Musings of a Therapeutic Mind

If your child is acting out at home or school it could be a good indicator to seek Family Therapy. Often times a child, through their behavior problems, can act as the barometer that actually measures problems inside the family unit. However, it is generally the child that gets referred to therapy because they show the most obvious signs of trouble. The child becomes known as "the identified patient." Whenever I see a child for therapy I always assess for stressors in the family first as typically the child's problem behavior can be traced back to the origins of that stressor.

I sat down to talk with Nancy Ruben, a Los Angeles based Marriage and Family Therapist who specializes in family work. She also believes that problem behaviors in children are often a symptom of a larger family issue.

Nancy: So many of the families that I see [often start therapy because they] have a concern over this behavior or that behavior [regarding their child]. There can be a concern over school failure or sadness or stress. One family I can think of specifically came in and their child was off the wall in terms of his acting out in the classroom.

It was fascinating because as we talked what emerged was a stress cycle going on in the family and that really everybody was involved in the stress. In fact, we started to scale stress from 0-10 and everybody would have their stress level for that week. There was a huge correlation [between his acting out in the classroom and the stress level in the family].

In other words, they walked in the door with the child being the problem but what they discovered in therapy was that everybody was involved in this problem in some way. It was really a family issue. It turned out that mom [as well as dad] was incredibly stressed. She was juggling this and that and as she amped up, the kids also amped up. This stress cycle was really running this family.

Julie: So it seems sometimes who really sounds the alarm of a potential family problem is the child as they start to act out. But their acting out is really in response to the parent ,and the parent being stressed or anxious.

Nancy: And what's so great about bringing families together to address those issues if you think about it, it's so isolating with the child alone [in therapy]. With the family present everyone gets to look at their own responsibility and also what difference they can make and what are the changes that they can make.

Another child that I was seeing was referred to me with school failure. It turns out the back story was that the parents were breaking up. The child was grieving really over the loss of his family. We got to talk about the effects of the break up with the family. This child was also very angry and [during family therapy] was able to come out and talk about it . . . it was very powerful.

The beauty of family therapy is that there is an opportunity to repair the relationship in the moment with every family member participating as part of the solution.

Families bring their children in [for individual therapy] with this idea that their child is going to talk with me and feel better. But what a better builder of intimacy then to be sitting with your mom [or dad] and talking about those very issues. I want to build the relationship between the family, not me. Ultimately, I'm not going to be around; the family goes on . . .