with his classmates rather than to kill them. This then becomes a workable therapeutic goal, and bal-
ances the goal of the child with the well-being of others.
A story that has remained in my mind since schooldays is the tale about little Johnny who was
caught kissing a girl in class. His teacher sent him to the principal, who sat behind his big, wooden
desk, pulled out a large blackboard ruler, slapped it on the palm of his hand, threateningly, and said,
“Listen son. I will teach you to kiss girls in class,” to which little Johnny replied, “But, sir, I already
know how.” Johnny’s teacher and principal had a problem with his behavior. Johnny did not.
In the case of Jessica, the six-year-old elective mute I discussed in Chapter 1, several people were
involved in her coming to my office, and all wanted the best for her. Her grandmother, who initi-
ated the appointment, wanted to see Jessica talking like other children. Jessica’s teacher had the prob-
lem that Jessica could not be assessed—as the system specified—and wanted her to meet these re-
quirements. Her mother did not see a problem as Jessica was garrulous at home, and would probably
speak at school when she was ready. As for Jessica, it did not bother her apart from being teased by
other children.
All this raises the question, “Who is the client?” Is the outcome to help the grandmother feel
she has a normal granddaughter, make the teacher’s job of assessment easier, accept the mother’s po-
sition that nothing is wrong, relieve Jessica’s discomfort about being teased, or a combination of these
outcomes?
Berg and Steiner (2003, p. 14) point out that never in their combined careers (nor I in mine)
have they had a child telephone and say, “Doctor, I have a problem. Can I make an appointment to
sort it out?” Generally, children are brought to therapy by parents, teachers, caregivers, or custodi-
ans like social workers, police officers, or probation officers. Of course, there may be exceptions to
this depending on the context in which you are working, the nature of your relationship with your
clients, and the way your clients perceive your availability. One of my peer reviewers who works in
a school environment said it is not uncommon for her to have students knock on her door and sit
down for a chat about something that has been bothering them.
Frequently, however, the child does not know what to expect, may not have been told the pur-
pose of the visit, or may even have been given a fabricated story. Recently a parent requested hyp-
nosis for a child with a behavioral problem. She told the child I was a man who did magic. The son
probably expected a birthday party entertainer who could pull rabbits from a hat or make things dis-
appear. With this expectation, it was obvious I was going to be a disappointment to him from the be-
ginning.
To follow up this question of who sets the therapeutic outcome, I would recommend the chap-
ter entitled, “Assessing Your Clients, Agreeing on Goals” in Children’s Solution Work(Berg & Steiner,
2003, pp. 32–47), as it provides a useful approach to negotiating goals with children and their care-
givers. In addition, I have elsewhere (Burns, 2001, pp. 321–237) given a fuller description, and an
adult case study, of the Outcome-Oriented Assessment that I have summarized below.
Ta ke an Outcome-Oriented Approach
This means adopting an approach to therapy that is both future- and goal-oriented, looking in the
direction that a child wants to move. Most approaches to metaphor therapy have followed a style that
PRO-APPROACHHow Do I Plan and Present Healing Stories? 257