Therapy for Children and Adolescents
Psychotherapies are interventions and techniques used by mental health professionals to assist children and teens who are experiencing emotional or behavioral difficulties. Therapy may involve parents, siblings or other significant people in a child’s life. The extent to which other people are involved is based on the child’s needs and a treatment plan that the therapist, parents, and child (if old enough) agree upon. Therapy may be used in conjunction with other services such as psychological testing, medication management, communication/work with teachers, speech and language therapists, etc.
When is therapy “right” for your child?
Most often a parent makes an appointment for their child to see a therapist when they or someone else (teacher, school counselor, pediatrician) have observed behaviors or emotions that are impacting their child in a negative or upsetting way. It is important that you tell your child/adolescent in advance of the appointment rather than telling them right before coming. Let him/her know that you will be with them and that they will be just talking and sharing. Going to a “doctor’s appointment” can mean having shots or other painful/scary procedures done. Make sure your child knows that nothing like that will happen at a therapist’s office.
What to expect in the first or initial appointment:
At the first appointment, the psychologist or therapist will meet with the child and the parent(s). They will ask questions regarding the reason for the appointment, as well as questions about the child’s family, school, social, behavior, development and medical history. It is important that the therapist have a comprehensive picture of the child in addition to the concerns shared by the parent in order to fully understand what the child’s needs are that can be served by attending therapy. This will lead to the development of a diagnosis and treatment plan that the therapist will share with you. Both the diagnosis and treatment plan may change and evolve during the course of therapy. If there are issues that a parent wants to discuss with the therapist without the child present, it is appropriate to let the therapist know at the beginning of the session that they would like a few moments to speak privately. The child must be present for the first session in order for the therapist to make a diagnosis and treatment plan.
Keep in mind that it is normal for both the child and parent to be “nervous” during the first session, especially if they have never been to a therapist before. It is okay to ask the therapist about their credentials (level of education, how long they have been in practice, etc.), their clinical orientation (theories and approaches a therapist uses in treatment) and any other pertinent questions. It is not unusual for younger children to ask personal questions and for adolescents to ask challenging ones. While the therapist may choose not to share details about his/her life, don’t be concerned if your child asks the questions.
At the end of the first appointment, if everyone agrees to work together and move forward, an initial plan of treatment will be made. The therapist may send home with the parent various checklists to complete and return at the next appointment, and may request that you gather various documents (previous evaluations, report cards, etc.) that may be helpful in understanding your child’s history. Future appointments may be scheduled at the end of your first appointment.
What happens in child psychotherapy?
While some children may talk about their feelings in therapy, their treatment plan will not be like an adult’s. Child therapists draw on a variety of techniques such as behavioral plans, role-playing to practice skills, creative art projects to encourage emotional expression, playing games that target a specific issue, and play therapy. A teenager may prefer talking while a younger child will be more likely to play. Emotions can be hard to understand or describe in words, so play therapy, picture journaling, and games can help a child to express his/her feelings while learning to identify and share them verbally. Each therapist has their own techniques that they use with children and adolescents.
Parents may or may not be a part of each session following the initial session, depending on the issues being addressed and the therapeutic needs of the child. The level of parent involvement is determined through assessment or needs that arise during treatment. If a parent has questions or information to share with the therapist, he/she is always welcome to be a part of the session.
Confidentiality is essential to help a child feel safe and the specifics of what a child says will generally remain private. This does not mean that secrets are kept between a child and a therapist. By law there are two issues which therapists must report to the appropriate authorities: possibly physical or sexual abuse, and any serious threat of suicide or harm to others.