We began by cutting therapy back to every other week, and then talked about what the mother might do to activate her job search and how they could reduce some of Craig's expenses. Discussing how to weather this economic crisis avoided a premature ending of the treatment and had a stabilizing, anxiety-reducing impact on the whole family.
Concrete rules run counter to the incessant, 21st-century messages to kids (and adults) about the need for instant gratification. Rules protecting the therapeutic frame provide reassurance that the therapeutic relationship won't, like so much else in kids' lives, melt into thin air.
"Dinner is ready and we're all sitting down. Okay, okay, but as soon as the show ends, come get something to eat." "I have to work late tonight, but there's some of that macaroni and cheese mix in the cupboard that you can make." "We're too tired to go to church tomorrow. I know it's the third week in a row. . . ." "I don't care if it is time for our family meeting. Everybody's busy. Johnny's working on the computer, Lisa's doing her project. The little one's watching TV. We'll skip it just for tonight."
By now, we all recognize that the simple routines that were once part of everyday family life are rapidly disappearing under a tidal wave of overscheduling. I've asked hundreds of children what in their lives they wanted to have happen more often. Over and over, I've heard the same deceptively simple responses: "pizza and a video," "reading before bedtime," "walking with my father to the school bus," "playing board games with my mom and sister," "cooking together."
Clinicians have long understood the significance of ritual, but mostly through a narrow, trauma-related lens. After a loss or a difficult life transition, we help people create rituals that heal and rebuild. Unfortunately, only a few therapists consider simple rituals in the consulting room sophisticated enough to help with anxiety. Yet research shows that the repetitiveness of rituals helps clients not only heal, but also open up. Simple rituals in therapy can soothe fears, help kids communicate, and inspire families to develop their own satisfying routines at home.