“How Does that Itsy Bitsy Spider Do It?”: Severely Traumatized Children’s Development of Resilience in Psychotherapy

This article explores the ways in which traumatized children make use of a treatment relationship to develop their resilience. First, the concept of resilience is deepened by synthesizing elements from two theories: 1) Self-Determination Theory’s emphasis on the importance for a person’s well-being of her/his choices of goals of relatedness, autonomy, and competence (Ryan & Deci, 2008) and 2) Hope Theory’s formulation that central constituents of hope are the ability to conceptualize pathways towards goals and a conviction of competence in goal attainment (Snyder, 2002). Applying this understanding of resilience to long-term child-centered psychotherapy, this study describes how the therapist and eight children in long-term psychotherapy co-identified treatment contracts and goals. By listening to children’s presentation of their concerns, the therapist communicated to the children her understanding of the children’s priorities. The children affirmed and/or revised the goals. This process continued throughout treatment, as goals were attained and children and therapist co-identified subsequent goals. The co-identified goals included sustaining a trustworthy, pleasurable alliance with the therapist; responding adaptively to disappointment; being able to think clearly; regulating violence toward self and/or others; developing friendships; caring for their bodies; mastering the challenges of learning and athletics; and optimizing their caregiving relationships (with parents and therapist). The goals could be categorized according to aspects of self-determination, specifically autonomy, relatedness, and competence. The therapeutic relationship can help children experience the pathways towards and fulfillment of their constructive goals, affirming their selfreflective competence. The resulting awakening of their hope and self-determination builds their resilience.