A Family Approach to Child Therapy

by Lynne Lyon, LCSW
Clinical Social Worker and Attachment Educator & Advocate

Soon after adopting my daughter from China, it became clear from her behavior that something was terribly wrong – that emotionally she was hurt and scared beyond the understanding of most healthcare professionals. As a result, in 1999, I became an attachment advocate and educator, and founded
Attach-China / International Parent's Network (, a web site and on-line support group for parents whose internationally and domestically adopted children suffer from attachment impairment, trauma, and the effects of institutionalization.

I received a Masters in Social Work degree from Widener University, where I have been a guest lecturer on Reactive Attachment Disorder and Post-Traumatic Stress Disorder in children. I also completed the Certification Program in Adoption at Rutgers University School of Social Work, and am a member of the New Jersey Society for Clinical Social Workers (NJSCSW) and National Association of Social Workers (NASW).

Attachment between a parent and child is life’s primary connection. It has exceedingly important implications for the child's future. A secure attachment facilitates a child's physical, behavioral, cognitive, and emotional development, and is an essential factor in learning how to love and trust others and oneself.

There is evidence that the bonding process begins in utero, during the nine-month period the child is developing in her birth mother. The attachment process continues during the subsequent 24-36 months, as the child expresses her physical and emotional needs for nurture, which are met by her mother. The child begins to develop a feeling of trust that she will be taken care of, and that the world is a safe place.

The other day I was asked by a prospective client if I would ever work with her child alone, and I thought I would explain why I almost always work with the parent(s) and child together.

Most children who I see have a poor attachment to their parents, either because of foster care, adoption, early hospitalization, post-partum depression in the mother, or other trauma which has prevented the child from forming feelings of trust and safety. This can be expressed by the child through excessive anger, tantrums, controlling behavior, defiance, aggression, anxiety, and/or nightmares or other fears.

Obviously, the cure for this is to form a better attachment between parent and child. This can only be done in Family Therapy, where the parent(s) and child are working together with the therapist. This is different than conventional child centered therapy, where the child works with the therapist alone. One way to look at this difference is to imagine that the family is a baseball team, and the child is the only player who gets sent to spring training to improve his skills. That leaves the other family members playing the game with their old skills which they learned on the playground. But if they all go to spring training together, they will all learn new skills and learn to function better as a team.

During a therapy session, I see parents as a sort of translator. I rely on Moms and Dads to tell me what their child is feeling, whether it’s fear or anger or something else – or whether their child is not being honest. They know their kid much better than I do. I can't pick up on these nuances of facial expression or body language until I've gotten to know a child well.

I need the parents to report to me on what's going on at home, because when asked, most kids will say that everything is fine, or shrug and say, ”nothing” or "I don't know".

Therapists are trained to be good at dealing with all these difficult emotions and behaviors. But we only see our young clients for about a hour a week. Parents, who see them 24/7, are the real agents of change. It's important to teach parents how to be Therapeutic Parents, and use some of the techniques that we use in the office.

Parents appreciate this approach, because they learn:

  • new skills in listening to their child
  • how to empathize with and validate the child’s feelings, which leads to better behavior
  • a different approach to discipline, which brings children closer to their parents instead of building resentment in both parent and child.

Parents report that they appreciate this approach because it has long-lasting results – that instead of dropping off their child and not knowing what happened in the therapy session, they are part of the therapy process, which continues at home after they have left the office.

Parents appreciate this approach because they are learning skills for a lifetime of parenting, instead of expecting the therapist to “fix” their child.

And most importantly, parents appreciate this approach because it allows them to form a secure and trusting relationship with their child which will last from childhood, through adolescence and into adulthood


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