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Interviews with Experts

Child Psychologist Marisol Cortés

"The most common behavioral problems I treat are conduct disorders (CD), attention deficit hyperactivity disorder (ADHD) and bullying. The emotional disorders that are most common are enuresis, excessive fears, low self-esteem, anxiety, aggression and anger, depression, divorce and grief."

  • Interview with child pyschologist Marisol Cortés

    Centro Yoga Om, Vilanova i la Geltru Image

    What nationality are you and what languages do you speak?
    I was born in Mexico City where I lived for 24 years. My family emigrated from Spain to Mexico. Therefore I have Spanish heritage. Spanish is my native language and I also speak English.

    What professional qualifications do you have?
    I acquired a Bachelors degree in Psychology from Universidad Iberoamericana de Mexico, a Masters degree in Psycho-oncology from Universidad Complutense de Madrid, and I specialized in Gestalt therapy and in Play therapy.

    What are the most common behavioral and emotional problems you treat in children?
    The most common behavioral problems I treat are conduct disorders (CD), attention deficit hyperactivity disorder (ADHD) and bullying. The emotional disorders that are most common are enuresis, excessive fears, low self-esteem, anxiety, aggression and anger, depression, divorce and grief.

    How do the problems of adolescents differ?
    Adolescence is a period that occurs from puberty to adulthood, a stage where physical, emotional, psychological and social transitions occur. It provides the opportunity for development, not just in the physical aspect but also in cognitive and social competency, autonomy, self-esteem and intimacy.

    They want to be adults but still feel like children. They are vulnerable and immature. Anxiety is one of their faithful companions through out this developmental stage. Panic attacks, decision taking, fears for the future, emotional and economic independence and anger outbursts are some problems adolescents have to deal with daily. Eating disorders start to manifest at this stage. The Physical aspect gains importance. Caring about their looks and others opinions will influence their behavior and the search for their own identity. Social life and peer groups are their priority; meanwhile they distance themselves from adults.

    Discussions and fights will increase at home. They fight for what they think they deserve and believe. The difficulties from their actual developmental stage can increase and they can feel lost, without control in their own life.

    What are some of the more unusual problems you treat?
    Some "unusual" problems that I treat are children with painful or frightening medical procedures or long hospitalizations. These problems are actually with children with acute and chronic diseases. Cancer patients are the ones that attend the most to therapy. I had one case with selected mutism. The child only talked to her nanny. Through play she could shared with me what was wrong and then started to talk to me.  Distress, anxiety, sadness, anger and frustration are reduced and liberated in both situations.

    Are any of these problems more prevalent in Expat children due to them adjusting to life in another country / multiple languages, moving away from friends and family etc?
    The impact of moving in children depends a lot on their personality, but moving can be very disorienting to a young child. They rely on predictability and attachment to caretakers to generate a sense of security.

    Older children can also feel insecure and disoriented. Bid farewell to their peers, extended family, house, school, pets, toys, food and places that are commonly evident and significant to them can provoke a number of internal concerns. There is very little empirical research on transcultural individuals. Some studies found that separation, unresolved grief, rootlessness and insecurity are the major issues that these children are challenged to deal with. All these, triggers self defense mechanisms such as avoiding long-term relationships.

    The most common difficulties they present include denial, anger, anxiety, bargaining, depression, rebellion, withdrawal, vicarious grief, delayed grief and attachment difficulties. Children that move a lot can often have angry and anxious behavior in school and at home. Parents dont know what causes it and the child cannot tell why this behavior is happening.

    This anxiety can increase when they dont feel they belong to a place, where they need to learn a new language and struggle to make new friends. The support received from family and teachers can also determine the prevalence of emotional, social and educational problems in Expats children.

    Does being bilingual yourself help you when you are working with children whose problems stem from coping with different languages?
    Of course it helps. Personally experiencing what the children are going through helps me understand them better. I had the necessities and frustrations they have. I know they may feel angry, sad, disappointed, or even having the feeling of not being enough. With this experience I can make them feel comprehended through empathy. Itll help the child feel secure to express his feelings and internal difficulties.

    Do you feel children suffer both emotionally and educationally when they enter into a schooling environment which is not in their native tongue?
    They will struggle a lot and maybe suffer. Changes are difficult for everyone, personality and coping strategies will determine if the child will suffer or not. It wont be easy for them, especially if they dont know the language. They can fall behind educationally because educational programs differ in each country. There will be subjects and lessons they will not know and will need to study from the beginning.  A personal effort will be necessary for them to succeed. Studying pressure may affect them and increase their levels of distress.

    The psychosocial development its on peak. The peer group benefits from different ways of interaction with others. It helps develop abilities needed for socialization and for intimacy. A sense of belonging will build up. They learn about communication, leadership, goals fulfillment, cooperation and a sense of identity. Struggling to create and belong to a peer group can increase anxiety and distress. Emotional problems can difficult the educational achievement.

    How do you know if your child has a behavioral problem or if they are just going through a difficult phase?
    A difficult phase may be a natural reaction. Nowadays we are getting a lot of information about emotional intelligence, how to pursuit happiness. "Negative" feelings are prohibited and we need to try to eliminate them as fast as we can. The problem with all this information is that "negative" feelings are as natural and necessary in our lives, as happiness. Feelings are just feelings. Whats happening, actually, is that when a child gets mad, sad, energetic, we tend to try and change immediately that feeling to a "positive" one. We, as adults, do the same thing.  And we interpret this behavior as difficult. But sometimes is normal, he can feel frustrated, sad, angry, because of different situations in life.

    When they are going through a difficult phase the behavior is present in the most trustful and supportive environment. What I recommend to parents is to talk to their child and try to understand and support whats going on with them. Maybe they just had a bad day at school. Their behavior can be caused by something in particular.

    Behavioral problems occur when the difficult phase becomes repetitive and persistent in all environments (school, park, home), especially with adults and lasts more than 6 months. Parents may be desperate and need help to deal with the situation because its out of control.

    How can behavioral problems affect a child’s performance at school?
    Research has found that behavior problems are link to poor grades. They tend to be very distracted; they wont pay attention for long periods of time. They usually disturb their classmates, or even make them join them in their crazy ideas.

    The teachers cant handle them; they are desperate because they dont know what to do with them, punishment is their only ally, but most of the time it doesnt work. They get bored very quickly and cant accomplish to maintain good friends.There are different degrees of bad behavior. Sometimes they can be aggressive to others, other times they do not obey to the rules and teachers. They get away with everything they do.

    What have you found are the main concerns among parents in recent times for school age children?
    The biggest concern I encountered is how to set boundaries at home. Most of their children do not obey them. The reason many parents can´t set limits is because they feel guilt. We work together to help them manage this feeling, so they can start restoring order at their home. I help them deal with very energetic children and tantrums. Communication is also a big concern, because they, usually do not know what to say or not say in certain situations.

    I help them deal with difficult adolescents, what to do and what not do. And I explain to them whats normal in their childs developmental stage.

    What are the most common anxieties in children?
    The ones Ive worked most are to fulfill their parents expectations. To be who they want them to be, even tough they dont like it. (For example they play football because his father loves it and wants him to be the best goalkeeper, but the child doesnt like football, he likes tennis). Fears, phobias, obsessive-compulsive disorder and post-traumatic stress disorder are also very common.

    If left untreated can anxieties in children affect their social and educational development?
    Yes. They will also affect their emotional development. The internal problems will increase provoking an increment in their behavior. It will affect their relationships and their educational achievement. Paying attention will get more difficult for them and their normal development will get affected. Thats why its very important to prevent these situations.

    To give children the space they need to express themselves is very important. Children do not have the cognitive capacity to understand and express their feelings in words. They express themselves through non-directive play.

    What treatments are available to treat childhood anxieties?
    The medical treatments are the most common in pediatrics. There are also different psychotherapies that can help children cope with anxieties. In Spain the most prevailing psychotherapy is Cognitive-Behavioral Therapy, but there are also humanistic, psychoanalytical and systemic therapies that can help them.  

    The ideal treatment is for the child to have a multidisciplinary team that will aid from different specialties and points of views. So that way the problem can be treated and be solved from the origin.

    How do you assess which therapy is suitable for a child?
    It depends on the problem and the personality of the child and parents. If its an emotional difficulty, humanistic therapies and psychoanalytical therapy can help. Making a decision will depend on the way each professional works and if the parent and child are willing to work with that method.

    Its important before starting the treatment to research about the working method of each professional. Some professionals’ work just with the parents, some with the child through play, others with the child through speech and some with the whole family. So its up to the parents to decide what therapy is suitable for them. The professional is ethically obliged to tell the parents if the therapy will help their child or if it wont help resolve that kind of difficulty.

    Two of the therapies you offer are Gestalt Therapy and Play Therapy. Can you explain what they are?
    Play Therapy is an approach in which play is used to help a child or adolescent to express their emotions, thoughts, wishes and needs. It helps them to understand muddled feelings and upsetting events that they have not had the chance or the skills to sort out properly. Children use play to communicate at their own level and their own pace, without feeling interrogated or threatened. Play is a central ingredient in learning, allowing them to imitate adult behaviors, practice motor skills, process emotional events and learn much about their world.

    The playroom is a privileged, confident, intimate an unconditional supporting space. Play therapists have the knowledge to understand and get involved in the childs play. Creating a confident and trustful relationship, which encourages the expression and management of the childs internal conflicts, the discharge and understanding of their deepest emotions, recognizing and exploring the issues that affect their lives.

    It can help children with: depression; hyperactivity; anxiety; shyness; lack of attention; death of relatives or friends; low self-esteem; excessive fears; night terrors; divorce or separation; illness, hospitalization, painfully or frightening medical procedures; anger; aggression; emotional, physical or psychological abuse; domestic violence; bullying.

    Adolescents often have difficulties for communicating verbally, their concerns and feelings. Activity is also important in their physical development, Play Therapy provides opportunities of movement and discharging excess energy. Play, expressive art activities, games, and other materials are used as a bridge to help them express and to obtain insight of their lifestyle.

    Gestalt therapy is an interactive and holistic form of psychotherapy that focuses on the total person, recognizing the unity of the mind, body and emotions. Its a creative and patient approach that is non-authoritarian and non-interpretive. Its a trustful, privileged space. Where the person can feel the support and the companion that requires for coping with the dilemmas, concerns and difficulties in their daily lives. Finding new alternatives and solutions.

    Helps to free energy locked into old, dysfunctional behavior patterns and re-organize ourselves in a way that allows us to live more fully and effectively, centered in ourselves, yet able to reach out and take in what the world has to offer. It can help the adolescent or adult to be aware of what they do and how they feel. Developing skills for self-acceptation, focusing in the here and now, encouraging self-knowledge. It benefits parents and adolescents with emotional problems, couples and/or familiar adversities and conflicts in their professional environment. It can help anyone who needs support to fin new and better psychological means to solve their internal and external struggles.

    What services does your company provide?
    Children and adolescents psychological treatment and follow up.
    Parents support sessions.
    Didactic lectures and workshops for children, adolescents and parents.
    Filial Play Coaching for parents.

    What is the best way for people to contact you?
    They can contact me by email: psic.marisolcortes@gmail.com and by phone 917 375 308. In case you need more information my website is www.marisolcortes.com and facebook page www.facebook.com/marisolcortespsicologiainfantil

    January 2015