Treating the Parental Relationship as the Identified Patient in Child Psychotherapy

My first externship in graduate school, over 25 years ago, was at a children's mental health center. My supervisor had two cases waiting for me on my first day, both teenage boys. At some point during his presentation of the cases, which had already been through an extensive intake and staffing process, he offhandedly mentioned regarding one case in particular: “The patient really should be the parents, not their son.” In my naivete I asked him, if that were true, then why were the parents not the patient. He told me that perhaps, after I saw the child for a while, they might come to trust me and be open for treatment for themselves, but they were unlikely to accept such a suggestion so early in the treatment. He said that some parents eventually come to treatment by way of their child's illness; others do not. In the meantime, he told me, our responsibility was to treat the boy.

Intrigued by this accommodation to the parents and full of graduate school bravado, I decided to make an attempt to see the parents more frequently than the suggested once a month. I was identified with the child patients and not with their parents, so I secretly wanted to right this wrong that was so apparent to me and virtually ignored by my supervisor. I wondered what it would take to make the parents the “real” patients. I asked my supervisor what I could read about working with parents. He suggested a book by Dr. Haim Ginott, called Between Parent and Teenager (1969). I bought the book but I was alarmed at this suggestion because I had seen Haim Ginott on TV many years earlier on the Merv Griffin Show while I was visiting my grandmother. “I did not go to graduate school to read books by TV personalities,” I thought indignantly. So instead, the night before I met the parents of my very first psychotherapy patient, I researched the topic of working with parents in the psychology library. I jotted down notes on 3X5 cards and then memorized them. It was like cramming for