Family-Focused Child Therapy

in Marital Separation
Shannon O'Gornnan
Private Practitioner, Brisbane, Australia
When marriages and long-term relationships break dov^n, parents may refer their
children and adolescents to therapy for a variety of reasons. While the systemic
therapist's preference may be t o work with the family system/s, high conflict
separation may prohibit such an approach. This article discusses family-focused
child therapy that prioritises the needs of children while seeking t o preserve a
systemic approach. At a practice level this may involve: (a) individual child therapy
(b) engaging with smaller subsystems including siblings, (c) joint therapeutic work
involving child/ren plus parent/s, and (d) any of these combinations; all while contin-
uing to maintain a systemic understanding of t he work. The article discusses the
challenges of working with children from separated families, where there is
restricted or no possibility of engaging with the broader family system.
Ke y wor ds : femily therapy, child therapy, separation, divorce
When marriages and long-term relationships break down, parents may refer
children and adolescents to therapy for a variety of reasons. While the systemic
thetapist's preference may be to respond to a referral by simultaneously engaging
with multiple members ofthe family system/s,' the reality of high-conflict separa-
tion may prohibit such an approach. This article focuses upon some challenges of
working with children from separated families, where there is restricted or no possi-
bility of simultaneous work with the broader family system. It presents a family-
focused child therapy approach that prioritises the needs of the child/adolescent
while endeavouring to hold a systemic perspective. In doing so it acknowledges a
similar term 'child-focused family therapy' that has been applied elsewhere
(Hecker, 2010, p. 53).
Marital Separation in Clinical Practice
In 2007, 49.3% of all divorces in Australia involved children (Australian Bureau of
Statistics, 2008a). Yet not all sepatations involve the traditional nuclear family or
married couples. For example, within Australia during 2006-2007 there were
Address for correspondence: Shannon O'Gorman. E-mail: therapyemailfeedback@gmail.com
THE AUSTRALIAN AND NEW ZEALANDJOURNAL OF FAMILY THERAPY 237
Volume 32 Number 3 2011 pp. 237- 248
Shannon O'Gorman
'14,000 families in which the grandparents were guardians or main carers of co-
resident children aged 0 to 17 years' and ' 27,000 same-sex couple families'^
(Australian Bureau of Statistics, 2008b). For the purpose of this article, the term
'marital separation' will be taken to describe the breakdown of the relationship
between the two adults including married/unmarried and heterosexual/same sex
couples heading the family system.
Family-focused child therapy in the context of marital separation is accompa-
nied by a range of challenges. First, working with children can itself present
challenges. For example: 'Some children can be noisy and chaotic, making it hard
for the grownups to have an ordinary conversation. Other children are so silent
that the therapist may feel lost, frustrated and impotent because her main thera-
peutic tool (words) proves to be useless' (Rober, 2008, p. 467). Working with the
child in isolation from the family can risk increasing a parent's feelings of inade-
quacy or jealousy, which may result in the child being withdrawn from therapy
and/or the family system being unprepared for changes in their child's behaviours
(Johnson, 1995, p. 56). If the therapist is able to assist the child in a manner the
parent cannot, this ' ... often raises sensitive issues of blame or competition in the
parents' (Rober, 2008, p. 468). Conversely, in the event that the therapist is
unable to assist the child, then parents may ' . . . flnd proof that they themselves
are not to blame: "Even this professional could not handle my child"' (Rober,
2008, p. 468). These issues can be helped where parents are engaged in parallel
therapy.
Second, this is an area of clinical practice that is frequently characterised by
high-conflict and acrimonious battles between parents. Relationship breakdowns
are likely to cause distress for the family system as a whole, and the marital
partners in particular. Emotional distress, changes in housing, restructured
finances, and the need to distribute the care of child/ren are frequently brought to
the attention of the therapist. In instances where the therapist seeks to highlight
the impact of such conflict upon the child, they will encounter parents with
varying degrees of insight into their own behaviours and motivations. For
example, adults described as being in the "precontemplative" stage of change,
"...take no personal responsibility for the problem, instead labelling the entire
problem as about the difficult behaviour of other family members." (Lebow &
Rekart, 2007, p. 83). In some instances parents will need to be informed of the
importance of ensuring that adequate boundaries are placed around parental
conflict such that the child/adolescent's exposure to it is minimised.
Third, as therapy progresses both parents may attempt to communicate infor-
mation to the therapist that relates predominantly to the parent's own experience
rather than the child's. In some instances it is apparent this sharing of material is
organised around the theme of communicating to the therapist that the other
parent is at fault for any distress or disturbance within the household. Frequently,
the issue of blame emerges when there is a separation that contributed to the child's
presentation. This challenges therapists to ensure that there are sufficient bound-
aries to prevent the proiiise sharing of details that compromises their focus on the
child's concern (which of course may differ to those held or anticipated by the
2 3 8 THE AUSTRALIAN A N D N E W Z E A L A N D J O U R N A L O F FAMILY THERAPY
Family-Focused Child Therapy in Marital Separation
parents). Again, the therapist may recommend the parent/s seek an alternative
therapeutic space to discuss their own concerns.
Finally, as separation is ofi:en accompanied by legal processes, there is the possi-
bility the therapist may be called (voluntarily or not) to be a part of this separate
process. This shift: in context most likely involves a different way of viewing and
evaluating conversations. While this is necessary for deflning the split from one to
two family systems, it does not necessarily fit well with the therapeutic process and
content. For example, the legal context automatically defines previous partners in
the adversarial roles of 'applicant' and 'respondent', whereas they are either simply
'parents' or 'carers' to the child/ren in question.
Prioritising the Needs of the Child
In family-focused child therapy the needs of the child are given greater priority than
the rest of the family. This might be seen as problematic for a systemic understanding
that sees the child as part of an evolving family system that is greater than the sum of
its parts (Becvar & Becvar, 2003; von Bertalanfiy, 1968). However, a decision to avoid
engaging with a larger family system is a response to situations where parents are
unable to be in the same location due to previous abuse, ongoing safety concerns, or
when parents are unable to interact without exposing the child to parental conflict. A
decision to see a child alone may come at the request of parent/s who decline dierapy
for themselves but seek it for their child. This presents a potential conflict with tradi-
tional systemic approaches as ' ... family systems therapists oft:en advocate seeing the
entire family and may even believe that seeing a child or adolescent alone, depending
upon their theoretical orientation, is countertherapeutic' (Hecker, 2010, p. 53).
Arguing in support of both a child-focused and systemic position, Kaslow and
Racusin (1990) have suggested child therapy is indicated where there are inadequate
parental resources and when the child lacks ' . . . a reasonable degree of ego strength'
(p. 285); whereas ' ... family therapy may prove most beneficial when parents have
minimal psychopathology' (pp. 281282). In instances of highly conflicted marital
separation, family-focused child therapy prioritises the needs of the child/adoles-
cent. At a practice level this may involve: (a) individual child therapy with the child
alone and/or (b) engaging with smaller subsystems including siblings and/or (c)
joint therapeutic work involving the child/ren plus parent/s and/or (d) any of these
combinations, while continuing to maintain a systemic understanding of the work
that is unfolding.
Family-focused child therapy offers the potential to apply various therapy
combinations (i.e., child therapy, parentchild sessions involving alternating
parents) within a defined context (i.e., marital separation). While it prioritises the
specific needs of children, it recognises they live within multiple evolving systems.
In dealing with marital separation it is likely to be brief or time-limited therapeutic
work.
Challenges of Working With Marital Separation
There are some additional, perhaps less apparent challenges of clinical practice with
marital separation.
THE AUSTRALIAN AND NEW ZEALANDJOURNAL OF FAMILY THERAPY 239
Shannon O'Gorman
Clarity Regarding a Range of Possible Agendas
'Fix my chi l d'
Where adults request assistance for a child, the therapist has to deal with multiple
clients. A common referral is a parent who asks for assistance to help a child cope
with changes in the family structure, or a more specific referral might involve a
parent discovering an adolescent's use of illegal drugs. In both instances the needs of
the adult are somewhat identifiable in seeking to address some concern about their
child. Upon interviewing the child, the therapist may find any number of previ-
ously undisclosed yet meaningful pieces of information.
For example, a child may be prohibited from phoning a parent when in the care
of the other parent; or an adolescent has moved cities due to the change in parental
financial and employment status. While this provides additional information and
raises questions regarding possible points of change, it may not strike the parent as
relevant. If so, the therapy may not fit the parent's agenda, summed up as 'fix my
child' and oft:en accompanied by: 'I am fine and if I am not, it is not up for discus-
sion'. There is a potential for conflict between the parent (i.e., in some practices a
paying customer) and the interests of the child (i.e., in many respects an involun-
tary or relatively uninformed client). Ultimately the capacity of the parent to align
with the therapist's professional judgement in attending to relevant issues will deter-
mine the scope or outcome of the ongoing work.
Unknown Agendas
Parents may be unable to identify, unwilling to articulate, or be unaware of the
outcomes they seek from therapy. For example, a parent may engage well with the
therapist, not miss appointments, pay fees promptly and be grateful for services
rendered. After six sessions the same parent states s/he is aware that therapeutic
reports were not part of the agreed service but a lawyer has requested the presence
of the therapist in an upcoming court proceeding. The therapist declines the invita-
tion (unless issued with a subpoena) and the parent starts cancelling scheduled
appointments, eventually making no further contact.
Alternatively, a parent may introduce the (accurate or otherwise) idea that the
other parent has alternative agendas for bringing their children to therapy. This may
be to reduce guilt associated with having engaged in an affair; to defend a position
of refiising to discuss the separation with the child; to present a better description of
parenting capacity for the purposes of child custody assessment; and so on.
Awareness that therapy may be serving multiple purposes is essential and explo-
ration of unstated and perhaps unconscious agendas may well prove necessary.
Shifting Agendas
The priorities of family-focused child therapy are formulated in response to the
needs of the child identified not only by the referring individual but also by the
therapist. For example, an adolescent may be referred due to self-harm behaviour
and the therapist allows space to explore their understanding of parental conflict.
While the parent may not have requested this therapeutic focus, the therapist's
professional training and experience informs an opinion these two concerns are
related (though one is not necessarily causal in a linear sense).
240 THE AUSTRALIAN A ND NEW ZEALANDJOURNAL OF FAMILY THERAPY
Family-Focused Child Therapy in Marital Separation
Potential also exists for family members to knowingly or unknowingly seek to
sbifi: tbe focus of tbe tberapy. For example, a parent may request martial tberapy to
reduce tension and conflict witb tbe otber parent. Tbis may prove beneficial for tbe
cbild but is accompanied by real risks regarding tbe break down of tbe tberapeutic
relationsbip. In essence, clarity regarding a range of possible agendas (spoken and
unspoken) reduces tbe likelibood of the tberapist detouring from tbe goals identi-
fied as part of a tbougbtful assessment.
Respecting Roles/Enforcing Boundaries
In separation and divorce tbe original family system evolves into multiple family
systems, wbicb requires tbe tberapist to form and maintain clear boundaries.
Transference
Transference was originally described witbin psychoanalytic psycbotberapy and is
described as: ' . . . a transference of emotions to tbe person of tbe pbysician, because
we do not believe tbat tbe situation of tbe cure justifies tbe genesis of sucb feelings.
We ratber surmise tbat this readiness toward emotion originated elsewhere, that it
was prepared within the patient, and that tbe opportunity given by the analytic
treatment caused it to be transferred to tbe person of tbe pbysician.' (Freud, 1922,
p. 382). Transference describes an unconscious process wbere tbe client transfers
emotions from some significant life figure onto tbe tberapist.
Tbis is relevant for family tberapy, particularly wbere conflict associated witb
marital separation is played out in tbe client/tberapist relationsbip. Tbis process
may expose tbe tberapist to tbe parent's insecurities, suspicions, or bostility. If
tberapy is not cbaracterised by tboughtful, flexible yet clear boundaries, tbe capacity
of tbe tberapist to focus upon the goals of therapy may be dramatically reduced.
Consent
In tbe context of marital separation and divorce, two adult parties are likely to sbare a
vested interest in tbe emotional wellbeing of tbeir child. Especially where both parents
retain or bave been granted joint custody, tbe tberapist must consider tbe legal and
etbical questions associated witb dual consent and information sbaring. Cbild tberapy is
best conducted in a context in whicb botb parents place tbeir trust in tbe capacity of
the therapist to work towards tbe better interests of tbeir cbild and tbougb tbe two
may bold competing needs at times tbe broader family system/s. Wbile tbe tberapist
may seek to gain consent from botb parents, complex questions arise when only one
parent gives consent, or worse still, tbe question of wbetber to continue witb tberapy in
cases in wbicb one (of two consenting parents) witbdraws consent after several sessions.
In tbe author's experience it is not uncommon for parents to refuse consent to
tbe tberapist selected by tbe otber parent and, as such, tbe selection of tberapist
itself becomes a matter for conflict. Tbis dilemma may present at tbe outset, or
especially in instances in wbicb one parent perceives a tberapeutic bias after
several sessions. Tbe realities of non-consent from one parent can include: tbe cbild
not turning up to tberapy if scheduled on a day tbe cbild is spending witb tbe non-
consenting parent; increasing tbe cbild's anxieties about tberapy by exposing tbem
to negative commentary about tbe appropriateness of tberapy; or even explicit
bostility directed from tbe non-consenting parent towards tbe tberapist.
THE AUSTRALIAN AND NEW ZEALANDJOURNAL OF FAMILY THERAPY 241
Shannon O'Gorman
Confidentiality
Once therapy has been agreed to by parents and/or guardians, the thetapist is tasked
with holding in mind differing degrees of loyalty towards both the child and
parents. The needs of both parties play out with respect to the therapist's position
regarding confidentiality. For example, to what extent does a younger child require
privacy, when compared with the parent's interest in and capacity to support the
child longer term?
According to Hecker (2010): 'There are six possible ways that confidentiality
can be defined' (p. 57).^ When working with younger children, the therapist may
consider applying a definition of'limited confidentiality', which includes ' ...the
minor knows ahead of time what the topics are that will be discussed with parents'
(Hecker, 2010, p. 57). Feedback may need to follow each session in otdet to enable
the parent to respond appropriately to their young child, who may return home and
raise short not always contextualised extracts from the session.
Where one parent has less access to their children (e.g., work commitments ot
financial resources make them less able to initiate therapy ot attend), e-mail
feedback to both parents at agreed-upon intervals may be useful. This covets key
themes within the session and increases the parent's awareness of the therapist's
neutrality, which reduces the likelihood of sudden termination. In order to
maintain the boundaries of the therapeutic space, each patent is instructed to 'reply
air with any feedback. Any subsequent response by the therapist to an e-mail reply
is minimal (outside of the therapeutic space). If using this practice, the therapist
would do well to be alert to the possibility that emails have the potential to be used
in a legal context. This represents a complexity for the therapist seeking to structure
the communication of information within a therapeutic (rather than legal) context
and with a therapeutic (rather than legal) intent. Naturally, the child will need to be
informed of the feedback arrangements in place and (with careful regard to their age
and understanding) the limits of confidentiality.
Responding to Practice Challenges
Referral
Therapeutic work relating to marital separation is not always accompanied by an
initial presentation involving the separated parental subsystem. Indeed, at the point
of referral the relationship may be intact although highly conflicted and
separation may occur part way into the therapeutic work. In some instances parents
will deliberately engage with a thetapist prior to informing their child (and often
the therapist) of theit decision to separate, whereas for other parent's this process
will be a less deliberate and/or strategic decision. The need for clarity with regards
to multiple or obscure agendas was discussed above.
Referrals can be a direct response to concerns regarding the impact of separation
upon the child, which is acknowledged from the outset. In other cases, the referral
may concern a pattern of behaviour like anxiety, violence or reduced academic
performance, where the possible impact of separation is not readily acknowledged.
Regardless of the initial presentation, most commonly it is the adult who initiates
242 THE AUSTRALIAN AND NEW ZEALANDJOURNAL OF FAMILY THERAPY
Family-Focused Child Therapy in Marital Separation
therapy and the child should not be considered a voluntary attendee, as parents may
have left the child with little real option of declining treatment.
Structuring tbe First Interview
The author takes the position that initial interviews ideally include the child/adoles-
cent, their parent/s and any siblings. Where it becomes apparent that it would not
be advisable to meet with both parents simultaneously, then a session is scheduled
with the child/adolescent and their referring parent, followed closely with a session
involving the child/adolescent and the other parent. A decision to communicate
and ideally meet with both parents early in the therapy reflects an understanding
that: 'Forging satisfactory therapeutic alliances with all parties is especially crucial in
these families' (Lebow & Rekart, 2007, p. 81). In particular, a position of neutrality
is highly signiflcant given that each parent will likely be seeking to ensure the thera-
pist does not form a closer alliance with the other parent.
Typically, an adolescent will be invited to attend the first interview with their
parent. This is not so in the case of the pre-school aged child. This difference
reflects the emphasis that an adolescent is likely to place on forming their own
relationship with the therapist, independent of any previously disclosed parental
views. Additionally, this difference reflects an understanding that parents are likely
to have shielded young children from adult themes and family secrets (that are
likely to be more readily apparent to an adolescent). Nonetheless, there is a need to
provide parents of adolescents with an opportunity be this a subsequent session
or towards the conclusion of the initial session to speak alone with the therapist,
so they can be provided with an opportunity to raise any themes not yet disclosed
to the adolescent.
A decision to include the referring parent (preferably accompanied by the other
parent) in the initial interview will help the child's capacity to interact with the
therapist, provide insight into the primary concern as well as assist with the compi-
lation of a relevant history. It is usually the concerns of the parent that have initi-
ated the referral and, accurate or not, they need to be heard to establish a working
relationship with the family system. The initial interview assesses current concerns
as represented by each family member, the child within multiple contexts (includ-
ing family and school), current family structures (including any court orders) and
discussion of possible treatment options (including the need for any additional
assessment sessions).
Goals of Therapy
Family-focused child therapy addresses marital themes only when they are directly
relevant to the parenting of the child; it is separate from marital therapy and/or
mediation though these interventions may occur in parallel. Its goals are individu-
alised to suit each client and are based on family therapy and related literature to:
assist children to ' ... better understand what it means to be in a divorced family,
to talk about their feelings about the conflict between their parents, and to find
ways to insulate themselves from that conflict' (Lebow & Rekart, 2007, p. 87).
This would include assisting children to integrate within newly evolved family
systems that may include new partner/s.
THE AUSTRALIAN AND NEW ZEALANDJOURNAL OF FAMILY THERAPY 243
Shannon O'Gorman
assist children ' ... in achieving healthy relationships with each parent' (Greenberg
&Gould, 2001,p. 475)
help in ' . . . assisting parents in more effectively supporting the child's needs'
(Greenberg & Gould, 2001, p. 475)
limit the extent that children are ' . . . used as pawns in parental conflict'
(Keoughan, Joanning, & Sudak-Allison, 2001, p. 159)
establish clear rules across multiple households (Keoughan, Joanning, & Sudak-
Allison, 2001, p. 160) and/or clearly defined and described differences
address any identified behavioural and/or mood related concerns.
At a different level, therapy with individuals and/or several members of the overall
family system may also serve to prepare the broader family system/s for family
therapy (Johnson, 1995, p.68). As such, the capacity to shift from family-focused
child therapy to family therapy may represent one of the goals of treatment.
Sequencing Attendance at Therapy
When considering the sequencing of attendees in therapy, there is a need to
consider the preferences of the family (Donovan, 2003, p. 131; Kaslow & Racusin,
1990, p. 281). In particular, it has been suggested that the ' . . . child should be
provided with the option to have some decisional influence in therapy, whenever
possible' (Hecker, 2010, p. 55). With regards to the sequencing of attendance, three
different structures will now be discussed.
Alternating Parental Attendance
In instances in which separated parents are unable to sit in the same room
(routinely or indeed, even for one session), the therapist may consider alternating
sessions such that the child attends each appointment, accompanied by the alterna-
tive parent at each subsequent appointment. This format holds the child to be the
main client but acknowledges the importance of each parent in the life of the child.
Where the therapist agrees to alternating parent-child combinations, each
individual is informed that information will be shared among all parties; that is, no
information is held in confidence. This position reflects the reality that the child has
been witness to each session and cannot be expected to deliberately withhold infor-
mation from either parent. It reinforces the need for each parent to speak of the
other parent in a respectful manner. This can be complicated where one parent
raises material that might leave them feeling vulnerable if shared with the other
parent. However, the emphasis upon the child's needs means such material is
unlikely to represent one of the key themes of the session. Rather, if these themes
are signiflcant, the therapist may suggest the parent consider raising them in an
alternative therapeutic setting.
If either parent has re-partnered and seeks to involve new members within the
therapeutic process, the author takes the position that the definition of the family
system lies with the parent and is largely unchallenged (i.e., in the absence of any
concerns regarding abuse or highly inappropriate interactions that may appear to be
sanctioned merely by this person's presence in the therapeutic space). This often
means that different family members may hold different views on the makeup of
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Family-Focused Child Therapy in Marital Separation
the evolving family system. For example, a mother may object to her ex-husband
inviting his partner to therapy. Yet, these very discussions regarding therapy partici-
pation can provide the therapist with valuable insight into the nature of the
relationship between any new partner/s and the child/ren in question. For example,
the implications for the child are dramatically different when comparing a 'new'
partner whom the child has rarely met versus a 'new' partner who has moved into
the child's home and has some input into the functioning of this household.
While a child may make the potentially accurate assumption that a new partner
should not be attending therapy in a parental role, the therapist may elect to
support the parent's invitation of the new partner. For example, if it appears that
the new partner has a significant role in either directly caring for the child (i.e., the
child spends time in the new partner's care without the parent being also present)
or heavily influences the parent's approach to interacting with their child (i.e., the
parent appears heavily reliant upon the new partner to inform or enact parenting
approaches). As such, it may be appropriate to attempt ' ... to bring them [new
partners] into the solution process' (Lebow & Rekart, 2007, p. 87).
Child in Isolation From Parents
In the second example, the therapist engages with the child/ren alone. When seeking
to engage with children, the therapist may consider the use of age-appropriate inter-
ventions, including carefully selected stories, providing access to art materials and
dolls, facilitating role plays and specific games (e.g., the squiggle game described
by Winnicott) as a means to providing the child with alternative forms of self-
expression. When working with children there is a need to remain ' ... mindful of
the potential effects of suggestibility, repeated or leading questioning, children's
exposure to adult information or their parents' emotional needs, and high-conflict
dynamics as contributing factors in children's statements and behaviour' (Greenberg
&Gould, 2001,p. 477).
Where younger children and the therapist meet alone, potential exists to invite
one or both parents (usually the parent who has driven the child to the appoint-
ment) in for a brief discussion at the beginning of each session. This is particularly
useful if the child struggles to recall events that elapsed since the last session. This
approach must consider the risk that the parent may then set the agenda for the
session and/or that the parent's descriptions of a child's limitations or disappoint-
ments may be confronting for the child to hear. Nonetheless, parents often raise
important material that may, or may not, be discussed with the child alone as the
session progresses. Opportunity also exists for the parent to be invited to join the
end of the session. During this time the child is encouraged to inform the parent of
any meaningful items discussed during the session and/or the therapist may provide
feedback arising from observations made during this, or a series of previous sessions.
Parental Meeting
If regular family therapy is not possible, the therapist may elect to invite both
parents simultaneously to a carefully structured, one-off'meeting'. Given the inten-
sity of emotion surrounding separation, this represents an option for those parents
who appear to have an amiable separation, or at a minimum, have maintained a
capacity to reliably interact with each other in a respectful fashion, at least in the
THE AUSTRALIAN AND NEW ZEALANDJOURNAL OF FAMILY THERAPY 245
Shannon O'Gorman
presence of the child. The idea of the joint meeting is introduced at a point in
therapy that allows the therapist to gauge its likely usefulness and the parent's
capacity to use it. The decision to include/exclude the child from this meeting
would be made in accordance with the items to be discussed within the meeting.
Prior to the meeting, each parent is invited to write down a list of child-focused
concerns (e.g., concerns that a parent holds with respect to their child, or topics
that they feel might be usefiil to discuss in front of/with the child), which the thera-
pist then compiles into an agenda and circulates in advance. The aim here is to
reduce the likelihood of deviating in the direction of less relevant concerns, thereby
stressing the focus upon child related concerns (content) and where indicated, the
child's presence (process). In essence, this meeting seeks to provide a brief opportu-
nity for communication (Kaplan, 1977) and is particularly useful in seeking to
ensure consistency or define differences in rules across households, providing the
child with an opportunity to discuss their experiences of the separation and
highlighting the child's perceptions of the current parental relationship.
A joint parental meeting also represents an ideal forum in which the therapist
can address any need for psychoeducation related to specific themes. As stated
previously, parents will present with differing degrees of understanding the possible
relationship between the primary concern and the breakdown in the marital
relationship. In many instances psychoeducation represents an opportunity to
provide the evolving family systems with new information in the hope that this may
be the ' . . . difference that makes a difference' (Bateson, 1979, p. 212). According to
Lebow and Rekart (2007): 'What is often not understood by parents is that there
are few conditions that are likely to be traumatic for children as the maintenance of
the ongoing parental conflict' (p. 84). In the case of those parents engaged in signif-
icant conflict, the therapist may communicate something like the following: ' . . .
that at this vulnerable time, when parents are dealing with their own emotional
issues, children are grappling with the transitions and strains in family relationships.
A central message of this discussion is how difficult, yet important, it is to listen to
children's distress at a time when parents and children are both feeling upset'
(Pedro-Carroll et al., 2001, p. 381).
The relevance and extent of psychoeducation within family-focused child
therapy will ultimately be determined by the goals of treatment.
Limitations of Family-Focused Child Therapy
Before closing, there is a need to acknowledge instances in which family-focused child
therapy may be partictilarly inappropriate. In the author's opinion, for preschool and
early school-aged children, child therapy should only be conducted if both parents are
able to listen to any material that the child may relay from therapy; and provide a
response that is free from hostility towards and/or degradation of the other parent and
the therapeutic process. Essentially, the parent must provide the child with a sensitive
response so the therapeutic process remains accessible and safe to the child, especially
where themes discussed in therapy are played out by the child outside therapy.
If parents appear insensitive to the emotional needs of the child, the therapist
may need to consider if child therapy could discourage family members from taking
24 THE AUSTRALIAN AND NEW ZEALANDJOURNAL OF FAMILY THERAPY
Family-Focused Child Therapy in Marital Separation
on a caring or parenting role. Also it needs to be stressed that child therapy cannot
negate the impact of continual exposure to parental conflict. Nor does therapy
enable a child to fulfil roles above their age or ability, such as discussing complex
adult themes with a parent. Parents may need to be informed that while the thera-
pist is able to contain the child's emotional experience and assist them to under-
stand their internal and external world, this process can be difficult and confronting
for the child and may not be viable in the face of unchanging and insensitive
parental behaviours. In other words therapists should be concerned where therapy is
sought for the child an involuntary client where parent(s) maintain a limited
and unchanging capacity to prioritise their child's emotional needs.
As highlighted above, therapists expose themselves and their child/adolescent
client to potential hostility if a decision is made to proceed with therapy in the
absence of joint parental consent. However, if a therapist requires joint parental
consent, then it may well be that those children/adolescents most in need of
therapy, namely, those living in the context of very hostile parental separations are
denied assistance at least outside of any court ordered therapy given that it
would not be uncommon for parents to disagree on most matters (including the
selection of therapist). In such instances, the therapist may elect to raise with both
parents the possibility that the issue of consent now mirrors established patterns of
conflict and the consequent impact that this will have upon the child's access to
treatment, in accordance with the therapist's own position on this matter.
Conclusion
This article has focused on therapeutic work with families affected by separation
where the possibility of work with the broader family system is constrained, yet the
emotional world of the child needs to be prioritised. Nonetheless, the child repre-
sents a part of a larger whole and an inability to adequately explore significant parts
of this whole may limit treatment. Thus in some cases the child and family will
require additional assistance for example, in working with a child/adolescent the
therapist cannot provide therapy for a depressed mother. Also therapists engaged
with the child/adolescent and/or alternating parents cannot adequately examine the
spaces between the parental subsystem (that continues to exist once the marital
subsystem has separated). It is hoped that family-focused child therapy addresses
some of the family's presenting concerns and provides each member with a success-
flil experience of therapy that may make way for the possibility of fiirther work.
In conclusion, this article has described a family-focused child therapy approach
to working with children in the context of marital separation. The author's position
is that being entrusted with the emotional needs of a child during times of vulnera-
bility is a privileged responsibility to be carefully traversed. This reflects a need to
consider both of the ' ... complementary sides of the systemic coin'."* (Keeney, 1983,
p. 70). The role of the therapist is also one to be respected and at times of intense
conflict and hurt, adult clients can knowingly or unknowingly present challenges
that run contrary to the interests of the therapeutic process. This article has
discussed responses to such challenges in terms of the pragmatic features of family-
focused child therapy.
THE AUSTRALIAN AND NEW ZEALANDJOURNAL OF FAMILY THERAPY 247
Shannon O'Gorman
Endnotes
1 In referring to the 'family system' there is an understanding that the original family
system that included the marital partners and children has now divided and is
evolving into two separate systems and as such, may be best described as 'family systems'.
2 It was noted that 'The majority of these couples had no children' (Australian Bureau of
Statistics, 2008b).
3 'These include: complete confidentiality, limited confidentiality, informed forced consent,
no guarantee of confidentiality (Hendrix, 1991), mutual agreement regarding confidential-
ity, and a "best interests" agreement (Sori & Hacker, 2006).' (Hecker, 2010, p. 57).
4. Keeney (1983) described these as being the processes of stability and change (p. 70).
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248 THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF FAMILY THERAPY
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