163 | Navigating Play Therapy with Siblings: Practical Tips for Child-Centered Play Therapists

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You're listening to the Play Therapy Podcast with Dr. Brenna Hicks.

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Your source for centered and focused play therapy coaching.

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Hi, I'm Dr. Brenna Hicks, The Kid Counselor.

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This is the Play Therapy Podcast where you get

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a master class in child-centered Play therapy

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and practical support and application for your

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work with children and their families.

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In today's episode. I am answering a question from

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someone who asked to be called Michelle. So Michelle from Ireland

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wrote in and was specifically asking about working with siblings.

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And I thought this was a really helpful topic because we discussed

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this in the coaching programs and in the collective quite frequently.

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But I don't know that I've spent a lot of time about it in the podcast.

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So I think this will be really helpful.

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I'm gonna read some of her email and then I'll share some thoughts

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about how to navigate working with siblings and what that looks like.

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Practically speaking

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because obviously

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there's some things to sort out logistically.

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So the email starts with,

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how do you feel about working with two children from the same family?

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I've heard different feedback from supervisors,

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but I've also read that it

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it can be good if children are dealing with the same

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issues such as grief due to the loss of a parent,

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et cetera.

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I'm wondering how you feel about it.

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In the past, I have worked with siblings but at different times, for example,

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taking one sibling for six months

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and then once I've finished with them, starting with the other sibling.

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But I have a lot of parents who are asking for

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me to work with two children at the same time,

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but in individual sessions,

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and I would love to know how to explain this to them better.

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As my typical response based on advice from supervisors is that I can't.

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How do you deal with this? Do you work with two or more children from the same family?

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Do you think this is ok?

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Are there any ethical considerations that exist around it?

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Thanks so much in advance for taking the time to answer the question.

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Keep doing what you're doing. This actually makes me so excited.

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I know so many people here in Ireland who had trained integrative

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that have now fully converted to child-centered myself included

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as a result of listening to your podcast.

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You've helped me to streamline and be far

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more intentional in my work with parents too.

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Thank you so much for the time and energy you put into your podcast.

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So Michelle, thank you for that encouragement and

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all my Irish friends. I'm so glad that you've seem light and converted to child

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centeredness.

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You'll never go back. I promise you that.

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All right.

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So let's talk through siblings and I'm gonna

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cover four things that popped into my head.

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I certainly don't think this is a comprehensive list of considerations,

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but certainly what I would consider to be

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the most for pressing considerations if you will.

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So I agree with you, Michelle, what you said that

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if the child?

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Oh, sorry, if both children in the family

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have dealt with the same thing.

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So if they both are struggling with the same issue, such as a

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cross country move

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or the death of a loved one or a divorce

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or a traumatic event

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or some stressful experience within recent months

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that they shared in the experience together and they

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are sharing in the processing of that together.

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I think that that is appropriate

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to see them together in joint sessions, which then at that point,

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it becomes group play therapy

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and I might actually make a note that I'll do an episode in

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the future on group play sessions because that's a whole other animal,

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but

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it becomes group work.

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And yes, it's sibling work,

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but it is defined as a group play session because

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you have more than one child in the room.

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But here's the caveat to that

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if you choose from the start. So parents reach out to you and say

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we just moved. They're having a really hard time adjusting.

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This has been really difficult on both of them.

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I think both of them would benefit. I'd like you to see both of them. OK.

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So from the start, you're going to work with both siblings.

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The caveat is you have to build a rapport and a relationship with each of them first.

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So what I do and what we do at the center

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is we suggest that you get three individual sessions with each child

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so that they get to build their own relationship

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and their own rapport with you as the therapist.

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Because we understand that the relationship is paramount in child-centered work.

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So it would be very difficult for each child

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to build a rapport and a relationship with you.

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If straight out of the gate, you have joint play sessions

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because the dominant one is going to engage with you more,

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the less dominant one is going to engage less.

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And neither one of them get to have that

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one on one time where they're actually building that trust

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and that bond is harder to form if there's someone else in the room.

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So we typically say to parents, yes, absolutely.

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We will work with both of your children at the same time,

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but we need individual sessions first so that we

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can work on that initiation and warm up.

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So that would be my suggestion if you're going to start from the beginning,

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seeing both children.

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All right, if you start with one and in your case, Michelle, you said

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I have worked with siblings,

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but at different times so I saw one for six months

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and then finished and then started with the other one.

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So if that's the case, so if you start with one, and what will often happen

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is

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they come in with one child as the pressing concern,

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right? So there's usually the quote problem child of the family.

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So they prioritize the one that quote needs the most help.

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And I'm air quoting both of that because all that's baloney and we all know it. But

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so they have the one that they say, ok, I'm prioritizing this child.

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Well, what happens is over the course of work

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and weeks and the therapeutic process,

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they see what takes place, they see the transformation, they see the change,

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they see the growth,

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they see the healing and then they're like, oh my gosh.

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Well, now the other kid needs it

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because remember legal scales of justice metaphor, right? So as one child changes,

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it recalibrate the whole relational dynamic in the family.

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And so the quote bad kid is no longer the bad kid.

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So then any issues that the other children were having,

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which were always overshadowed by the quote bad kid.

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They're even more obvious than ever. And so it's like, man, it used to be that one.

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Well, now it's this one, this one needs therapy too.

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So you will often find that even if they don't intend

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to have you work with both kids from the beginning,

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halfway through the process with one. They say, oh my gosh.

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Now I need to get so and so in

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all right.

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So if that is the case,

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our

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policy is that when the parent raises that as a question, hey,

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can you start seeing my other child too?

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Our standard response is,

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I wonder if you've asked my current client

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about that yet?

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I wonder if you've had any conversations with my current client about that?

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Sometimes they say yes, sometimes they say no.

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And in either scenario,

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I always follow up with,

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ok, well, since I have the therapeutic allegiance with my client

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and

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I want to preserve that, I would never want there to be a perception of betrayal.

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I would never want there to be a breach of trust.

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So if my current client

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gives me permission to start working with their sibling

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and they're ok with it and supportive of it,

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then absolutely. I can start working with your other child.

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But if my current client says no,

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then we will wait for my current client to be completely finished and

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then we can transition into working with the other child because above all,

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you preserve the relationship.

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You don't want there to be a fracture.

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You don't want there to be a breach, a break, anything.

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So we always get permission from the active client.

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I wonder if you think it would be ok if I started working with your sibling

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or I wonder if mom told you that they really want sister to come and see me.

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I wonder if you would be ok with that.

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And if you say if you choose to say no,

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then you choose for me to only work with you until you are done.

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And then I will work with your sister

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and the child will tell you. And I've only ever had a couple of kids say no.

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But when they say no, I honor that. And then I go back to mom or dad and I say

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the child chose not to. So we're gonna wait

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and parents are ok with that because

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they understand the importance of the relationship and

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the trust that has been formed with the child that I started with first.

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So that is how we address if we're going to work with both siblings,

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but we've already started with one.

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And here's kind of

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a little sidebar that I think is another consideration

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when a parent comes to you and says I want you to work with

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both of my kids or all three of my kids or in one case,

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she had five children and she wanted me to work with four of them.

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And

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when you have a mom or a dad or whomever caregiver

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that

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feels that all of their children are struggling in some capacity,

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it's usually a really, really helpful fit to say,

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I think CPRT would be

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the best solution for you

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and then you advocate for why?

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And then you talk about how it will change the

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way that the parent interacts with all of the children,

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all of the children will get the benefit of the parenting skills.

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The child-centered principles,

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the change in the relationships between the parents and the kids.

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So now all of a sudden, instead of you needing to work with 2, 3, 4 children,

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which logistically is very difficult.

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You have one session with parents each week,

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they do play sessions at home with their children

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and that takes care of the whole family system rather than just one child at a time.

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So I always at least approach the idea of CPRT

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if a parent says, yeah, I'm gonna have you work with, you know, all my kids.

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Well, I think it would actually be more effective if you worked with your children.

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Let me explain why.

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So that would be a conversation that would be warranted in that case.

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And then finally, Michelle,

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I wanted to share some logistical thoughts with you and

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actually for everyone because this is a pretty common thing,

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right?

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Many of us are asked to work with multiple children from the same family.

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So then logistically speaking and practically speaking, what do we do with that?

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Because that can be tricky, right? What if we only have one space available?

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And then you know, what does that look like for the schedule, et cetera, et cetera. So

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here are your options,

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you can do a 30/30 split,

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meaning you're not gonna do group sessions.

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Sorry,

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I should clarify that this would be if you're going to work with both children,

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not in group play.

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So you're going to do individual sessions

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each week with more than one child.

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So you can do a 30/30 split.

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So you only book one hour, they're only paying you for one hour

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and you give 30 to 1 child and 30 to the other. So they get a truncated session.

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So it goes from 50 to 30

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but 30 minute sessions are still effective.

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And then you actually get to see each child individually within the span of one hour.

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That's one option.

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Second option is you, if they are willing and able to pay for two spots

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each week, then you do back to back sessions.

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So they come on Mondays at two and at three, you take one back at two,

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you take the next one back at three and they switch off.

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That would give them the full 50 minute therapeutic hour

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and then it doesn't force the family to come more than once a week.

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So they get back to back sessions.

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And then the third option is

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alternating weeks at the same time

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once the relationship is established.

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So once you've seen each of them individually for three weeks straight,

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you can move to and every other week schedule where they get an hour each week.

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But it would be brother on the first week of the month,

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sister on the second week of the month, brother on the third week of the month,

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sister on the fourth week of the month,

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but it's still Tuesdays at five.

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So their spot remains the same. They just alternate.

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And then keep in mind, you know, we're looking at a 30 to 40 week average

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for a number of sessions.

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So if they're coming every other week

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that's pushing it out to more than a year

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because we're looking at probably 60 at least sessions,

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right

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in total.

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But each kid would be getting the 30 but it's going to take 60 weeks to get there.

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So parents need to understand.

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It doesn't delay the process and they don't go through everything,

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they need to go through slower.

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It's just on a calendar, it takes longer.

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It doesn't mean it's gonna take them 50 weeks instead of 30. If it's every other week,

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it just means it's going to take twice as long to

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get through the full course of 30 weeks for each child.

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All right.

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So Michelle,

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thank you so much for the question and I hope that was helpful for all of you.

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And if you

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are wanting to kind of dive into questions

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like these and have these types of discussions,

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the collective might be a really helpful place.

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We have these kinds of dialogues a lot, not only in the live calls,

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but also in the chat So, if you wanted to check out the collective,

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you can go to ccptcollective.com

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and you can find out more about our online community, which is so much fun. Oh my gosh.

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All right, Michelle. Thanks again. I appreciate it to all my Irish friends.

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It's nice to have you on the other side of the pond listening

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and I'm really grateful for each and every one of you. Thanks so much talk again soon.

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Love you. Bye.

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Thank you for listening to the Play Therapy Podcast with Dr Brenna Hicks.

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For more episodes and resources.

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Please go to www.playtherapypodcast.com.