Letter to the Editors

Janet Toye, 2013. Letter to the Editors. Reformulation, Winter, p.4.


Ethical dilemma in working with children and adolescents

Among the several very thought provoking articles in the last issue of Reformulation there is one to which I think my experience is somewhat relevant. This was more than ten years ago when I was working as a couple therapist while using CAT. I have in mind three clients each of whom had a ‘difficult’ partner.

In two of those cases the client ‘s partner had declined or dropped out of work with both of them. The client in each case had decided she wanted therapy in order to stay with her partner and do whatever she could to improve the relationship, while also maintaining enough self-esteem to cope with the partner’s volatile and often abusive behaviour. Both people had given considerable thought to their situation and, for love of the partner, had decided they would stay come what may. In the third case the client had not suggested to his partner that she join him in couple therapy. He came with doubts about whether he wished to stay in the relationship with a strong tendency to think not. The work, which involved the usual CAT approach, moved apparently fairly steadily towards that conclusion but then, without my noticing any warning signs, the client suddenly dropped out and did not wish to return.

I found myself reflecting again on that case in the light of the article about children and young people with parents who are abusive towards them and very needy. While it is years since the case I describe and I have no access to the notes I think it likely that we did not explore adequately the client’s feelings about his partner’s neediness. Finding an exit strategy would have been helpful to him only if that had been done and a) he was completely sure that was what he wanted to do and b) he felt able to cope with the anxiety such an action would be likely to provoke. If that had proved impossible, the approach I had adopted with the other two clients would have been worth exploring.

I realise that attempts to explore fully a child’s feelings about both the possibility of staying and the possibility of leaving the parent, may or may not prove helpful. However, I think it worth considering as a potential way out of the dilemma of either reporting to the court and breaking the therapeutic bond, or of feeling like an accomplice in allowing a situation damaging to the child to continue.

It is indeed a very uncomfortable idea that a therapist should try to help a child adjust as well as possible to living with an abusive and needy parent. But is that not better than trying to help them leave, then finding that instead, the child is even more anxious about leaving the parent and more suspicious of other adults who may try to help?

Full Reference

Janet Toye, 2013. Letter to the Editors. Reformulation, Winter, p.4.

Search the Library

Related Articles

Clarifying an ethical dilemma with CAT in work with children and adolescents
Marie-Anne Bernardy-Arbuz, 2013. Clarifying an ethical dilemma with CAT in work with children and adolescents. Reformulation, Summer, p.28,29,30,31.

K.I.S.S. (Keep It Simple. Stupid) - Reflections on Using CAT with Adolescents and a Couple of Case Examples
Jenaway, A., 2009. K.I.S.S. (Keep It Simple. Stupid) - Reflections on Using CAT with Adolescents and a Couple of Case Examples. Reformulation, Winter, pp.13-16.

What Happens After “Happy Ever After”?
Jenaway, A., 2010. What Happens After “Happy Ever After”?. Reformulation, Summer, pp.8-9.

Change your Parenting for the Better - exploring CAT as a parenting intervention
Dr Alison Jenaway, 2013. Change your Parenting for the Better - exploring CAT as a parenting intervention. Reformulation, Winter, p.32,33,34,35,36.

CAT in One Session
Goldzweig, J., 2000. CAT in One Session. Reformulation, ACAT News Summer, p.x.

Other Articles in the Same Issue

ACAT Membership and auditing ACAT CPD
Anna Jellema, 2013. ACAT Membership and auditing ACAT CPD. Reformulation, Winter, p.10.

ACAT Training and Workshop Events 2014
Maria Cross, 2013. ACAT Training and Workshop Events 2014. Reformulation, Winter, p.49.

Adaptions of a CAT skills course
Jenny Marshall, Kate Freshwater and Steve Potter, 2013. Adaptions of a CAT skills course. Reformulation, Winter, p.6,7,8.

Aims and Scope of Reformulation
Julie Lloyd and Rachel Pollard, 2013. Aims and Scope of Reformulation. Reformulation, Winter, p.52.

CAT as a bridge between confusion and psychoanalytic thought
Maggie Gray and Maria Falzon, 2013. CAT as a bridge between confusion and psychoanalytic thought. Reformulation, Winter, p.26,27,28,29,30,31.

CAT as a model for development of leadership skills
Mel Moss and Claire Tanner, 2013. CAT as a model for development of leadership skills. Reformulation, Winter, p.11,12,13,14.

CAT in dialogue with Mindfulness: Thoughts on a theoretical and clinical integration
Jayne Finch, 2013. CAT in dialogue with Mindfulness: Thoughts on a theoretical and clinical integration. Reformulation, Winter, p.45,46,47,48.

Change your Parenting for the Better - exploring CAT as a parenting intervention
Dr Alison Jenaway, 2013. Change your Parenting for the Better - exploring CAT as a parenting intervention. Reformulation, Winter, p.32,33,34,35,36.

Cognitive Analytic Therapy (CAT) and (Open) Groups with Adolescents within an Inpatient Psychiatric Setting: Initial Thoughts and Experiences
John Mulhall, 2013. Cognitive Analytic Therapy (CAT) and (Open) Groups with Adolescents within an Inpatient Psychiatric Setting: Initial Thoughts and Experiences. Reformulation, Winter, p.37,38,39.

Darren Deene - The Naughtiest Boy in School
Jason Hepple, 2013. Darren Deene - The Naughtiest Boy in School. Reformulation, Winter, p.20.

Disappointingly Different? Perhaps not...
Lorna Gray, 2013. Disappointingly Different? Perhaps not.... Reformulation, Winter, p.21,22,23,24,25.

Editorial
Julie Lloyd and Rachel Pollard, 2013. Editorial. Reformulation, Winter, p.3.

Letter from the Chair of ACAT
Jason Hepple, 2013. Letter from the Chair of ACAT. Reformulation, Winter, p.5.

Letter to the Editors
Janet Toye, 2013. Letter to the Editors. Reformulation, Winter, p.4.

Problem solving in an empathic task: an experimental study of expertise and intuition
Peter Spencer, 2013. Problem solving in an empathic task: an experimental study of expertise and intuition. Reformulation, Winter, p.41,42,43,44.

Reflecting on my first placement - A CAT understanding to illustrate learning
Louise Johnson, 2013. Reflecting on my first placement - A CAT understanding to illustrate learning. Reformulation, Winter, p.9.

Some reflections on the Malaga International CAT Conference "Mental health in a changing world"
Maria-Anne Bernard-Arbuz, 2013. Some reflections on the Malaga International CAT Conference "Mental health in a changing world". Reformulation, Winter, p.50.

The 16 + 1 interview
Carlos Mirapeix, 2013. The 16 + 1 interview. Reformulation, Winter, p.51.

'Five Session CAT' Consultancy: Using CAT to Guide Care Planning with People Diagnosed within Community Mental Health Teams: Brief Summary Report
Dr Angela Caradice, 2013. 'Five Session CAT' Consultancy: Using CAT to Guide Care Planning with People Diagnosed within Community Mental Health Teams: Brief Summary Report. Reformulation, Winter, p.15,16,17,18,19.

Help

This site has recently been updated to be Mobile Friendly. We are working through the pages to check everything is working properly. If you spot a problem please email support@acat.me.uk and we'll look into it. Thank you.