Family- or Child-Centered Therapeutic Approach?
摘要
This chapter explores the relationships that are created in the affected child between CP motor and perceptual pathology and psychological suffering, as well as emotional mechanisms that appear within their family (parents and siblings). Development of CP children has a strong bearing on acceptance of their body, a body exposed to permanent conflicts, experiences of marginalization, hospitalizations, surgeries, orthoses, aids; a body that disorients and is unwanted and invested with denial. Rehabilitation professionals also experience suffering transmitted by CP children and are very often unprepared to deal with this aspect. The family is an indispensable resource, but it must be in turn helped so that it does not become a further critical or negative element. Professionals must be able to recognize both difficulties of the child and family members and those of their own, by avoiding facing these aspects with an overwhelming silence. It is essential not to minimize emotional suffering, not to erase it by escaping (concretely or emotionally), but to learn to accept and respect it. Among the first tasks of taking charge of CP children is supporting parents and their sense of guilt and consequent aggression, avoiding falling into a perverse alliance (CP children must do physiotherapy because their mothers still need it). A good therapeutic relationship must defeat silence and encourage open dialogue, starting from communication of the diagnosis (what, when, and how it is said). In this sense, clinical supervision of the team by specifically trained psychotherapists is determinant. Among the most significant experiences, the Canadian Family-Centered Care (FCC) is compared with the Italian Child-Centered Approach.