Introduction

As art therapy becomes more common and integrates into the global education system, it is essential to understand the nature of the relationship between the parents of the student undergoing therapy, and the therapist. This article sheds light on an the aspect of the complexities involved in therapeutic work with adolescents at a critical stage of physical, emotional, and intellectual development (Erikson, 1968). This is in addition to the therapeutic aspects of working within an educational framework. One study addressed the perspective of the therapist regarding the school system and the parents, while the second study addressed the parental perspective on the therapist role and the school system.

This article was written within a framework of thinking about the philosophy and practice of multi-systemic work and within this, the position of the CAT within an educational system, with an emphasis on the parent–therapist relationship. It is an integration of two studies that were conducted simultaneously in two special education middle schools in Israel. The article describes the joint work in therapy within the special education system based on the authors’ many years of experience in this domain. The purpose of the article is to shed light on the relationship dynamics and the therapist’s perception of the client’s parents in the school, alongside the parents’ perception of their child’s therapist within the school framework.

Both researchers have worked for many years in the special education system and have collaborated with a variety of teams in a multidisciplinary framework, including the parents of the clients and, of course, the clients themselves. Over the years, the researchers have discovered the complexity and tension between all the factors that significantly impact therapy, the parents, and especially the emotional and academic functioning of the child. Raising awareness of the topic and its many aspects is crucial for the well-being of the child and the parent, allowing the school therapist the most professional scope of action. The writers have experience working with the Ministry of Education in Israel for many years, contributing to both integrative and special education school systems. They have provided therapy for adolescents dealing with various learning disorders, behavioural difficulties, and emotional challenges, while also offering consultation services to teachers and parents in diverse settings (Ministry of Education, 2003).

The nature of special education in Israel

In recent decades, most Western countries have begun to understand the importance of special education accommodations. In Israel, the Special Education Law was enacted in 1988. At the core of this law is the perception that students need special teaching materials and special methods for their learning to be effective, as without adaptations in teaching methods, students will not be able to learn the content and acquire the skills expected of their age group. The aim is to support them to access equal opportunities in their development. This will help them integrate into society and the workforce during their adult lives (Special Education Law, 1988).

There are many special education frameworks tailored to a variety of disabilities and developmental issues, ranging from preschool (age 3) to post-secondary settings (age 21). To receive placement in a special education framework, a psycho-didactic assessment is required. These are conducted by a clinical psychologist recognised by the healthcare system, in which a diagnosis and a recommendation for an appropriate educational framework is determined. It is important to note that parents are involved in the placement process; they are present during the discussion about their child and are an integral part of the process. Their own opinions and stance are very important (Ministry of Education, 2003).

Schools that integrate special education are characterised by multi-systemic work. This refers to teamwork that includes various professionals, each offering a distinct perspective and approach toward the student (client). This includes the homeroom teacher, counsellor, emotional therapist, teaching assistant, and subject-specific teachers from different fields. In the context of special education, multi-systemic meetings are held every few months. These meetings aim to provide a comprehensive pedagogical and emotional overview of each student. During these sessions, each team member shares their experiences and insights regarding their relationship with the student. The team collaborates to address questions such as: What are the objectives for this student?

Arts and creative therapy within the school framework

CAT is a therapeutic specialty that encompasses a variety of artistic and expressive methodologies: visual art therapy, movement therapy, drama therapy, psychodrama, bibliotherapy, and music therapy. All these therapies share a central, dual purpose of direct application of the expressive tool as a healing instrument, as well as indirect application in the form of psychotherapy. The aim of therapy is to improve the client’s emotional and physical functioning and overall well-being (McNiff, 2009). In recent decades, CAT ‎has begun to be integrated as part of the educational system within various frameworks all around the world (Abramovski & Fogel-Simhony, 2019). 

The goal of therapy in schools is to provide students with an expressive therapeutic space to gain strengths and tools to ease their adjustment and reduce emotional barriers, which will help them cope with personal, family, and social difficulties. Additionally, the goal of CAT in schools is to enable students to have a more meaningful engagement with learning and to experience a sense of competence, self-confidence, success, self-acceptance, and significance for their future adult lives (Ministry of Education, 2016).

Adolescents with learning disabilities (LDs) often experience their world in a state of disorder and lack of organisation; therefore, every encounter or conflict can be felt by them with very high intensity (Plotnik, 2008). As a result, they often encounter difficulties in their ability to express what they are experiencing in words. CAT utilises additional communicative and visual channels that can help them express their emotions and distress (Malchiodi, 2012). It is evident that CAT helps students explore their emotions, enhances their ability to identify problems and difficulties, and improves their capacity to share with the therapist –thereby deepening self-awareness and insight (Freilich & Shechtman, 2010). CAT empowers adolescents who experience challenges due to the numerous LDs they face and struggle to cope with. CAT provides adolescents with tools to connect with their creative side and thus deal with experiences and difficulties that cannot be expressed in any other therapeutic process (Isis et al., 2010). The integration of CAT in schools exists not only for adolescents with LDs but also for a variety of populations, including students with emotional and behavioural difficulties, among others. The therapeutic interventions address emotional and educational needs aimed at support, rehabilitation and hope through the creative tools (Nelson, 2010). Education systems around the world have recognised the importance of integrating CAT within schools and have begun to use therapy as an additional support source for children and youth (Snir & Regev, 2018).

The perspective of the parents of the student undergoing therapy

Parents of adolescents in special education schools often face significant emotional burdens, including burnout, fatigue, and a sense of lost control. These challenges stem from the demands of caring for their children, providing both educational and emotional support, setting boundaries, interacting with educational and therapeutic professionals, and more. At times, parents may have low expectations for children with learning disabilities and tend to convey their lack of academic expectations to them, which can impact the children’s evaluation of their own achievements (Oren, 2015).

Bowlby (1988) argues that the foundation for adult behaviour patterns lies in the nature and quality of attachment formed by infants and young children with their parents. As they grow and develop, these attachment patterns play a crucial role in shaping their personalities, becoming the foundation for their adult behaviours. The child’s attachment patterns with their parents are internalised and become traits of the child as they grow. This internalisation is reflected in their relationships, as children develop a ‘working model’ for communication with their parents, which influences their interactions with everyone around them. These models become deeply ingrained and eventually operate on an unconscious level in the child’s communication with their parents.

The awareness and understanding of the importance of involving parents in the therapeutic process for adolescents have increased in recent years against the backdrop of the understanding of the family unit’s formation, its roles, and the perception that parents contribute to the proper development of the adolescent, a contribution that will accompany them for many years (Cohen, 2017). Parents’ attitudes regarding the treatment of their child are directly related to their parental stance, both in terms of their perception of themselves as disciplinary and central figures in their child’s life and in their understanding of their involvement within their child’s therapeutic relationship (Oren, 2012). Lately, there has been acceptance and recognition of the importance of identifying parents’ attitudes toward the therapeutic process for their adolescent child within special education frameworks and beyond. Currently, the emphasis has been on expanding the interaction between the parents and adolescents with the educational and therapeutic professionals (Katznelson, 2014).

Good relations and communication between the parent and the therapist are important for the success of the treatment and understanding of the emotional and environmental world of the adolescent (Edwards et al., 2016). Within the framework of working in the school, how parents perceive and experience the therapeutic and educational professionals in terms of supportiveness, educational skills, presence and reliability is if great significance. In addition, the parent can receive support and assistance from the therapist throughout the adolescent’s therapeutic process, which is particularly evident during moments of crisis with the adolescent (Nisimov-Nahum, 2013). Another element in the therapist's relationship with the parents is related to the parental position. The parents’ experience of the therapist as critical and judgmental toward them may harm their perception of their status and self-esteem (Cohen, 2017; Ishay & Oren, 2006).

The therapist’s relationship with the parents of the student

Few studies have examined the parent’s perceptions of and desires and needs from the treatment and therapist (Edwards et al., 2016). There is now an understanding that for the child’s treatment to be effective, communication with, and involvement of, the parents is essential. Engaging the parent will enhance the functioning of all parties involved in the child’s welfare and advancement (Greenbank, 2016). In relation to the therapist’s relationship with the parent, the Israeli Ministry of Education states:

Maintaining continuous contact with the parents is part of the therapist’s involvement with the student. This contact should occur at defined points throughout the school year: at the beginning of the year, in the mid-year, and at the end of the year. (Ministry of Education, 2016. p.10)

One of the main components influencing the success of therapy and its progress is understanding the parents’ expectations and how they perceive the treatment offered to their child (Nock & Kazdin, 2001). Most parents who seek the help of a therapeutic professional expect them to listen and show understanding and empathy, as well as provide support, encouragement, and even closeness (Baldwin, 2014).

Sullivan (1953) argues that at the core of therapeutic work lies the human component, meaning the essence of therapy is in the interaction between two individuals within a relationship. Each individual has a unique attachment style, usually shaped during childhood, which impacts all subsequent relationships in their life. Since both the therapist and the parents share responsibility for the student, their relationship becomes a collaborative one, with both parties sharing a common goal: the student’s well-being. Each party brings their own internalised relationship patterns to the dynamic, alongside the influence of their specific role (as a parent or therapist).

In general, most parents’ expectations regarding the treatment of their child are directed towards the professionals themselves, their status, and their contribution to the therapeutic process. Parents place great importance on the therapist’s training and expertise; they expect them to be knowledgeable, experienced, and proficient in a variety of therapeutic theories and techniques that will contribute to the child’s progress, and provide tools for enhancing family functioning (Siklos & Kerns, 2006).

Previous studies on the relationship between school therapists and parents indicate that therapists find it very challenging to maintain regular contact and engage in periodic meetings with the parents of their child clients. Among the reasons for the lack of cooperation from parents are socioeconomic background and low parental functioning to begin with. Additionally, the fact that the treatment is provided within the school at no cost as part of the Special Education Law does not encourage investment on the part of the parents (Snir et al., 2018).

Another challenge of the therapist’s work stems from the complexity of their integration, working according to therapeutic principles while operating within the educational system, which has different and sometimes conflicting principles. This integration is accompanied by the therapist’s struggle with the system in which they work (Fogel-Simhony, 2021). It is important to note that the therapist plays a central role in the nature of the relationship and communication with the parents, which is reflected in the therapist’s personality, the perception of their professional identity, and their professional experience (Abramovski, 2020a).

Methodology

Research method

This qualitative study included an attempt to understand the research subject from the perspective of the participants. The purpose was to understand their worldviews and thoughts. Qualitative research claims that phenomena can only be understood in the context of the time and place in which they occur. Such a study enables a unique understanding of the studied phenomenon and its complexity (Denzin & Lincoln, 2011).

This study used a grounded theory aimed at facilitating the process of identifying and integrating themes and categories from the data gathered, and the latter in turn helped understand the meaning of the data and develop new theories (Sabar Ben-Yehoshua, 2016). Grounded theories help conceptualise social patterns that arise from the research and that can be affiliated with a time, place and population (Denzin, 1983).

Recruitment of participants and research ethics approval

The participants were drawn from two groups: one group consisted of 18 parents of children in middle school (grades 7–10) who had been diagnosed with learning disabilities, studied in a special education setting at a large school in Israel, and had been receiving CAT for at least one year. The second group consisted of eleven CAT therapists who were working in special education in a middle school, with at least one year of experience. 

The recruitment of participants was conducted simultaneously by both researchers. For the group of parents, the school principal was approached to obtain approval to conduct the research, in accordance with procedures and accepted ethical principles. After receiving all the necessary approvals, the homeroom teachers were asked to identify parents who met the research criteria. The teachers assisted in locating suitable parents, explained the nature of the study to them, and obtained their initial consent to participate. After receiving the parents’ approval, the researcher contacted the candidates for interviews.

For the therapist group, the recruitment process was different. The sampling method was non-probable sampling of the snowball type. Each interviewee recommended another staff member suitable for an interview on the research topic. The sample consisted of eleven expressive and creative therapists specialising in various mediums, each with a minimum of one year of experience in the same school. The selection of participants was intentional to ensure a diverse representation of therapeutic approaches and a broad geographic distribution across the country. All interviewees who expressed willingness to participate signed an informed consent form.

Participants in each group received an explanation of the research purposes and assurance of full confidentiality with regard to revealing their personally identifiable information.

Research tool

This study utilised semi-structured in-depth interviews: in-depth interviews are a study’s major source of knowledge (Glaser & Strauss, 2017). The purpose of the interviews was to understand people’s experiences and the meaning they attributed to these experiences (Shkedi, 2003). The interviews provided access to the cultural context of human behaviour and provided a way of understanding the meaning of this behaviour (Knox & Burkard, 2009). Semi-structured in-depth interviews are characterised by a flexible and dynamic structure, where the course of the interview and its nature depend on the trust and contact formed between the interviewer and the interviewee as well as on the interaction formed throughout the interview (Schwartz & Jacobs, 1979). 

Each interview lasted between one and two hours and was based on an interview guide. The interview guides focused on a range of topics related to the perceptions and expectations of parents of adolescents receiving CAT in a special education school, as well as topics related to therapists’ perceptions of their relationships with parents within the educational system. The main topics addressed in the semi-structured interviews included: perceptions, prejudices, involvement, relationship with the therapist, parameters for therapy success, setting therapeutic goals, guidance, and more. The interview guides were constructed based on a relevant literature review in the field. After the interview the contents were transcribed for the purpose of their analysis. 

Data analysis

The interviews were analysed based on the principles of grounded theory in order to identify and define main ideas, categories, themes, and sub-themes (Charmaz, 2006). The data analysis process was based on the three stages defined by Strauss and Corbin (1990). In the first stage, the transcripts of the interviews were read several times, first for initial familiarisation with the text and to note central themes (Agar, 1980). In the second stage, axial analysis was performed to find most of the categories that arose from the interviews as a whole. In the third stage, selective encoding was performed and the story of the studied phenomenon was constructed. Later, another reading was carried out to organise and link the main themes, and to create a sequential structure between the categories (Sabar Ben-Yehoshua, 2016). 

Findings

The nature of therapeutic work within the educational framework is fundamentally different compared to a therapeutic setting in the community. Due to the integration of therapy and education, the therapist faces various challenges. This section will discuss the unique nature of the therapist’s relationships in their work with the school’s educational staff as well as the nature of the relationship between the therapist and the parents of the client within the educational framework.

The findings present two themes reflecting the therapist’s perspective and three themes from the parents’ perspectives.

CAT therapists’ perceptions

Therapists noted that the integration of therapy within a school, which is primarily an educational rather than therapeutic setting, significantly impacts how they fulfil their role. For example, one respondent said, “Therapy within a school has a different nature. It’s a different kind of therapy compared to private practice. The therapist must be flexible and open to teamwork”. Therapists reported that the nature of their role and their interactions with the primary groups – students (clients), parents, and the educational staff – often present them with professional dilemmas. For example, “I find myself between my client and the system, which requires concrete things from me, and I understand them. I need to be able to see both sides. I try to remain flexible and make adjustments...”.

The relationship between the therapist and the student’s parent, is influenced by the unique setting. Meetings with the client’s parents require the cooperation of three parties: parents, therapist, and the school system. Therapists highlighted the difficulty and complexity of their relationships with parents, particularly the lack of availability for meetings. For example, “It’s very hard to work with parents in a school setting, and I didn’t realise this before. They work in the morning and aren’t available for meetings with me, and they don’t take the therapy seriously at all.” A minority of therapists mentioned that the educational framework complicates their ability to hold meetings with parents. For example, “Unfortunately, within the Ministry of Education, I don’t have a mandate to work with parents. There is great frustration. I’m allotted only 2–3 meetings for the entire year, and it’s impossible to conduct in-depth therapy this way.”

Parents’ perceptions of the CAT therapist

Parents expressed a fundamental need for consistent communication, trust, and a strong connection with the therapist. For example, “I expect my daughter’s therapist to see the good in her, to allow her to open up, to build trust, to foster a warm and honest relationship, and to ensure my daughter feels good in this space and connection”. Another aspect of their expectations relates to the therapist’s communication with the parents. One parent responded:

It’s important to me that the therapist is communicative, that they care to hear all the details, provide us with tools, understand our difficulties, and suggest ways and solutions for handling specific challenges. Overall, I’ve had a positive experience with therapists. They offer a perspective I don’t always see, and in general, they provide significant contribution and help in our lives.

In addition to the parents’ expectations of the therapist, there are also expectations stemming from the professional tools that are part of the essence of the role. The study found that most parents were unaware of the formal definition of the role of the CAT therapist within the school, their qualifications, professional background, and therapeutic experience. Responses included: “Isn’t he a psychologist?”, “Kind of like a counsellor?”, “I was too embarrassed to ask, it felt awkward...”. Parents expressed a desire to know more about the therapist’s qualifications, with one parent responding:

It’s important for me to know who is treating my son, what their qualifications are, what they studied, what their education is. Do they have experience with this type of population? Do they also work in the private sector? The more I know about their professional background, the more I might be able to trust them.

Most parents expressed high expectations regarding the CAT therapy provided in school, emphasising the unique value and importance of integrating therapy within the educational environment. One parent stated:

My expectation from the school-based therapy is for it to definitely be part of the overall support system for my child... Academically, the school provides a very good structure, but my expectation from the CAT therapy is that it addresses social and emotional difficulties as well. My child struggles with verbal expression, let alone expressing emotions. I want the therapy to help my child connect with themselves, to support them in understanding social situations, and to strengthen their self-confidence.

Discussion

This article aims to present the challenges faced by CAT therapists working within an educational system. The school has full authority in decisions regarding treatment: it selects the therapist, navigates the treatment goals, and its approach to therapy is educational, based on pedagogical/educational objectives rather than therapeutic ones. The purpose of therapy in school is to improve the student’s capacity for learning. This creates a conflict between a purely therapeutic approach and an educational perspective that views therapy as a tool for improving academic success. In other words, in this case, the therapy does not fully reflect the parents’ perception of the purpose of treatment.

The declared goal of school-based therapy is to enable the student to focus on learning by addressing their emotional difficulties (Ministry of Education, 2016). The setting in which the therapy takes place significantly influences the nature of the therapy and the therapeutic framework, especially in the context of a school. There are substantial differences between therapy conducted within a school environment and therapy conducted privately in a community setting.

In school-based therapy, many individuals are involved, starting from the referral to therapy, including the school principal, the school counsellor, and the homeroom teacher. The complexity of the therapist’s role is evident in the dual responsibilities they carry. On the one hand, they must provide school personnel (parents, teachers, counsellors, and other involved staff members) with a broader perspective on the factors affecting the child’s life. On the other hand, they must help parents recognise not only external or behavioural changes (if such changes occur) but also the internal shifts happening in the child’s inner world.

The therapist’s perception of their role within the unique structure of the school system reflects the intricate dynamics of the triangular relationship between teacher, parent, and therapist (Snir et al., 2018). It is evident that there is often a lack of understanding and awareness within the educational system regarding the importance of the relationship between the parent and the therapist. In times of a child’s distress (whether behavioural, emotional, or academic), the initial contact is usually made between the homeroom teacher and the parent. The complexity increases when the therapist becomes involved, potentially creating a disconnect between the therapist, the parent, and the teacher.

At times, parents may prefer to adopt the teacher’s perspective because it is generally more familiar and understandable to them. The different gap between the teacher, therapist, and parent often leads to a division among the different parties, causing the parent to rely more on the teacher than the therapist, thus adopting a more educational approach rather than a therapeutic one.

The therapist, as a member of the school staff, offers the parent and the educational team additional perspectives that contribute to a more comprehensive understanding of the child’s functioning. There is significant importance in working within a systemic framework, understanding the diverse perspectives of the parents, the student, and the school staff, which ultimately supports the well-being of the child and the parents (Connor & Cavendish, 2018; Plotnik, 2013).

The therapist must be aware that the parent’s interactions with educational and therapeutic staff may provoke a wide range of emotions, potentially leading to various reactions that may impact both the parent and the child within the school system (Plotnik, 2008; Snir et al., 2018). In these cases, having a therapeutic figure in the school is crucial – someone who can support the parent according to their understanding and acceptance of their child’s difficulties. The therapist can significantly contribute to the child’s integration into the school and, subsequently, to the parent’s involvement in the therapeutic process.

However, due to a lack of understanding, the school system often does not allocate enough time or resources to allow therapists to meet regularly with the parents to communicate the therapeutic work. This is despite the fact that parents seek knowledge, tools, empathy, and understanding from their child’s therapist (Baldwin, 2014). In reality, there are very few opportunities for therapists and parents to meet because key decision-makers often fail to fully grasp the importance of therapy and collaboration with parents.

Part of the complexity of the therapist’s role is related to the characteristics of the educational setting to which they belong, as there is often a lack of shared understanding regarding the nature of the therapist’s work, both from a systemic perspective and in relation to the student-patient (Fogel-Simhony, 2021). The involvement of parents in their child’s treatment adds further complexity, and therapists often see parents as additional clients alongside the student (Abramovski, 2020a). There are different approaches to parental involvement in a child’s treatment; therefore, it is essential for the therapist to identify which approach and style of involvement is appropriate for themself, as well as those of the client’s parents (Abramovski, 2020b).

It is important to recognise that during meetings with educational or therapeutic personnel at the school, parents are compelled to expose their private lives (personal, marital, and even familial), thus becoming ‘the clients’ – the focus of attention – often against their will. This exposure is not their choice and is not entirely within their control. Sometimes, parents themselves struggle to cope with their child’s issues, and this difficulty can exacerbate other existing tensions between the parents, which can place the therapist in a position akin to family therapist (Cohen, 2017). All of these factors can create a sense of tension among parents, leading them to perceive the therapist as judgmental towards them.

In the therapist’s meeting with the parents within the school setting, the therapist must be aware of the parents’ interaction with other personnel within the educational environment. The therapist gives space to the parental voice, highlighting and empowering it in contrast to the educational system, which often focuses on the child and their difficulties. In situations of conflict, the therapist frequently acts as a parental figure for the distressed parent. In such cases, the parent seeks a parental voice that will comfort them. The therapist’s role in these situations is to mediate and express the parental voice.

Literature describes this type of encounter as raising the ‘ghosts’ of the parent’s childhood (Fraiberg, 1980). It can often uncover traumatic events, difficult experiences, and occurrences from the parent’s past where they felt threatened by authority figures. These issues can affect the parent’s involvement in treatment and, consequently, their level of satisfaction with the therapy. Moreover, the therapist’s role is to help the parent develop a dialogue between the parental part that identifies with the school voice and their ability to speak emotionally about their own difficulties.

It is evident that in many situations, the parent feels more comfortable reaching out to a therapist who provides a listening ear and a supportive shoulder. Thus, the therapist is not only there for the child but also for the parent, who sometimes feels helpless due to the conflict between their desire to protect and help their child succeed and their mature, rational understanding of the complex situation within the system (Oren, 2012).

Undoubtedly, the introduction of a therapeutic figure into the educational system is a positive contribution for both the child and the parent. The opportunity for emotional discourse within the educational framework significantly benefits the development of all educational and parental stakeholders. Therapists must emphasise the importance of the parental perspective and encourage parents to attend meetings. Despite the therapist’s desire to connect with the parents, there is mutual difficulty for both parties in scheduling appointments and maintaining ongoing communication. From the therapist's perspective, there are several challenges: technical difficulties such as coordinating appointments during what are effectively the parents' working hours, and a more professional difficulty that comes from their specific approach to therapy. Parents also have similar difficulties, both technically and emotionally (Belity, 2021).

In the meeting between the therapist and the parent, valuable information can be gathered regarding the parent’s ability to engage in treatment and be involved in the therapeutic process. Additionally, the therapist can assess the parent’s strengths, including their capacity for mentalisation, communication patterns, and primary attachment styles. All of these factors enable the therapist to gain a comprehensive understanding that cannot be obtained simply from reading the personal file, accompanying reports, or through phone conversations.

Understanding what CAT therapy is and the parents’ self-perception as significant figures in their child’s life and therapeutic process is crucial for parental involvement in treatment (Oren, 2015). Parents’ perceptions of their children’s emotional therapy and their prior experiences with emotional treatments are generally positive regarding their child’s participation in CAT therapy. Factors influencing parental perception of the benefits of seeking help and engaging in emotional therapy include the parent’s recognition of their own difficulties and their child’s challenges, acceptance of the need for help, and their view of the relationship with the treatment providers (Tapp et al., 2018). Parents who have previously interacted with the therapeutic system in its various forms tend to feel satisfied with the therapeutic process and their encounters with the therapist. This satisfaction positively influences their perception of therapy and the therapist. Consequently, parents with a positive outlook on treatment are more likely to cooperate and be actively involved in therapy occurring within the school setting (Abramovski, 2020b).

Positive parental perceptions of the CAT therapists’ skills and training are crucial for engaging them in supporting the treatment process. Most of the parents’ expectations regarding therapy are directed toward the therapists themselves, their status, and their contribution to the therapeutic process (Baldwin, 2014). Parents want the therapist to possess extensive knowledge, significant professional experience, and expertise in the specific disability they are treating. Another key point relates to parents’ expectations for maximum information from the therapist to alleviate the uncertainty they are experiencing (Ingber, 2004). In the complexity of therapy within the school setting, the more a parent perceives the therapist as knowledgeable and professional, the lower their stress levels will be, making them more willing to ‘entrust’ their child to the therapist’s care.

A parent who has not met with the therapist and is unaware of the benefits of therapy may experience unconscious resistance or conflict regarding the child’s relationship with the therapist, which could distance them from involvement in the treatment. For instance, a parent may not encourage their child to attend a session if the child expresses even slight resistance to therapy. Additionally, if a parent does not establish a positive connection with the therapist or feels that the therapist is not sufficiently engaged with them, these factors can lead the parent to diminish the importance of the treatment. They might even contradict the therapist’s opinions or express their views about the therapist in front of the child (Abramovski, 2020a).

In terms of therapy within the school framework, there is a significant lack of awareness among parents regarding the unique meaning of therapeutic work within schools. For most parents, the integration of emotional therapy within an educational and pedagogical framework is unfamiliar. There seems to be confusion surrounding parents’ understanding of the role of therapy and the therapist’s function in the school setting. This raises the question of how well parents are aware of and comprehend the unique platform of therapy within the school system. Moreover, does the parents’ knowing and understanding that therapy occurs within the school influence their expectations for the treatment? 

While parents often prefer therapy within the school due to the collaborative nature of the work, they miss the personal and direct communication with the therapist. Professional literature emphasises the importance of establishing a relationship with the therapist from the early stages of treatment (Ellis et al., 2010). Support and guidance within the school setting increase the likelihood of parent cooperation. In this framework, parents can gain a broader perspective on their child’s functioning and raise questions and issues that arise from any emotional or functional gaps manifested at home or in school, and vice versa.

In summary, the CAT therapist working within the education system operates in the space between the adolescent (the client), their parents, and the educational system. Their role requires them to engage all three parties as clients, which necessitates a high degree of creativity in navigating the various stakeholders, as well as integrating theories from psychotherapy with systemic theories. Emphasising the connections between the adolescent, their parents, and the educational environment allows the therapist to employ a variety of therapeutic interventions and foster a collaborative multi-systemic approach. This invites parents to be active participants in the process, ultimately helping them see themselves as engaged in and significant contributors to their child’s therapeutic journey (Snir et al., 2018). 

The staff in special education schools, along with the therapists working there, learn through collaborative practice about the complexities of the intersection between education and therapy, as well as the differences and nuances between the fields. They utilise the unique advantages of having a therapist embedded within the school to best serve the needs of the client (Fogel-Simhony, 2021).

Parental involvement in therapy is an essential component of the creative arts therapist’s work in special education settings, directly influencing the therapeutic process and the child’s well-being (Oren, 2015). The therapist’s work within the school setting with parents raises and sharpens the question of parental involvement in adolescent therapy. This issue can be addressed from two perspectives: one concerns the developmental aspects of adolescence, where the adolescent navigates processes of separation within their relationship with the parent, bringing up the question of parental involvement in therapy. Under the influence of cultural perceptions of parenting, each parent perceives their involvement differently, resulting in varying levels of parental engagement in the therapeutic process.

Conversely, the parent, who is also a client in this situation, must navigate emotional aspects, including their feelings about personal exposure, their experiences and perceptions of emotional therapy, as well as functional aspects, such as their parenting patterns and coping with their child’s challenges (Tamir & Regev, 2021). Metaphorically and dynamically, it appears that both parties – the therapist and the parent – stand on opposite sides of the divide, striving to navigate their way toward a common goal. The educational system and the child are positioned in between, with the adolescent serving as the connecting element, while the school provides the framework for all interactions.

Recommendations 

• It is important that an understanding of the role of the therapist be incorporated into the training of special education managers and teachers. Understanding what emotional therapy is and how the staff can benefit from the therapist will enhance educational processes.

• The school system, and the therapist in particular, should mediate the complexity present in the relationship between therapy and education to the parents, thereby providing greater significance to the therapeutic process their child is undergoing. This is to ensure that the parent becomes more involved in their child’s therapy, encouraging and supporting the success of the therapy. 

In order to make it easier for the parents, meetings between the therapist and the parents should be scheduled for the day that parents have their semester meeting with the teachers. The first meeting, at the beginning of the year, is critical in order to have an intake for the client and to lay the ground for continued cooperation. In this meeting the therapist should introduce themself to the parents, explain their role and professional background, and define the goals of the therapy developed in consultation with the school and the client. The therapist should also identify parental expectations regarding the nature of the relationship and future communication, to get an impression from the characteristics of the parent’s communication and their expectations of the meetings that will be held throughout the year.