, and fostering their problem-solving skills helps make therapy the exciting adventure it can be. /// So think carefully; plan carefully; and include those you enroll in therapy as your partner, regardless of their chronological age. My best, Ellen-Marie Silverman