I was interviewed by the Health Supplement  for this article which looked mainly at my work in Barnardos , as well as my private practice. 

Sally O’Reilly, a child and family bereavement therapist with Barnardos, says children are good communicators once you learn their language. Sally feels there is less of a stigma attached to the idea of therapy for children.

I work as a therapist with Sólás, a service provided by Barnardos for children and families who are affected by bereavement. Generally, I work with the child and the family, or family member, together. The children can range from anywhere between two years up to 18 years of age.

Usually, the child is bereaved because of the death of a parent, or sometimes a sibling or close relative. Broadly speaking, there are two types of grief reaction: reactions that can be classed as normal and those that can be defined as traumatic. Normal grief reactions are not necessarily something that should be dismissed or ignored. However, if someone is displaying traumatic reactions, then this needs to be addressed as soon as possible.

Initially, I would carry out an assessment of the child and family to see how they are dealing with the bereavement. Trauma symptoms that I would look out for in a child include excessive nightmares, bed-wetting, sudden outbursts of screaming, prolonged silences. Very often the parent is aware that the child is traumatised in some way, or sometimes I get referrals from schools.

Children express themselves differently from adults and tend to be much more creative and imaginative in the way they communicate. Often, they will express themselves through game-playing, painting or stories. As part of the therapy process, we give them total freedom to draw, paint or play with toys or clay. Once you begin to understand how children communicate, you realise how extraordinarily good they are at telling the therapist what is going on or what they need. For example, we have a doll’s house in the therapy room and sometimes the child will act out scene by scene the traumatic event that has occurred.

Children are a lot wiser and more aware than adults give them credit for. Another part of my role is to help the child verbalise what they are feeling. This is particularly important for the parent or adult family member who is present, as they often find it difficult or are too distressed to understand the ways in which the child is expressing themselves. So, in this sense, my role is one of a facilitator, to channel communication between the child and the adult. One of the most challenging aspects of this work is addressing the sense of guilt that a child might be experiencing. Children tend to think that they are in charge of the world and that everything that happens is about them. So, in the case of a parent who has committed suicide, the child may believe it is their fault in some way. It is extremely important to address this early on and to explain to the child that they are not responsible for what has happened and also to explain to them what has occurred.

Because children are so resilient and energetic, and good at expressing themselves in their own unique way, I find this work extremely rewarding and interesting.
Once you give children the permission to express themselves freely and to make them feel that they are being understood, it’s amazing how quickly they begin to heal after a traumatic event.

In addition to my work with Sólás, I also run my own private practice as a psychotherapist, where I work with both teenagers and adults. I really enjoy the level of variety that my work entails and the fact that in any one week I could be working with anyone from the age of two up to 75. Increasingly, I feel that there is less of a stigma, or sense of shame, attached to the idea of therapy, which is very heartening. The sooner we can equip children and young adults with the skills and knowledge to deal with difficult or traumatic events, the better it will be for them in their adult lives.

Sólás runs a national helpline for families affected by bereavement, tel: 01-4732110.
(In conversation with Susan Calnan)