During my first year studying psychology in Nantes, I met a clinical psychologist working in a Medico-Psychological Center for children and teenagers in order to ask her few questions about her profession. Here is an excerpt from the transcript of this interview dating from November 19th 2013.
Why did you choose to do this profession ?
“What was most important to me was to succeed in helping a child in a period of existential suffering. It’s this side of the profession that motivated me the most to start studying psychology. I think that taking care of a child as soon as possible can allow him to live a “normal” adolescence, which could have been very hard to live if the pain of this child had never been treated before. Doing that for someone, it’s just amazing!”
Can you describe a typical day in the Medico-Psychological Center?
“Well, I usually start the day with a meeting. In fact, we meet with colleagues in order to discuss about our patients, and thus, expose our difficulties. It allows us to keep an objective look on our practice. We advise each other and it’s very important in this environment! Then, in the afternoon, I have got a rhythm of one consultation every hour (each one lasts about 30 minutes), it leaves me about 30 minutes after each interview to transcribe the important elements of the exchange. I have to do it afterwards because I can’t record everything in front of the child, he wouldn’t understand why I’m scribbling things on my sheet instead of listening to him/her. In short, we can say that I am quite busy!”
Which methods do you use to better understand your patients ?
“Indeed, there are several methods. As you can see, my desk is full of drawings, play dough and Playmobil but I wouldn’t change this decor for anything in the world! I also work with parents. First, I meet them with their child, in fact it allows me to have a first glimpse of the relationship between the child and its family environment. It also gives me access to the parents’ impressions which could explain me more precisely his/her troubles at home or at school for example. This first interview is very important because it allows me to have a holistic view of the child’s difficulties and his/her behavior with others. Sometimes, if it’s necessary, I can also use psychometric test to assess various dimensions of the child’s subjectivity. Then, I regularly make a point with the parents to explain the evolution of the child and see if it needs to be redirected to a particular therapy or continue with me.”
How do you handle some children’s muteness in interview?
“Yes, that happens regularly… Most of the time, parents ask that their child consult a psychologist. So, when children are sitting alone in my office, they don’t understand why they are here or what they have to tell me, and let alone why they should answer my questions. The silence of a child is always more difficult to understand than an adult’s, because we can leave some silences with an adult in an appropriate moment, but for children it’s different. We have to reassure them and thus, never leave heavy silence, which can become frightening. So, if they don’t speak, I’m waiting a little but if it lasts too long, I offer to draw or play with me. Furthermore, it allows establishing a bond and sometimes, drawing or to playing with them says more about them story than simple words.”
Did you ever feel particularly involved with some children?
“Yes, especially when a child’s life is at stake. I particularly remember two cases that I had to deal with about 10 years ago. The first one was a 9-year-old boy, parents and teachers wanted him to consult a psychologist because he had a strange behavior. When I first saw him entering in my office, I knew that something was wrong. He walked in an abnormal manner: his knees were always bent and his arms were slightly bent forwards, his shoulders were tensed and he was continuously squinting. I immediately advise to his parents to consult a doctor to make medical examinations, and the diagnosis fell: it was a brain tumor. Then, there was this little girl, I don’t remember her age, less than 10 years for sure. She was brought by the hospital after three suicide attempts by hanging, the last one, her father found her and saved her. I remember very well, everyone was counting on me, this little girl was in a such state of fragility, I felt that I had a huge responsibility… So, during this period I had sleep disorders, I woke up often at night seeking over and over how I could help her. Fortunately, I’ve got a personal supervision every week, where I can discuss about my patients with a psychologist and he helps me to find alternatives. It’s true that sometimes we have the impression to have tried everything with a child, that’s why supervision can be useful to see some aspects that you didn’t necessarily thought for instance.”
Have you noticed an evolution of the seriousness of cases in your department?
“Oh yes ! It’s true that, nowadays, we can have the impression that people want to consult a psychologist for not much, but in reality it’s very frustrating because we have to make a selection because of the large number of demands. And so, children that we see are qualified as “heavy cases” because we have to offer them a psychological care urgently most of the time. Therefore, we are less and less likely to deal with “mild” cases.”
Words I have learned:
- An excerpt = un extrait
- To sccrible = gribouiller
- A glimpse = un aperçu
- “When a life is at stake“ = quand une vie est en jeu
- To squint = cligner des yeux
Louise Chesneau, M2 PCPI