Monday, February 13, 2017

Animals in Therapy

The vast majority of people love animals – a cat, a dog, bird, lizard, rabbit, horse or even a mouse. They show us love as much as we show them, and it’s completely unconditional. Almost any domesticated animal can be a comfort animal or have therapeutic benefits – there is no certification for this but it helps to have a therapist write an official letter indicated a child or adult needs their companion to address mental health symptoms. Often therapists are asked to do this so a family can move into a new apartment with strict rules about pets. There is an enormous amount of research already on the books about how animal contact can improve post surgery outcomes, improve social contact in older adults, increase walking times and distances for dog owners, experience a generally higher sense of well-being through their pets.
So why would someone need a therapy animal? All you have to do is adopt a pet and all your troubles are gone, right? I am writing this because I have an amazing dog, a 6 year old black Labrador retriever named Rocky. He’s calm, intuitive, quiet, completely harmless to kids and older adults. I do not have any certifications at this time in doing any “real” therapy work with him but often kids or adults ask me to bring him in. I let everyone know that while he’s healthy, has all his shots, but I am not covered to use him officially. They don’t care; and I am not worried that he’ll hurt anyone. I’ve seen toddlers manhandle him and all he does is lie down and get comfortable. When you stop patting him, he’ll nudge you or put his paw on your knee to remind you that he’s still there. I have a security system because frankly he would just lick a robber to death.
To use an animal for therapy, you need a therapist. The animal can’t go to school for that. The animal should pass a screening for the right behavioral attributes and have basic training for obedience. Many therapists have their own pets – horses at a ranch, dogs, cats, goats. People who are anxious benefit from talking while petting the soft fur – that tactile stimulation can help ground people in the present moment, and help them connect back to their body (see my NARM post) as so often people will disassociate when stressed. Children who have impulsive behaviors learn more empathy so see that their rough treatment might not be the right way to get the animal to “make friends” with them.
The animal therapy has specific goals for treatment. It is the primary intervention for the client. The other type is animal-assisted therapy (AAT) where the animal’s presence is secondary to the therapy going on. An animal can get a reticent child into the office, or motivate a teen to engage, or be a surrogate face to talk to when in distress.

My favorite example of Animal therapy is from the first book written by abduction survivor, Jaycee Dugard. She wrote that for her first session she was handed a saddle and assigned to saddle a horse (something she had never done before). Her two daughters did fine. She could not do it, after many failed attempts. Her therapist then asked her why she did not ask for help? This then spurred a discussion and realization that for years she could have asked for help while living with her captors. Everyone brings something different to therapy, and animals can offer something different and unique to each situation either as the therapy or as a jumping off point. 

Wednesday, February 1, 2017

FIX MY KID


I see a fair number of adolescents in my practice. I enjoy them a lot because when I was in High School I was in therapy and it damn near saved my life. Not because I was suicidal, but because I was able to process out all of the stupid, silly, stressful and annoying parts of being a teenager and decide what was right for myself. I mentioned before that the therapist wasn’t perfect but he did his best and sent me out into the world a little better than I was before.
I wanted to go to counseling – I asked to go. It meant my mom spending a little money on me every week but I babysat a lot and I often paid for my own luxuries that way so why not? I could walk to the office on my own, and I was a good client – only missing one or two appointments. Parents now ask for counseling for their kids – and they should. I always ask if the teenager wants to come, and usually they do. I explain that I am not the snitch for the parents – in front of them both. The kid needs to be able to tell me things without the parent hearing ALL. But the parents also need to be involved to a degree, so they know what progress is taking place and any changes that need to happen so they can support their budding adult.
I cannot “fix” anyone’s kid. There are times, when the teens behaviors are direct result/rebellion of their parents’ behavior. In those cases, I help that teen learn healthy ways to deal with their parents so they can move out someday and lead a healthy life. These are very difficult situations from my point of view. But when it works, the parent sees “improvement” because the teen stops butting heads with the parent as much. They see the end date ahead – college and independence. Often teens don’t realize until you point it out, that they WILL grow up and they CAN live somewhere else. The ability to imagine the future is located in the pre-frontal cortex of the brain, which is not yet fully developed until we become adults. But we can give them a little nudge.
In discussing this with some colleagues, after being “fired” from a teen I had a nice rapport with, because her symptoms weren’t gone after 2 months, we came up with a few ground rules:

1.       The above rule – I’m not your snitch

2.       I can’t fix your child. Therapy is a process and it takes time to dive deep under the surface. Some symptoms are serious and debilitating and your teen may need at least a year of work.

3.       Therapy isn’t forever – my goal is to get the parents to learn to be the supportive adult in the teen’s life. You should grow alongside your child. You are forever.

4.       If your child is being treated for trauma – their “bad” behaviors in school or at home are often a direct result of the trauma. Punishing them for their trauma responses is counter-productive. Setting limits is good. A good resource on this topic is Heather Talbot Forbes’ Beyond Consequences.

5.       Check in and participate once a month at a minimum. Ask questions about how you can help support your child grow into an adult.

Unfortunately, a little “getting over” on parents is part of growing up, and very common. Be patient with your teen. They’ll make mistakes and they’ll learn from them. It won’t usually ruin their whole lives. You can warn them but they’ll still insist on finding some things out the “hard way.” Listen to them, ask questions, repeat back what they say and ask if you are understanding them right. “What do you think about that,” and “Hum, interesting,” will go a long way. And I am here to help!