Therapy for Children
Children often begin therapy when they start to show emotions or behaviors
that are concerning to an adult in their life. This might be a parent or family
member, but might also be a teacher. A child may also ask their parent to speak
to a professional for help in dealing with difficult thoughts, feelings, or
problems that arise at home, in school, or with friends.
While every child is different, there are many common issues that can cause children to experience intense emotions and painful struggles in their lives. These might include:
- Anxiety/Worry - Concern about performance in school even when doing well, being afraid that something bad might happen to a loved one, a catastrophic event occurring, becoming ill, adjusting to the next grade in school.
- Social Difficulties - Problems making or keeping friends, being withdrawn, poor decision-making in a group, trouble reading subtle or non-verbal cues.
- Attention Problems - Being easily distracted, forgetfulness, losing things, disorganization, inability to complete a regular routine in a timely manner.
- Impulsivity - Controlling urges, not being able to stop themselves from doing something they know is inappropriate, being unable to think before acting.
- Sadness - Losing a loved one, coping with parental separation or divorce, adjusting after a move to another home and/or transition to a different school.
- Low Self-Esteem/Self-Confidence - Seeing themselves as not good enough, judging themselves harshly, comparing themselves negatively to others, overreliance on ways to escape problems, hesitance to try something new.
- Anger - Recurring conflicts with others, irritability, constant tension in family relationships, unwillingness to accept not getting their way, fighting with limits placed on electronics or other activities they enjoy.
THE FIRST SESSION
The first time we meet, I will meet with you and your child together. I will outline that the goal for our time together is to talk about what is and isn’t going so well in his or her life. We will then figure out what can be done to help.
Let’s face it - everybody has strengths and weaknesses, as well as successes and areas where you would like to do better. Having problems doesn’t make you different or bad, it just means you are normal. We will work together to help make things better, and it will likely mean that your child will learn new skills and ways of dealing with problems.
It is preferable for both parents to attend the first session, but it is not a necessity. If a parent wants to be involved in the therapy process but can’t make the session day and time, there is always the option of scheduling a phone call to discuss the issues we will address together. Email is also an option if connecting over the phone is difficult.
Depending on the age of your child and the preferences of all involved, the first session might be done with everyone together or certain people outside of the room for periods of time (either in the waiting area or just outside the office). Some children want the independence of talking about their own thoughts and feelings without their parent present, while others prefer that their parent does most of the talking the first time.
WHAT NOT TO DO
Getting the right support for your child is more likely to occur when your child has some ideas about the goals of therapy before they even come to my office. Being too vague, deceptive, or not saying anything at all until you arrive at an unfamiliar place can impact developing a beneficial rapport. It might also limit your child’s willingness to participate in the process of learning how to deal with problems in life. It is also not effective to threaten losing items or privileges if they don’t come.
Many children want to come in and learn better ways of dealing with the concerns they are having. Chances are, they understand that what they are doing isn’t working for them. Those who are more hesitant or don’t really understand therapy will benefit if the parents frame it as a place where you learn about yourself and the skills for dealing with your problems.
Explain that just like in school, where a teacher shows you how to do things like math, spelling, and reading; when you come to therapy, you will discover better ways of handling emotions, thoughts, and tricky situations. Those who are already involved in sports, music, art, drama, or similar activities usually transition easily into understanding how a therapist teaches techniques that help them become better in an area that is important to them.
If your child initially refuses to participate in the therapy process, significant improvements can still be made. Parents are encouraged to come in on their own to learn effective strategies and skills that can help your child when their issues arise. Some children will need more time to become ready to work on their problems, but tremendous healing can be done before then.
THE COURSE AND GOALS OF THERAPY
After we get a sense of what led to the current difficulties and the goals for going forward, we begin the techniques of Cognitive Behavioral Therapy (CBT). This type of therapy builds an understanding of how someone’s thoughts, feelings, and behaviors interact with each other. While thoughts and feelings are very difficult to control, you can learn how to change your reactions to them. This means your child will be ready to move towards the important outcomes they want.
During sessions, your child will develop the skills and techniques for dealing with strong emotions, troubling thoughts, and problematic behaviors in healthier ways. As well as strategies for handling difficult situations that occur at home, in school, or with friends. They will learn how to be responsible for their own actions, even when they are hard to stop.
Age-appropriate books about the area in which they are struggling, workbooks to use, and apps for practicing specific skills are often provided as “homework.” These help your child to continue developing their understanding of the problems he or she is facing and the best coping strategies to use. A specific action or goal after each session will be created. These aid in expanding your child’s use of and confidence in the skills they are learning in therapy.
THE ROLE OF PARENTS IN THEIR CHILD’S THERAPY
Parents have an extremely important role in therapy with their children. Finding the right balance between being supportive and allowing your child to have the space to grow and use their newly-emerging skills can be difficult. It’s important for parents to also be their child’s best role model in the areas where they struggle.
Depending on what is being worked on in therapy, parents may be invited into sessions to observe or participate. This allows parents to learn how they can assist their child in mastering the techniques and strategies being taught. Parents may also have their own sessions without the child present to receive an update and/or learn how they can better help their child. The goals and techniques that were covered may also be reviewed with parents at the end of their child’s session. You are always encouraged to provide information and feedback that can be helpful in working with your child.
In general, the younger the child, the more reliance there may be on parents. This will help set the stage for their child to make the desired gains. Older children may be asked to take on more responsibility for themselves as they strive towards achieving their goals. While parents have the right to confidentiality for their child, there may be some topics discussed that a child would not want their parents to know. When this occurs, clinical judgment and a cautious approach will be used to determine how to find an appropriate balance between a child’s need for privacy and their parents’ right to know about their care.
WORKING WITH SCHOOL
When issues arise for children at their school, ongoing collaboration with the staff is a crucial component of effective therapy. This can include:
- Collaborating with the school for your child to be observed in the classroom/building to assess the difficulties that are occurring.
- Incorporating systems to help your child with attention, hyperactivity, impulsivity, organization, memory, self-regulation, and other areas of executive functioning.
- Creating positive reinforcement opportunities during the day.
- Working with teachers and support staff on Functional Behavior Analysis and a Behavior Intervention Plan, if needed.
When coping skills for emotions such as anxiety, depression, and anger are being developed, teachers and school psychologists are kept in the loop and advised on how to further support your child as he or she begins to use these techniques.
Annual Review, 504 Plan, Committee on Preschool Special Education, and Committee on Special Education meetings can be attended by request.
FINAL THOUGHTS
As a parent it can be very painful when your child begins to exhibit signs that show they are struggling. Fortunately there are therapeutic techniques that can help children deal with their struggles and remain happy and healthy. If you have any questions, please reach out today.