Phase II Reworking of the Child Family Relationship

The second phase of the therapeutic process is the reworking of the relationship of the child to the family, with the mother-child relationship as a central component of this process. The elements to be addressed during this part of the process include maternal identification of the child as a unique individual rather than the object of maternal need gratification, followed by a significant period of redefinition of the attachment relationships within the family and a re-framing of the child's identity from that encompassing illness to one embracing wellness. Safety issues for parent and child should be addressed continually along the way. Some mothers, for example, do not want to assume any responsibility for a child when he or she is legitimately ill. Fathers and other relatives may have specific roles as active participants in these situations.

Communication between perpetrator and victim about the MBP abuse is another critical part of the healing process. Mothers in a small treatment group were able to tell their children about their abuse and were responsive to questions from their children about the factual basis of the children's recollections (Ayoub 2006). This process greatly enhances the children's ability to differentiate reality from perceptions that were distorted for them with self-blame or denial.

Finally, marital communication, which was re-framed in the first phase, is actively supported and reinforced through both marital and family therapy during the second phase.

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