What can I expect to happen in an assessment for my child?

In this article, I will explain the process that takes place when you first come with your child for an appointment and the reasons for these initial meetings. Assessment sessions typically have a little more structure than ongoing therapy sessions. This is because the Psychologist will be interested in finding out about the reason for why you have come and also other areas of your and your child’s life. Ongoing therapy sessions are typically more explorative, when the Psychologist may ask fewer questions. This is because, although both assessment and therapy sessions have a therapeutic goal, the latter by their nature are more explicit in this objective. As a result, their aim is to permit exploration of your child and/or your mind at a pace that you can determine, as noticing difficult thoughts and feelings can inevitably feel challenging and therefore may need to happen gradually.

The first appointment: Parents and child(ren) attend

When you first talk to the Psychologist over the phone, you will decide then who it seems will be most helpful to come to this first meeting. Usually, it will be you, your partner and your child. This of course is not always the case and it might be that you meet with the Psychologist by yourself first, as sharing the challenges you face and wanting to have the opportunity to talk separately from your child can understandably feel pressing.

The focus is on discussing your main worries about your son or daughter and gaining the perspective of each person. The intention is to gain as much detail as possible in order to provide a basis for formulating an understanding your child’s difficulties. It is important to learn about your child’s views, but depending on their age and how they are feeling, they may struggle to verbalise what is in their mind. As a result, attention to their expressions is interwoven with conversation with you. This child focussed attention is then largely on the non-verbal expression, which may include play or drawings. An example of this may be of a child who is playing with some cars. It is noticed that most of the cars are together, yet one is left to the side. When asking about the car by itself, the child says that it feels lonely. The child may then be able to go on to talk about how they feel at school. This brief scenario demonstrates the importance of acknowledging the child’s expression of emotion initially within the symbolism of play, as this is one step removed from acknowledging the emotion as directly pertinent to oneself. It may take time for a child to relay their play to themselves and indeed this is not always necessary. This is because play is considered to be parallel to speech and an indication on one’s mind, as well as a healthy expression of such.

The second session: Individual meeting with parent(s)

There are a number of conversations which are best held without your child. This includes certain thoughts and feelings you may have about them and being a parent and indeed about one another. The Psychologist will seek to gain an understanding of your family context, so finding out more about you, for example, any difficulties you may have had with your mental health, your relationships with your family of origin and childhood experiences. This is necessary in order to build up a picture of how emotions are managed in your family home and to understand how your experiences impact upon you as a parent and how you manage emotion and interactions.

In addition to the information learnt from the previous sessions, it is often helpful to get a report from the educational setting your child may be attending. This is in the form of a report that the Psychologist will give to you to pass to the school to complete. It is helpful to have an account of your child from people who know them reasonably well in another context, as it allows a fuller picture to be built about them, including for example the nature of their social and academic functioning.

The third session: Individual session for your child

This is typically play based and child-centred. This means that toys and art materials are provided and your child is told that they may talk about or do whatever they wish, as long as they are safe. This is intended to provide them with the opportunity to express through the medium with which they are most comfortable some of the thoughts, ideas and feelings which may be uppermost in their mind. This can provide a preliminary insight into how your son or daughter may think about themselves and view their internal world.

With children under the age of five, it is more typical that this play-based session will take place with you. If both you and your partner have thus far attended, it is often more helpful for only one of you to attend on this occasion. This is because the presence of three adults can restrict your child’s feeling of freedom to play. Depending on the type of play and the age of your child, this session may take place on the floor. This is in order to be explicitly at the level of your child and to demonstrate our interest and focus on their play. The aim is similar to that described above, with the additional benefit of being able to begin to think about the interactions between you and your child and the impact that you have upon one another.

Fourth and final assessment session: Feedback discussed with you

The Psychologist will share their understanding of what has brought you to seek help for your child, their understanding of your child’s perspective and what may be helpful.

If you have requested a report, it is important it is shared with you before it is disseminated, should you like for example your GP or school to have a copy. This is because it is based upon conversations and interactions with you and your child and so is in essence, co-constructed. The report is a summary of what the Psychologist has learnt in the previous sessions and is largely factual. You will have the opportunity to discuss any errors or alterations. A formulation is written, which is an attempt to draw together the differing types of information to provide an initial hypothesis for the reasons you may have sought help for your child. It is intended that these ideas are drawn from and are grounded in the information and resonate with you.

Out of the above stems the suggestions for an intervention, if needed. There are a variety of options. This includes individual therapy for the child with intermittent parent sessions, joint sessions for you and your child, couple sessions for you both to think about your relationship and co-parenting, or you possibly accessing your own individual therapy.

All of the above is discussed together with you so that you begin to build a shared understanding with the Psychologist about your child’s challenges. It is from this that the type of therapy and who is most helpfully involved will follow.