Helping Children Relax at the Beginning of the Initial Interview
“There should be at least a room or some corner where no one will find you and disturb you or notice you. You should be free to untether yourself from the world and set yourself free, loosing all the fine strings and strands of tension that bind you, by sight, by sound, by thought, to the pressure of other men. Once you have found a place, be content with it, and do not be disturbed if a good reason takes you out of it. Love it, and return to it as soon as you can.”
Thomas Merton
French-Born Trappist Monk
Helping Children Relax at the Beginning of the Initial Interview
TISA Description of the Problem: Children rarely, if ever, arrange for their own initial interview. They are told to come by an adult, and they are brought by an adult. Consequently this first clinical encounter can feel quite unnatural to a child. In some ways the interview process may feel even more uncomfortable for a child than for an adult patient. Feeling confined and trapped, children often feel that they must be there and that they must answer questions because an adult has decided “that is the way it is going to be.” The motives of the clinician may appear to the child as unknown or difficult to understand, generating even more feelings of distrust. At the very least the clinical environment may seem strange or artificial.
Tip: In order to break through the increasing anxiety and, as a method of helping the child to settle down, the clinician can inject a nonsense question early on in the interview to break the ice, like this:
Clinician: So, what do you like to be called? Elizabeth? Beth? Liz?
Child: Beth
Clinician: Beth, where do you go to school?
Child: Kennedy Elementary
Clinician: What grade are you in?
Child: 5th grade.
Clinician: Are you married?
Result: This kind of question (another example is: “After school, do you drive yourself to your job, or, do you sometimes fly?”) invariably results in the child “waking up,” looking briefly puzzled, and then amused. The clinician becomes, for the child, someone who is fun, at once both more human and more safe. The resultant interview, usually then leads to more trust and rapport, as well as a more complete and valid assessment.
TISA Follow-up:
Tip provided by:
John Jeffers, L.C.S.W., Camden, Maine
