There are few tasks in life as challenging as raising a child. From the moment of birth each child is encountering and exploring the world around them. Each child is unique and must be understood from the perspective of how they are different even when they are acting as others around them are acting. Infants are curious and without hesitation without a concern about what others might think. There are no inadequate babies, something we might take note of and wonder how we might return to that point when we are yet all grown up.

Having witnessed my father practice as a pediatrician for almost 60 years has given me thought about how we see children as "different" when they are actually typical. I work from a perspective that starts with the view that the child is best viewed as normal but that unique aspects of themselves may need to be better understood.

In developing the approach to use in my practice with children I must take into account the nature of the world around them. To say that I work with "parenting issues" is to limit myself in the view of whom I am going to be working with. The ring of adults that surround a child today is much broader than just the parents. There are grandparents, extended family, professional caregivers, schools, aftercare programs, and other community resources that may be a part of the child's life. Each of these groups may bring a different expectation about the child and their techniques may have great variability.

There may be specific conflicts among the caregivers such as when parents are divorced or when the grandparents play a large role in the child's life with responsibilities after school until a parent can pick them up after work. Caregivers may need to express feelings of frustration, helplessness, and inadequacy in their experience in the parenting role. They may need help in understanding what is expected for their child and the differences between boys and girls in terms of developmental stages and social roles.

Therapy may involve helping the caregivers to decrease their reactivity to the child's behavior and to learn to respond in a more modulated, thoughtful, planned manner. Role-playing with the child and caregiver can help to learn this planned response instead of automatically reacting to the child's demands or negative behaviors. I may assign reading for the caregivers to expand their repertoire of intervention options and learn how to give feedback and redirection as needed. Family connectedness is important and I may ask the caregivers to provide a weekly schedule of the entire family's activities and then evaluate the schedule with them, looking for which activities are valuable and which can be eliminated to create a more focused and relaxed time to parent.