Filial Therapy is a form of Play Therapy where the therapist trains parents or carers in four key skills so that they can be in the therapy sessions and, in time, be supported to continue the therapeutic support for their child or children without the supervision of the Filial Therapist. Parents and carers report that, through entering into their child’s play, they develop a greater understanding of their child’s thoughts and feelings, and feel more equipped to know how to respond to their child’s difficulties.
Who can benefit from Filial Therapy?
Just as with Play Therapy, Filial Therapy has been robustly researched and shown to be helpful for all kinds of presenting difficulties in children, including trauma, attachment problems, anxiety, depression, grief and loss (e.g., divorce), toileting problems, Obsessive-compulsive Disorder, Oppositional Defiant Disorder, Attention Deficit Disorder, where children are experiencing chronic medical illness or injuries. In addition to drawing on Humanistic theory, the Filial Therapy model also incorporates Psychodynamic, Humanistic, Behavioural, Cognitive, Interpersonal Psychology, Social Learning Theory, Developmental Theories, Attachment Theory, Family Systems and Community Psychology theories. Research has demonstrated the beneficial effects continue to be felt within family systems several years after the intervention has ended (VanFleet, Ryan & Smith, 2005).
When Filial Therapy might not be appropriate.
As with Play Therapy, there are some situations when Filial Therapy might not be appropriate, and Amanda would always be happy to offer a free and no-obligation discussion around your child’s particular needs or family situation to help you find the right support. Times when Filial Therapy might not be recommended include:
- If your child was about to experience a significant change in their lives, e.g., move house or school.
- If parents or carers were unable able to respond sensitively to their child’s ‘challenging’ behaviours (e.g., as a result of the birth of a new baby, a bereavement, divorce, personal mental health difficulties, etc.)
- If parents or carers did not have the capacity to learn the key skills
- Very occasionally, developmental delay, certain medical conditions or a history of abuse might mean that Filial Therapy would not be appropriate for your child at that time: Amanda would always be happy to offer a free, no-obligation discussion around the suitability of Filial Therapy for your child and, if this form of therapy were not appropriate, would direct you to other areas of support.
What are the stages of a Filial Therapy support package?
- Initial Contact. This will usually involve a free, no obligation phone call conversation to discuss your child’s difficulties and explore whether Filial Therapy would be a suitable intervention. The entire Filial Therapy Model usually takes about 20 sessions, this might need to be extended up to 30 where the child’s needs or family situations are particularly complex.
- Referral Form. This will need to be completed and consent obtained from all people who have parental responsibility for your child.
- Assessment. This usually involves having a meeting with you so Amanda can get a more informed picture of the difficulties your child is currently experiencing and what positive changes you might like to see. At this stage, Amanda would be likely to talk to other professionals supporting your child’s development: this might include their Class Teacher, Social Worker or relevant Health Professionals.
- Home or Playroom Visit. It is at this stage that Amanda would want to introduce herself to your child in a way that feels most comfortable for you as a family. It may be that you and your child come to meet her and have a look at the playroom or, if a child is particularly anxious, she might recommend coming to your home. This meeting enables Amanda to assess your child’s development; their ability to play and discuss with your child how they feel about having Filial Therapy.
- Suggested Therapeutic Package Discussion. If you are happy with Amanda’s recommendations, then sessions can be scheduled!
- Parent Training Skills and Play Demonstration. Amanda will usually spend some time getting to know you as parents or carers and deepen your understanding of how your child’s past might have impacted on their development, their relationships with key adults and peers and possibly given rise to negative self-beliefs. She then trains parents and carers in the four key skills required to hold a non-directive play session with your child: how to provide structure; empathic listening; child-centered imaginative play and limit setting. Once these skills are embedded, Amanda will demonstrate them by asking you to observe her hold a play session with your child: this helps you to understand how your child might respond and helps to build confidence.
- Supervised Filial Therapy Sessions and Feedback Discussions. These usually take place in the Lostwithiel playroom and will be offered to you at the same time each week to ensure a sense of predictability for your child: the play session is 45 minutes long and if followed up by 1-to-1 support from your therapist (which can be offered at a time that best suits you). Amanda will be present in the Filial Therapy sessions with you and your child, thereby helping parents and carers to feel supported as they become more confident, both in applying their new skills within the session and reflecting on their child’s play in the follow-up discussion.
- Reviewing Unsupervised Filial Therapy Sessions. When Amanda feels you are ready, she will support you in preparing to move your Filial Therapy sessions into your home. Once the Filial Therapy sessions are being offered by you at home, Amanda will no longer be in the sessions with you and your child, but she will continue to support you in reflecting on your child’s play, while your confidence continues to build. Amanda might also continue to support you by thinking of further strategies to support your child outside their Filial Therapy session, possibly coordinating with other professionals supporting your family.
- Preparation for Ending. Often families like to reduce the frequency of their unsupervised Filial Therapy Review Sessions as they get ready to end support with Amanda. One of the delights of Filial Therapy is that this is something parents and carers can continue to offer their child, long after Amanda’s support has ended: most parents and carers are delighted with the positive changes they see in their child and the resulting closeness in their relationship.