Reflections on “Stealth Therapy” in Therapeutic Residential Care

ABSTRACT The therapist’s office can often be an intimidating space for children and adolescents, especially those in residential care who have experienced multiple traumas. This environment can block the therapeutic process and hinder a therapeutic alliance from forming between the clinician and the youth. Although unconventional, integrating the method of stealth therapy into the therapeutic work with children and adolescents has shown impressive results in building a stronger therapeutic bond and putting them at ease when discussing difficult topics. Stealth therapy involves the therapist meeting the youth where they are most comfortable and giving the youth space and time to adjust to the therapist’s presence. Allowing the youth to have some control over the situation gives them a sense of safety and security that they may not have ever experienced. Once the youth feel safe with the therapist, they are more likely to open up and discuss traumatic events. Therapists in Therapeutic Residential Care (TRC) traditionally felt guilty if they didn’t offer weekly formal psychotherapy to the youth with complex trauma that populate contemporary TRC. But the outpatient model of traditional psychotherapy meets the needs of a small portion of the youth in TRC. This paper describes an alternative model emphasizing creativity and flexibility in the therapeutic engagement of youth with complex trauma to more adequately meet their needs.