Does the therapist’s gender matter? –
Psychotherapy with children (and parents) and the impact of gender A systemic view

Text unseres Vortrags beim Internationalen Kongress für Familientherapie
Istanbul 2004 IFTA 23 – 27.3.2004

The workshop will demonstrate some aspects and possibilities of doing systemic psychotherapy with children. What are the advantages or disadvantages of working therapeutically with children including or excluding their parents, or their grandparents, or their siblings? Could it be helpful to change the setting during the therapy-process, and if it is so, at what moment should we change it?
Frequently children do not participate in psychotherapy freely, instead they need to become convinced by their parents to join them. So how could the psychotherapist welcome them in the best way? How could he motivate a child to cooperate? And how will he be able to join in with them sufficiently? In other words: How will children become our clients in the very sense of the word, i. e. how will they become ready to give us a specific job as their psychotherapists? Lastly, how can we perform a solution-focused brief and effective therapy with children, eventually including parents, grandparents or siblings?
In doing so, does gender matter? Does it make a significant difference whether the therapist is male or female? Does it determine the therapy process in some way? Do male therapists fit better for boys because they frequently attract the boy’s temporary fantasy to be a father or a fatherly friend? (or: to be a better father? Or, in the case of divorced parents, a father substitute? etc.) Do female therapists fit better with girls because they may easily attract the girl’s temporary fantasy to be a mother or a motherly friend? (or: to be a better mother? Or, in case of divorced parents, a mother substitute? etc.)

Introduction

Good evening, ladies and gentlemen. So I would like to introduce myself briefly: My name is RK and I’m a systemic family therapist from Vienna Austria. I work in the Vienna Institute for Couple Therapy and I’m a board member of the Austrian Association of Systemic Studies and Psychotherapy which is the largest training centre for family therapists in Austria. I work as a free-lance therapist partly together with my wife BG, who assists me at this conference.

The purpose of this workshop is to demonstrate some aspects and possibilities of doing systemic psychotherapy with children including the question in how far the therapist’s gender matters. My talk should last about 45 minutes.

I have divided my presentation into three parts:
First, work with children and families in Austria in general.
Second, varied, helpful and manageable settings in family therapy
and finally, does the therapist’s gender matter?

I would like to show you a DVD to illustrate my approach to family therapy. There will be a possibility to discuss the issues raised in the video at the end of my presentation. I will mute the German sound of the tape and explain what is going on in English while showing the DVD
Before I show you the DVD, which I recorded last summer, I want to make some general comments on work with children and families in Austria.

At the moment a widespread discussion on the gender issue (and gender mainstream) is going on in Vienna. That’s why we have been working in a mixed-gender set-up in partner therapy for some time – a male and a female therapist working together. Therefore we offer therapy with children alone as well as family therapy. The first session is usually a family therapy session where we listen carefully and try to find out who is a part of the problem and who could contribute to the solution of the problem. Here it sometimes becomes obvious that the child’s problem does not appear continuously but in certain contexts, for instance just at school. So the parents might look at a situation they themselves have not encountered yet. „Exceptions are the building blocks of the solution“, Insoo Kim Berg says. After this first talk we can decide whether we are going to do family therapy or single therapy with the child or both. Solution-focused therapy is a good tool to keep the gender of the therapist out of focus in the beginning and by that keeping the family therapy talks „gender-free“. The difference in approach to therapy with adults and children is that adults have assumptions of how therapy works and what the outcome could be and children don’t and they usually never come voluntarily. But once they have decided to cooperate they are very creative and clever to find solutions to their problems. For children visible progress is essential for success from a systemic point of view because the children will get positive feed-back from the „system“, namely school or parents. From time to time we work with Ben Furman’s „15 steps“ described in KidsSkills: Children define problems as a lack of skills and they learn these skills.
When I started my work with children, I worked a lot with bed-wetters. I also published some material on that.

Once I asked my 6year old daugther celina what to tell a boy who wetted his bed an what advice I should give to him?
She answered: Tell him to keep his bed dry. That’s how KidsSkills works, that’s how the CD-Rom of Furman helps to solve problems and learn the skills. A solution focused way.

In Austria there are more female than male therapists and in child therapy usually the mothers select the therapist. If mothers want to find understanding for their own problem as well they usually select a female therapist. But sometimes the mothers feel that the child is looking for a father figure and so they choose a male therapist. A male therapist can show the boy a male point of view of the world. And probably there is also an expectation on the part of the mother that he could bring up the child instead of the father and there is the danger of competition between therapist and father. The choice of the female therapist often relates to feelings and the choice of a male therapist relates to solution, technique and expert knowledge. But I’m sure that the only experts are the children and their parents.

As I mentioned before another issue I would like to discuss is: Does the therapist’s gender matter? I can see myself as a young boy in Nino, I cannot see myself in an 8-year-old primary school girl that I never was. Sometimes I ask myself who would I have preferred as a therapist when I was a child? A fatherly friend or a caring mother or vice versa: a caring father and a „comrade“(„buddy“) mother?
So now I would like to know from you what the outcome of this therapy would have been in a mixed-gender or all-female setting or only family therapy setting? Could you come up with examples from your own therapy experience where you now think that your gender contributed to the progress or hindered the progress of the therapy?

Violence against women and children constitutes a serious problem for male therapists as the aggressor usually has the same gender as the therapist. Only later in the stage of a therapy it can be helpful to establish a contact to a male therapist who can acquaint the victims of male aggression with a different kind of male behaviour. In the area of aggression and abuse commonly female therapists work with victims. It’s their task to balance their emancipated attitudes with exaggerated female understanding in various therapy situations. It’s difficult on the one hand to remain neutral and on the other hand to be empathic. Female clients should be guided towards more self-determined decision-making, less dependent on the therapist and the family system, but the changes have to be adapted to the personal situation of the client.

Ending:-

Before we stop let me just say thanks for your interest, your participation and professional input. We tried to focus on an aspect of our work that we tend to forget while doing our work, namely that we are not only therapists, but also men and women with our in-built constructed roles. Thanks for your attention and enjoy the rest of the conference.