As children and adolescents grow, they continue to develop in so many very important ways. There are predictable ranges of cognitive, emotional, and social growth according to the age of a child and kids will experience shifts in their thinking, mood and behavioral patterns as they mature.
During these periods of growth, it can be difficult for families to know when a change reflects the normal challenges in child development or, rather, signs and symptoms of something that more significantly interferes with their child/teen’s happiness and functioning within the family, at school or with social connections. If a parent, family member, or a child/teen is questioning whether the problems they are facing fit within the range of normal development, they might seek consultation with a mental health practitioner who has specialized training and experience in working with families and pediatric populations.
Therapy and counseling services include initial assessments by qualified mental health professionals that can help define if there are problems that need attention and what type of services might be of assistance. The assessment is a getting-to-know each other period and a time when information is gathered about the child’s current problem or concern. Parents and caregivers are generally involved with this step of the process. A history of the problem is reviewed along with other information about the child/teen’s level of development. Parent and child/teen questions are also discussed at that time.
Following the initial assessment, the mental health professional discusses the interventions that are most likely to be a good fit toward addressing the areas of concern. Psychotherapy for children or teens allows families and kids to learn more about themselves, their strengths and their paths toward problem-solving about the obstacles in their lives. Therapy refers to a variety of methods that specially trained clinicians use to help children and adolescents who are experiencing difficulties with their emotions or behavior. Although several therapeutic methods exist in order to provide options about how to work with different types of problems, all psychotherapy involves communication and support toward health and development.
The goals of therapy will depend on the particular area being addressed and will be discussed at the beginning of the process. Therapy might be focused on emotional support during a difficult event or transition, resolution of conflicts with others, learning more about coping with feelings and upsets, building on strengths in order to solve problems, and/or experimenting with new ways to address old problems or patterns. The length of therapy depends on the complexity and severity of the problem.
Psychotherapy may involve an individual child, a group of children, a family, or multiple families. Methods used with children and teens might include playing games that teach coping concepts, drawing, building, writing, pretending, doing creative experiments in order to practice a skill; as well as talking in order to support the path of sharing feelings and resolving problems. The therapy environment promotes and supports a level of trust that can make it easier for children and teens to express themselves and to become willing to utilize therapy as a helpful tool.
Introducing the Idea of Therapy to Your Child or Teen
It can be difficult to know which type of services might be of benefit and how to talk about therapy services as a family. In our experience, it is a good idea to use the same tools that you might use to find another type of doctor or clinician. Talk to a variety of therapists about their training, experience, and areas of interest; ask other trusted professionals for referrals; and take time during initial meetings to get to know who is working with your child.
At times your child might come to you requesting to talk with a therapist or counselor. In other situations, it might be a parent, caregiver or teacher who might suggest therapy or counseling services as a path to solving a problem or addressing a concern. Either way, the child/teen is likely to have questions about therapy. It is best to answer their questions honestly and to also provide reassurance that if you do not know the answer to a question, you can ask the therapist together or find out ahead of time by calling the therapist. It is common for a therapist or counselor working with young children to have a separate meeting with parents/caregivers to begin the assessment process. This is the time when the therapist will review any questions and when the process of therapy can be reviewed in more detail so that the family can begin to understand what to expect.
Some common questions that a child or teen might have about therapy include:
- What is therapy and why do I have to go?
- Do I have to take tests or get a shot?
- Do I have to go because I did something wrong?
- Is something wrong with me?
- Do I have to tell the therapist everything and will they tell my parents or teachers?
- What if I do not know what to say?
- What if I do not like the therapist?
- Can I talk to someone about some problems that I am having without upsetting my family?
- What is confidential and what is not?
Things to Consider as you Search for a Therapist to work with your Child or Adolescent
A good fit between child/teen and the therapist assists the achievement of therapy goals. Many professionals claim to offer child/adolescent therapy, but it is up to you to choose a therapist who is best for your child. It is critical to review your questions and concerns with the therapist to increase communication about the goals and methods of therapy and to enhance the success of the visits.
It is common for parents/caregivers to request information about a therapist. Make sure your child’s therapist is trained in the most current, scientifically-based approaches to psychotherapy. There are a variety of mental health professionals that are trained to work with children and teens, but it is important to know about their training backgrounds and level of experience.
Mental health providers that work with children and teens include psychiatrists (M.D., D.O.), psychologists from traditional training programs (Ph.D.), and psychologists from more clinically-based programs (Psy.D.); as well as various other mental health providers, such as school psychologists (Ed.D. or M.Ed.), social workers (L.C.S.W.), licensed professional counselors (L.P.C.C./L.C.P.C.) or licensed marital-family therapists (L.M.F.T.). Each might be a good fit for your child depending on their experience with scientifically-based approaches and the needs of your child and family.
When selecting a mental health care provider, be certain that you understand the credentials of the professional rather than assuming someone has training and experience because they list themselves as a “psychotherapist” or “counselor.” It is wise to look for a licensed professional. A state license protects the public health and welfare through the regulation of that professional’s practice in the state. While it is not illegal for someone to hold him or herself out as an unlicensed mental health care provider, unlicensed providers may have not satisfied the same education and training requirements as a licensed professional. Unlicensed providers are not accountable through a board disciplinary action if you have reason to file a complaint. You may verify that someone practicing “unlicensed” has not had a license revoked by a state board. State licenses are earned by members of several types of mental health care providers including psychiatrists, psychologists, social workers, counselors and marital/family therapists.
Common Child and Adolescent Mental Health Issues
Children and adolescents receive mental health services for a variety of reasons. It is important to recognize that any problem needs to be considered in context with a child’s development. As children and adolescents grow, they are changing in a variety of ways. There are predictable ranges of cognitive, emotional, and social growth according to the age of a child and kids will experience shifts in their thinking, mood and behavioral patterns as they mature. During these periods of growth, it can be difficult for families to know when a change reflects the normal challenges in child development or, rather, signs and symptoms of something that more significantly interferes with their child/teen’s happiness, and/or functioning within their family, at school, or with social connections. Consulting a trained and licensed mental health professional who is experienced in working with children and teens can help shed light on the nature of the problem and help in providing options toward solutions.
Some child/adolescent areas that might be addressed by mental health services include:
- Developmental delay in speech, language, or toilet training
- Learning, attention, or social skill problems
- Behavioral problems (such as excessive anger, aggression, acting out, opposition at school or home)
- Peer problems, relationship difficulties
- Episodes of sadness, tearfulness, or irritability
- Difficulties with regulating mood
- Changes in appetite or sleep
- Social withdrawal or isolation
- Fearful behavior that results in avoidance or gets in the way of healthy development
- Obsessions or compulsions
- Experiencing bullying or bullying other children
- Excessive school absenteeism or tardiness
- Test anxiety
- Development of or an increase in physical complaints (such as headache, stomachache, or not feeling well) despite a normal physical exam by your doctor
- Management of a serious, acute, or chronic illness
- Signs of alcohol, drug, or other substance use (such as solvents or prescription drug abuse)
- Problems adjusting to transitions (following separation, divorce, or relocation)
- Bereavement issues
- Experiencing or witnessing a traumatic event including sexual, physical, or emotional abuse
- Signs of self-destructive behavior, such as head-banging, cutting, or extreme risk-taking
- Repeated thoughts of death, suicide, or losing a peer or loved one to suicide.
What Makes Good Child/ Adolescent Therapy?
There are several different types of mental health therapy approaches that are considered credible and evidence-based and have been shown to be effective for various kinds of presenting child/adolescent concerns. These therapy approaches include, but are not limited to: Cognitive-Behavioral; Interpersonal; Family-Systems; Dialectical Behavioral; Client -Centered; Group; Play; Psychoanalytic; and Milieu.
Research indicates that in addition to the therapy approach, the relationship with the therapist is key to successfully reaching therapy goals. Therapists best assist others when the therapist feels competent to handle the problems and concerns, when the therapist has enough experience to carry out treatment, and when there is a good fit between the child/adolescent/family and the therapist.
There are some common characteristics of helpful child/adolescent therapy. While not every therapist will be able to provide all characteristics of helpful therapy at all times, and no therapy comes with a guarantee; reviewing the areas below might assist the search for a good start to a therapeutic relationship:
- For child/adolescent work, the therapist will be be open to discussing how they might cultivate a relationship of comfort, trust, and good boundaries with the child/adolescent and the parents. A helpful therapist can usually engage a reluctant child. A good fit between child/adolescent and the therapist is not only about the therapist’s treatment approach or education or experience, but is also related to their ability to show their genuine interest in the child, willingness to listen and to understand the world as the child understands it, and a priority for supporting the child/adolescent in their communication of their feelings with their family.
- For child/adolescent work, the therapist, without blame or judgement to the child/adolescent or family, will support the child and the family to think through the problem at hand and to find specific ways to reach better health and development. The therapist will highlight the child’s strengths and will assist in the family’s understanding of the problem as an obstacle that needs functional strategies and solutions.
- For child/adolescent work, the therapist will regard the priority of the family system and will support the family as the primary structure of care for the child/adolescent. Therapy is temporary and a step in a process of building upon healthy development.
- For child/adolescent work, the therapy will address the cultural traditions and beliefs of the child/tee/family. Therapy will regard these areas during the development of therapy goals.
- A child/adolescent therapist will assist the child/adolescent and family to create support networks and to practice healthy patterns between therapy meetings.
Therapists who are trained and experienced with kid/teen populations are trained to communicate in a direct and creative fashion with children and with their families. If the child/adolescent or parent has questions or concerns about anything that happens during the therapy process, the therapist will be open to discussing questions or concerns.