Filial Therapy – forming therapeutic partnerships with parents to achieve intra-psychic and interpersonal change for families.

Presentation delivered by Geraldine Thomas, on Saturday 15th April 2015, to the International Attachment in London, N19.

Written by Julia Benard

This was a fascinating talk by Geraldine Thomas on a subject which I was not familiar with. The term ‘filial’ is from Latin and concerns parent-child relations. By working closely and sensitively with the parent(s) or care-giver(s) whom s/he watches at play with the child, the therapist is able to help the parent to focus on the child’s expressed attachment needs and the parent on their own attachment dynamic which may conflict with the child’s needs. The rationale is that with child patients, unlike with adults, it is risky, and possibly wasteful, to build a new attachment relationship (with the therapist) only to hand the child back again to rebuild the relationship with the parent(s). It thus uses the therapist to train the parent in how to conduct play therapy with their own child (Guerney 1964).

Geraldine showed some videos which illustrated the process very clearly. A recently widowed father was struggling with his 4 year-old daughter. In their early session, while she played with the toy oven, he sat on the floor seemingly totally disengaged; there was no interaction between them. Following the session, he would have received feedback from the therapist who was observing unobtrusively, and it would be 75% positive in order for him to be able to hear the 25% ‘room for improvement’. By the final session (there are usually about 5 or 6) the two were playing imaginatively together and having fun – it was moving to witness.

Play is children’s universal language and the idea is to get the parent to speak their language and for the child to express his/her problems via play. And they can create new memories together through the medium. It can be hard for parents to accept their child’s anger but expressed in play there’s safety. Parents who have a fearful attachment style, who fear being rejected, find it hard to set limits. The therapist will explain and demonstrate appropriate ways of overcoming this.

Geraldine told us how she has an array of toys for each family so as to enable the child to express a range of emotions and scenarios. She has a big inflatable character which can be used to enact power struggles (but it can’t be kicked with shoes on.) She has knives, swords and guns – all plastic! This caused some concern in the open session after the talk, especially with those members of the audience who work in schools or public service environments, and a lively and interesting discussion ensued. The explanation presented was that parents need to learn to manage the limits of aggression. There are dressing-up clothes and arts and crafts materials, sand, water, play-dough, baby stuff, a dolls’ house, cars and lots more. In play you can return to where the wounds were inflicted; play doesn’t lie.

Geraldine spoke about the neurobiology relevant to this therapy. She mentioned the Bruce Perry model.   Attachment is associated with the limbic area of the brain, it’s a primitive need. Talking doesn’t access the deeper levels which playing can. After 12 years of age, children are more cognitive so 14 is usually the maximum.

The talk was delivered by Geraldine in an engaging, knowledgeable and clear way with warmth and humour. She states that her clinical work is ‘informed and guided by attachment theory’ and she ‘works with adult attachment style to aid therapeutic progress in children’. I found it realistic to work with the family as a whole and not the child in isolation as if s/he was the ‘bad egg’ and I found it hopeful in that secure attachments can demonstrably be built between children and their parents despite what has gone before.

Julia Benard

Guerney, B. (1964). Filial Therapy: Description and rationale. Journal of Consulting Psychology, 303-10.

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