Doing therapy using a systems framework has never been easy. As a colleague recounts of her early reaction to family therapy principles, “You mean we have to invite the grandmother, too?!” Cumbersome and time-consuming, intimidating and complicated, it can feel like herding cats. Yet over my four-plus decades of working as a child and family therapist and school consultant, I’ve learned that strong, invaluable supports are created when therapists collaborate with schools to help kids who are struggling. Time and again, I’ve seen that the better we understand the overlapping spheres of influence impacting a child’s life, the better the solutions we can formulate.
The devastating sweep of the pandemic has made the importance of this collaboration unavoidably evident. Families with school-aged children who were already on the poverty line and struggling to support their child’s schooling are likely to be struggling more. Similarly, school systems already disadvantaged by inadequate and overburdened teachers are grappling with how to provide safe and high-quality education for their students. Even well-resourced schools have been severely affected, with teachers and administrators pushed to their limits.
So where do we therapists fit into this new landscape? What can we do to help kids facing difficulties at school, pandemic-related or not? And what can we do to support the schools in our communities? More than ever, we need to push ourselves to collaborate with school personnel and find creative solutions to support our clients. Before the pandemic, there were many reasons why therapists might decide not to contact a school, ranging from the family’s distrust of a teacher, to our own insecurities and doubts about how to work with schools effectively. There was also the persistent issue of time—who wants the burden of yet another meeting or phone call? Though these reasons may still be valid in select cases, the need for collaboration supersedes them now more than ever. As a middle school teacher in an urban high school told me, “We’d breathe a sigh of relief if a therapist approached us to discuss one of our students.” Her tone was similar to that of a school administrator who implored, “We need all the help we can get!”
Looking for a Teammate
Lucas, a capable yet enigmatic 10th grader at a public high school in Philadelphia, was struggling in school even before the pandemic. “Excuses were his middle name,” as one teacher put it, and he sometimes fell asleep during class. After March, when his school shut down, his problems only grew worse. He rarely logged on for Zoom classes, and when he was present, he kept his camera turned off, despite teachers’ repeated requests to see his face.
Worried and frustrated, his history teacher reached out to Bruce, the school counselor, for help. The previous year, Bruce and Lucas had formed a connection over their mutual love of sci-fi movies when they’d met a couple of times to discuss Lucas’s writing difficulties. Bruce was looking forward to seeing him again and was disappointed when he failed to log on for their scheduled appointment, which he later claimed was due to internet connection issues. When they finally met the next week on Zoom, Bruce made a point of asking him about his thoughts on the latest Mandalorian installment. But Lucas responded unenthusiastically, and proceeded to give short, monotone answers throughout their conversation. He also looked visibly uncomfortable, repeatedly glancing at something over his right shoulder.
Although navigating these kinds of awkward online interactions had become the new norm for Bruce, he was feeling burned out from the effort. He found it difficult to establish a conversational flow without the help of body language, and seeing into people’s homes made him feel like a voyeur. The scene in Lucas’s house, in particular, struck him as a bit chaotic. Piles of clothes littered the floor and bed behind him, and what appeared to be prescription bottles were visible on the nightstand.
As Lucas haltingly explained how hard it was for him to keep up with school while taking care of the household chores, Bruce found himself momentarily distracted by a shape moving in the corner of the room. He realized that he was watching Lucas’s mother rolling over in bed, clearly asleep in the middle of the day. Nothing about the situation seemed right—not just the visible clutter and view of Lucas’s mom, but the very fact that he was witnessing the scene at all. Who was he to peer into this family’s life, and what responsibility did he have for what he saw?
Bruce ended the session feeling unsettled, unsure he’d made any progress or had a concrete plan to help Lucas cope. Looking over Lucas’s file again for anything that might help, he saw that Lucas had seen a therapist who’d been in touch with the school’s learning support staff the previous fall. Feeling momentarily hopeful—an emotion he hadn’t experienced much in the past few months—he decided to see if she could shed some light on the situation. Since the appropriate consent form was still valid, he sent her an email that night.
Lucas’s therapist, Maxine, was quick to call Bruce back the next morning. For weeks, she’d been asking colleagues if they had any strategies to connect with Zoom-shy teenage clients, and she hadn’t made much progress. Lucas, in particular, had been difficult to reach during the initial months of the pandemic, and he’d skipped several of their recent sessions. She was grateful to have any additional insight from a trusted source like Bruce, especially one who’d managed to connect with Lucas so recently.
After speaking for a few minutes, they discovered that they had similar concerns about Lucas. Bruce described his failure to show up to class and mentioned seeing his mom in bed. Maxine commiserated and provided some context about Lucas’s home life. Though she’d only met his mother, Gracia, a handful of times, Maxine knew from Lucas that she suffered from depression, and had recently lost her job at a furniture store, shuttered because of the pandemic.
Lucas often struggled to “keep everything together” when his mother was experiencing a low mood, so Maxine wasn’t surprised to hear what Bruce had observed, though it did trouble her. “I was worried that he was getting overwhelmed even before the pandemic,” she said, somberly. She added that she believed he too was suffering from depression, which was likely affecting his motivation.
After hearing about the family’s economic situation, Bruce asked Maxine if she knew of the new services the high school was offering, including classes to help motivate kids to study online, job-networking meetings offered by the social worker and parent liaison, and meal services arranged between the school and local faith-based institutions. Maxine was happy to hear that such services existed, and made a note to recommend them to her other clients from the same district.
As a next step, Maxine suggested they set up an online meeting that would include Lucas and his mom. Together, they could get a sense of the shared care for Lucas and come up with some good ideas about how to solve his school challenges. “I’d be happy to set this up and facilitate it, since I know Gracia better,” Maxine offered. Bruce agreed it was a good idea, but worried about whether his presence would constrain Gracia from speaking about her situation openly. Maxine offered to meet with Gracia and Lucas before meeting with the school to sort out how best to support and encourage Gracia’s involvement.
Initially, side by side with her son on the hazy screen, Gracia expressed reluctance to meet with the school. “I just don’t really have the energy for that right now,” she told Maxine. Lucas made his own discomfort clear by frequently turning away and fidgeting with something in his hand. Fighting through awkward silences, Maxine said she understood Gracia’s exhaustion, but thought she might be interested in hearing about some of the new resources the school had available. “And I think it would be great if you had another trusted point person you could reach out to for help, someone who also knows Lucas and cares about him” she added. Gracia looked skeptical as she listened to Maxine describe her conversation with Bruce and the ways the school could help, but by the end of the conversation, she’d agreed to the meeting.
Filling the Gaps
As was the case with Lucas, certain details of a child’s situation might not be known to adults at school who are in a position to help. Beyond providing some context, therapists can offer valuable clinical frameworks for understanding what’s going on. In turn, school personnel can provide therapists with important information that allows us to serve our clients better. As one teacher I interviewed said, “It matters more than ever that we can work with a professional who’s knowledgeable about the mental health needs of the student and family. We’re looking for a teammate. If I have a therapist on board, it changes everything.”
Both sides can work together to fill in crucial gaps—which may continue to widen from the current lack of in-person instruction and communication. There’s no real substitute for gentle pats on the back to remind students to wait their turn in line, or casual chats on the way to the lunchroom. It’s much harder to figure out what’s going on with kids who are struggling, and a certain kind of exhaustion sets in from trying. “Our brains are fighting through the screen to pick up the pieces that aren’t there,” a dean of students in a large public school remarked.
Therapists’ brains are doing the same. However, through the fog of pandemic exhaustion, we can still recognize that school is a vital component in children’s lives, and the most effective treatment of their problems calls for us to work together with school personnel. Since all of us are only as strong as the support figures around us, we need to embrace our role in taking on a systems approach, no matter how burdensome it might seem at first.
Building Trust Is What We Do
But how can therapists help bridge a lack of trust between families and schools? A good example is with the case of Nia, a fifth-grader who, in prepandemic times, would often get into skirmishes with her classmates. In her eagerness for social connection, she’d poke at her classmates when she ambled across the classroom, but would then deny having touched them and become angry at the accusation. She’d try to insert herself into a certain girls’ social circle, but would lash out when rejected, calling her classmates ugly and stupid or pushing books off their desks.
When her parents reached out to Morris, a local therapist, for help, he immediately discerned a chilly relationship between the family and the school. Over the course of several sessions, the parents complained that teachers had unfairly labeled Nia as mean and impulsive. With agreement from the parents, Morris emailed Nia’s teacher to find a time to talk. The school counselor joined the teacher for the initial conference call, and both expressed frustration with the parents and called them bullies.
Being in the middle of a family–school showdown was nothing new to Morris. He could see that the parents were frazzled by Nia’s behavior, but were certainly not bullies. He could also see that the way the teacher and counselor spoke about Nia got under their skin, further impeding productive communication. He viewed Nia as a frustrated and unhappy kid, but not mean, even if she could appear that way at times.
Morris observed that when COVID had hit, Nia’s mood, surprisingly, brightened. “I like Zoom school; I never get in trouble,” she said cheerily, during one session. Morris realized that when classes moved online, she suddenly wasn’t around the group of girls who triggered her seemingly mean behavior. He wondered if it might make sense to lobby for Nia’s placement in a different classroom, given the unhealthy stalemate that had developed among Nia’s parents, her teachers, and the other students in the class.
Over the summer, he tried relentlessly to engage the school around this question, waiting days or sometimes weeks to hear back from busy and exhausted administrators. Finally, he got a call from the counselor and principal, and listened to them express their disgruntlement on behalf of the school for all the time they’d spent dealing unsuccessfully with Nia and her parents. Morris empathized, saying, “Nia has really let me have it at times.” He shared how he’d learned that after letting off steam, Nia would become tearful and talk willingly about how left out she felt at school. He could see that she was hurt and scared and unable to restrain herself in the moment, but he was helping her build coping skills while guiding her parents to set appropriate expectations for her behavior at home.
Morris’s ability to understand the school’s frustrations while reframing her behavior as that of a hurt, frustrated kid helped the school trust his point of view and, ultimately, listen to his suggestions. With the parents’ support, Morris persuaded the principal to change Nia’s online peer group to see if a bit of social engineering might continue to improve her functioning.
Looking back, Morris speculates that the pain of the pandemic and uncertainty he felt about the future for his own young kids gave him additional reason to trust his intuition and hang in there. In the beleaguered voices of the counselor, the principal, Nia, and her parents, he heard echoes of the voices in his own family after a long day’s work. No one is happy here, he’d thought, but aren’t I in a position to do something about it?
Nia settled in quickly when online school began last fall, and her behavior improved, along with her mood and attitude. In a way, COVID was the pause button that Nia, her family, and the school needed, and Morris was the bridge that helped them all get on better footing. While online learning is clearly exacerbating entrenched inequities for many kids, some, like Nia, have fared better, at least for now.
Like Morris, therapists need to be more explicit, deliberate, and persistent in the work we do with schools, given everyone’s increased stress and workload. Attending family–school meetings, in particular, is more important than ever. These meetings are the crux of a therapist’s collaboration with schools, where true teamwork happens. And on the plus side, they’ve never been easier to attend. Given that most of them are now virtual, we no longer need to carve out hours of travel time to go to a child’s school for a meeting.
We have any number of reasons to initiate a family–school meeting, such as when a child’s school-related problem needs urgent attention, the child’s school problem isn’t being addressed successfully in any other way, multiple perspectives are needed to figure out what’s going on and create plans for what to do to help, the family–school relationship needs strengthening, and momentum is needed to push through a problem.
Therapists can set up and facilitate the meetings, ask someone at the school to set them up, or ask to join a meeting, depending on the nuances of each circumstance. If a school has already scheduled a parent–teacher conference, for example, you can simply ask to sit in. Given the current pressures on schools, don’t be afraid to take it upon yourself to initiate a meeting if you feel one would be helpful. This will give you not only access to more information, but also a chance to join the team of people working together to support the child. And if you aren’t sure such a team is operating, you can help discern who’s there to help and what services might be available.
When Lucas, Gracia, Maxine, and Bruce had their first family–school meeting, it was like a badly synced nightly news production. The only thing more frustrating than the lag times between people talking were the pauses that occurred after people inadvertently interrupted one another.
Maxine stepped up to conduct the meeting, telling herself, “Be flexible, breathe deeply, it’s okay.” She said that the main goal for this meeting was to find out what she and the school could be doing to better support Lucas. Bruce was quick to say that, though he didn’t know Lucas well, he’d noted that other kids seemed to like and respect him. Maxine chimed in with a similar sense of Lucas—he was funny and competent, especially with anything tech related. It was just that he was finding it hard to motivate himself.
When asked about her feelings, Gracia said that she wasn’t surprised to hear that Lucas wasn’t turning on his video or getting his work done, but her responses were flat and noncommittal. At one point, she mentioned that, since the start of the pandemic, things hadn’t been the same at home. When Maxine asked her what was different, she exhaled and said, “Everything. I lost my job and can’t pay the bills. My sister gives me what she can, but it’s barely enough for pizza a few times a week. It just feels like we’re drowning.”
Bruce took the opportunity to ask Gracia whether the school social worker could contact her that afternoon to talk about some services being offered, including free meals. “I’ve never needed charity before, but—.” Her voice caught in her throat, and she trailed off, wiping away tears. Though quiet throughout the conversation, Lucas looked up at his mom to gauge her response and was visibly relieved when she accepted the offer. Perceiving that gesture to reflect an opening on Lucas’s part, Maxine jumped in to ask him if they could take a minute to discuss how to make virtual learning easier for him.
When it was clear that Lucas was sleeping late and then finding it hard to motivate himself to get online for school or therapy, Maxine tried out an idea that she was doing with another teenager who was having a similar problem—she and her client would have a brief phone conversation in the morning, during which he’d get online for his morning classes. Lucas agreed to give it a try. Bruce was clearly pleased. And the strategy turned out to be just the jump start Lucas needed to begin to motivate himself, which he was able to do after several days.
At the start of the pandemic, schools did their best to address myriad issues kids might have with online schooling, but some problems were harder to anticipate than others. Take the case of Charlie, an eighth-grader in the early stages of transitioning from male to female when the pandemic struck. She’d always done well in school, especially in the language arts, where she was known for her own brand of hip-hop limericks, but her struggles with gender dysphoria had caused her to experience periods of anxiety that occasionally reduced her productivity.
Charlie’s recent decision to adopt female pronouns, made in conjunction with her family and therapist, had given her a newfound confidence. She was excited about entering the local public high school the following year with a clean slate, where teachers and most peers would know her only as female. But when her classes went online in March, Charlie experienced a sharp decline in mood, and began doing poorly in classes she’d previously excelled in. Her teachers reported it to the school psychologist, who, in turn, reached out to Charlie’s therapist, saying Charlie seemed “listless and distracted.”
“Every time I look at myself on the screen I want to throw up,” she said to her therapist when presented with this assessment during their next session. Instead of following along during class, she said that she typically spent the time making lists of all the things she wanted to change about her appearance. The worst was French class. Every night, she had to upload a video of herself speaking French for homework. And every night, the combination of her perfectionism and gender dysphoria resulted in hours of her picking through the video she’d recorded, while her mood spiraled downward. “The videos are torture!” she said.
“Does your teacher know how hard it is for you to make the videos?” the therapist asked. She knew that Charlie had been hesitant to share details of her transition with her current school. A few of her teachers had been inconsistent with their use of her new pronouns, leaving her weary and distrustful of their support. “What’s the point” she sighed, resigned. The session ended with the therapist feeling increasingly distressed about the erosion in Charlie’s self-confidence that they’d worked to build together.
Charlie’s therapist understood that the first task was to help Charlie’s French teacher understand that she wasn’t simply avoiding the homework assignments. And she knew that Charlie would have to be the one to talk with her about this as a way to regain the sense of personal pride and efficacy that seemed to be slipping away. That night, the therapist wrote out several sample scripts of what Charlie could say to the teacher in which she could propose sending in audio recordings of the homework, without revealing more at this time. She sent the scripts the following morning, and Charlie was quick to choose one of them.
A brief conversation between Charlie and her teacher resolved the current crisis since it was evident that Charlie was making an effort to find a solution. The therapist, who’d worked with Charlie’s school before, was certain that the student-support staff would eventually connect with Charlie around her social-emotional needs. They had an active LBGTQ student club, with an advisor who was often called in to help students identify activities and other avenues for making friends and getting the support they need. For now, Charlie simply needed a practical pathway for getting there—and her therapist was able to help.
It’s never been easy to take those oh-so-familiar systems principles and put them to work in real life. In the break between sessions, emailing a friend or paying a bill online can supersede the wish to contact the teacher of the child you just saw over Zoom. We always have something else to do, even though so much of our life is now virtual. Yet as I sit in my office longing for the ordinary, maskless, up-close human contact with which we’re deeply familiar, I’m encouraged by the therapists embracing the challenges of the time and going above and beyond to support the kids in their communities.
We have the opportunity to take a world that one school principal called disconnected and look for ways, old and new, to make essential connections. Though we have reason to be discouraged, we can still be the bridge that schools and families desperately need. By adding crucial information, empathy, kindness, and clinical understanding to a situation, we can ignite the common motivation to do our best for struggling kids and the families who love them.
PHOTOS © TOP: SHUTTERSTOCK FIZKES, MIDDLE: ISTOCK ULTIART, BOTTOM: ISTOCK FIZKES
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