necessarily going to provide the mechanisms to effect change? For this reason it is therapeutically
beneficial to have a clear understanding of the outcome. Where does the clientwant to go? How might
the client want life to be happier? What does this teenager want for herself and her relationship with
her parents?
Having defined the outcome, it is easier to ask the question about what resources, abilities, or
means your child or adolescent—and, consequently, the character of the metaphor—needs to reach
the desired outcome. Focusing on the outcome puts you in a better position to structure a healing
metaphor than if you were caught up in the client’s story of seemingly endless problems. In the rest
of this chapter I explore how to undertake an outcome-oriented assessment, plan your metaphor,
present it to the child or adolescent, adapt it to the client’s responses, and generalize the outcome into
real life.
- MAKE AN OUTCOME-ORIENTED ASSESSMENT
The assessment and treatment of children has unique problems that are not as common in adult ther-
apy. Berg and Steiner (2003) describe children as “involuntary clients” who represent a unique pop-
ulation with unique ethical and consent issues. Most of the children we see are younger than the age
of legal consent and, in many cases, are too young to understand the processes of informed consent
we may use with an adult client. The debate in the literature about this issue (Baldwin, 2001; Bald-
win & Barker, 1995) falls into two main schools of thought: the liberationists who claim that chil-
dren should have the same rights as adults, and the protectionists who say that children need special
considerations because they are developmentally different from adults. How you seek consent will
also depend upon whether you operate from an individual, family, or social model of therapy. It is
not my intent to get into a debate on the legal, ethical, or philosophical issues about this matter, but
rather to point out the concerns and what they mean in the pragmatics of therapy.
Who Sets the Goals?
Answering this question is likely to determine the success or failure of whatever intervention you em-
ploy. When a parent, teacher, grandparent, or caregiver leads a reluctant kid, by the hand, into our
consulting room, sits him or her down, and proceeds to list off all their problems, what do we see as
the goal? Is it what the parent wants the child to do or be, or what the child wants? What if the par-
ent says that a child’s behavior is causing unacceptable sibling conflict or threatening the parents’ mar-
riage, and the child says he or she does not care? What if a child says that, because kids at school are
bullying him, he wants to take his father’s gun and shoot them all? Do we listen to the express goal
of the client or take a morally, socially responsible stance? And how do we match this with our eth-
ical responsibilities? Exploring the child’s goal in a specific, solution-focused approach with questions
(like, “How would you prefer to be feeling about the other kids?” “What things can you do other
than taking a gun to school?” “What do you think you can do to help form better relationships with
them?”) may differentiate between the actions of the bullying and the perpetrators of those actions,
thus highlighting the point that the child’s goal is to cope better with the bullying and relate better
256 Creating Your Own Healing Stories for Kids