The Hanna Perkins Center therapeutic approach is grounded in the understanding that every person has an inner emotional life that impacts and is impacted by interaction with others in the environment. We see personality development as occurring within the context of close relationships and involving mastery of developmental conflicts, particularly during the first five years of life. For over 60 years we have studied the way this occurs, what can cause interferences in development, and what can be done to help children resume progressive development.
When working with children in therapy, we help them become more aware of their feelings by identifying the ways in which their maladaptive behaviors protect them from uncomfortable feelings. As children become more able to know their feelings, we help them sort out whether their feelings are related to current situations or are repetitions of earlier difficulties. This sorting out is accomplished in the context of a trusting relationship between therapist and child.
Our work with children tends to take place over many months or even years. We work closely with parents while respecting the child’s need for privacy. The pace of the work is set by the child and we are respectful of the child’s need to maintain defense mechanisms until they can be surrendered. Therefore, work is patient and respectfully collaborative, with a focus on the lifelong outcomes. Where other treatment modalities focus on the alleviation of a single symptom in a short amount of time, our goal is to help manage interferences and restore progressive personality development over time.
All treatment at Hanna Perkins is designed to respect the individual. Accordingly, treatment at Hanna Perkins is based upon helping a child acquire inner control over feelings, troubles and behaviors. In our experience, control is achieved through better knowing oneself and one’s feelings, as well as through insight and understanding of earlier experiences that may have aroused intense feelings, conflict, and confusion. Improved inner controls promote self-respect and encourage progressive personality growth.
When treatment is recommended it is based on a judgment that the child is able to benefit from the treatment and that the parents are able to support it. In fact, parents of children in treatment at Hanna Perkins are part of the treatment team, thinking together with a therapist and applying the understanding that has been gained at home and in other social environments. Following a careful evaluation with one of our associates, parents will receive a recommendation regarding treatment options. Included in this packet is information about the different types of treatment that we provide.
When the decision is made to begin treatment, we find it helpful for parents to keep in mind that achieving mastery takes time. Understanding early experiences in an integrated way is a gradual process that can only be accomplished in “bearable bits.” It is helpful to keep in mind that some symptoms will not be alleviated immediately. But through close collaboration between parents, child, and therapist, we can better understand the difficulties and work at the child’s pace toward healthier behavior and development.
A child’s behavior always serves a purpose, even if that purpose is not immediately apparent. A persistent symptom may result from an overused coping mechanism that was originally helpful to the child. Therefore, we are careful to respect the child’s need to go slowly while work is getting underway. We find that progress is regularly marked by back and forth changes in a child’s symptoms and when parents and/or a child feel discouraged by inevitable setbacks, it is best to discuss these concerns directly with the therapist.
Parents often ask about our experience with medicating children. The decision whether or not to use medication is a difficult one for parents, children, and clinicians. In our experience, we find that it is most helpful for a child to “look inside” to develop inner controls that will be long-term resources, rather than becoming reliant on medication. While we do not prescribe medications through our clinic, for children already on medications we are available to work with families and with the prescribing doctor.
Over the years, we have worked with many children who were taking psychiatric medications and whose parents sought a complimentary or alternative treatment that could reduce or alleviate their use. Following are some of the concerns that parents, children, and we have encountered regarding the use of medication with children:
- Medication can have the effect of dulling a child’s feelings, interactions, and perceptions.
- Medication can interfere with a child‘s ability to accurately understand the emotions of others.
- A child relying on medication to manage intense feelings does not have the same opportunity as a child using a talking therapy to develop age-appropriate ways of coping with inner and outer stresses.
- Medication can interfere with a child’s ability to develop long-term coping strategies to manage behavior and feelings.
- Reliance on medication over time can leave a child more susceptible to the use of socially unacceptable or illegal drugs when faced with the challenges of adolescence and adulthood.
- Many parents and professionals remain highly concerned about the long-term effects of exposing a developing child to psychiatric medications, particularly ones not approved for use with young age groups.
In our work with children, we have noted that American children are medicated far more frequently for behavioral and emotional difficulties than children in other countries. It is important to state that research on the use of psychiatric medication with children is still emerging and is often financed by pharmaceutical companies.
Again, we understand the decision on whether or not to use medication in the treatment of children is difficult. In our view, using medication can only address immediate behavioral problems. By engaging in a talking therapy that is supported by parents, children have the opportunity to address underlying causes and to develop coping skills that will serve them throughout their lives.