A Parents’ Guide to Mental/Behavioral Health Therapy for Children, Teens, and Young Adults
When a child starts therapy for mental/behavioral health, parents may have lots of questions. And it may be hard to know where to get answers. Over the years, we’ve heard parents ask many different kinds of questions and share various concerns about child and family therapy. If you are a parent who has a child, teen, or young adult in therapy, or you are considering therapy for your child, read on to learn how you can best support your child through the therapy process.
“How can I explain what therapy is to my young child?”
When introducing child and family therapy to a young child, it may help to explain that therapists are like doctors or dentists. You go to a doctor if your body is sick or hurt, or for physical check-ups, and you go to a dentist if you have a cavity, or need a dental check-up. Similarly, people go to therapists to work out strong feelings or difficult experiences. Therapists are ‘feelings experts’.
It may also help to explain that when kids go to therapy, they work through difficult experiences or strong feelings using play and the arts. They might draw, dance, or play games together with the therapist.
Know that your beliefs about therapy will likely affect your child’s perception of therapy. If you present child and family therapy as an exciting opportunity to learn and grow, your child will be more likely to see it that way, and more likely to want to give therapy a try.
“What can I expect at my child’s first appointment?”
Therapy begins with an intake process, where the therapist asks a lot of questions to get a complete picture of the child’s history, challenges, and strengths. The intake is also a chance for you to get to know the therapist and for the therapist and family to decide whether the relationship seems like a good fit.
If your child is young, the therapist may meet with parents/caregivers alone during the intake. With older children, tweens, and teens, the therapist may invite your child to participate and ask to spend some one-on-one time with your child. Young adults get to choose who participates in the intake process, and may invite a parent and/or another loved one if desired. Some therapists conduct two intakes to ensure that they have enough time to get a thorough history, and depending on the age of the child, they may designate the first intake session for parents/caregivers only.
Sometimes children may experience separation anxiety when invited to spend time in the therapy room alone with the therapist. If you have questions or concerns about this, ask your therapist about the best way to support your child with their anxiety before your child’s first meeting.
When young adults choose not to include parents or other loved ones in the therapy process, this may indicate that they feel like they need some time and space to get to know themselves on their own. You can ask your young adult child how you can best support them, and what they would like from you. Listen and and see what they have to say.
“What’s the difference between individual therapy and family therapy?”
In individual therapy, the client is the individual child, teen, or young adult. Parents are usually included, but the therapist spends most of their time one-on-one with the child. In family therapy, the entire family unit is the client. The therapist may have a few sessions solely with parents, a few sessions with both parents and children, and other times, sessions with just the children. Sometimes, they may split up a session and meet with different members of the family for different parts of the session.
Children can participate in individual therapy with one therapist and family therapy with another therapist at the same time, however if both types of therapy are long-term, that can be a lot to ask of a child. If your child’s struggles are deeply intertwined with family relationships and family dynamics, family therapy may be a good choice. On the other hand, if your child’s struggles tend to be more personal in nature or involve relationships with peers or others, individual therapy may be a good place to start. If you have more questions, don’t be afraid to ask when inquiring about services.
“I don’t understand why my child/teen/young adult needs therapy.”
Children, teens, and young adults sometimes ask their parents for therapy. Other times a teacher or other professional may recommend it. Parents may agree to send their child to therapy even though one or more parents/caregivers may not fully agree with the need for therapy.
Perhaps it seems that your child already has everything they need to succeed, and that they can work through their difficulties on their own. Alternatively, a request for therapy may cause you to worry that you haven’t done enough for your child, or spark confusion, anger, or frustration. If any of this is the case, know that you are not alone, and that a request for therapy isn’t an indicator of your child’s capabilities or your success as a parent.
Also know that sometimes children can benefit from extra support. Talking with a skilled therapist who is not a family member or friend, can help children, teens, and young adults feel more seen and heard, and feel more confident in themselves. Research shows treatment for mental health concerns is effective and saves lives.
Mental health wasn’t talked about as much years ago as it is now, because many more people considered mental heath concerns shameful. Over the years, mental health has become a bigger and bigger concern in the United States, with rising rates of youth depression, anxiety, and suicide. More than 50% of people in the U.S. will be diagnosed with a mental illness or disorder at some point in their lifetime.
“What is my role when my child is in therapy?”
Allowing your child/teen/young adult to do things and share things in confidence with a therapist will go a long way to helping them feel safe in the therapy room. It will help them open up in therapy and work through their challenges. Asking your child what they talked about or did during therapy may make them hesitant to share feelings and concerns with their therapist. If that happens, it’s much harder to make progress.
Ensuring that your child shows up consistently to therapy also helps the therapy process. When a child misses sessions a lot, it’s hard for them to form a trusting relationship with a therapist, and for the therapist to keep track of a child’s progress and stay on top of new developments in a child’s life. As a result, it’s more difficult for children to make progress on working towards their goals.
A lot can happen in just two weeks, especially for young people. That is why many therapists start with weekly therapy sessions.
If you have concerns about being able to come to therapy on a consistent basis, address these with your child’s therapist. There may be ways you or your child/teen/young adult can stay in touch with their therapist if needed while they are away.
Child and family therapists work with parents/caregivers as well as an individual child/teen/young adult. They recognize that in order for a child to be able to make changes, parents/caregivers have to be involved. They also know that turning 18 years old doesn’t necessarily mean that an individual can be fully independent, and that including parents in the therapy process is often helpful for young adults as well.
Child and family therapists often schedule parent check-ins, conduct parent sessions, and/or include parents at the beginning or end of therapy sessions with a child. They can help you recognize things you may be doing unintentionally that are perpetuating a child’s struggles.
For instance, parents often unintentionally protect children from things that cause them anxiety or fear. This doesn’t give children the chance to work through their anxiety or fear, and as a result, it tends to grow. A child and family therapist can help parents learn alternative ways to support their child with anxiety.
Child and family therapists can also help parents learn how to acknowledge and validate their child’s feelings. Strong feelings tend to be avoided in our culture. But we know that bottling up feelings isn’t healthy, and can lead to mental health concerns. Learning how to help a child feel their feelings and accept them goes a long way to helping them develop into healthy adults.
Sometimes parents feel like they need more support than their child’s therapist can provide, and want to work through their own emotional concerns so they can be more emotionally available for their child. Other times, parents might want to see a couples counselor to work out their relationship concerns so they can more effectively parent a child. If this is the case, your child’s therapist can refer you to a therapist who specializes in providing individual therapy or couples therapy to adults. Some therapists specialize in providing treatment to mothers or parents.
Feedback & Updates
Providing feedback to your child’s therapist about changes you observe in your child helps inform therapists’ understanding of how things are going. It also helps to keep your child’s therapist updated about recent events that might have impacted their mental health or wellbeing, and how your child seems to be responding to therapy.
Child and family therapists are usually open to receiving emails, calls, or voicemails with updates in between sessions. If you want to share an observation that you think might be important or feel like something isn’t working, talk to your child’s therapist about it. They can brainstorm different ways to approach the situation with you.
When a child receives individual therapy, your child’s therapist may not directly address your concerns with your child in session. This is because therapists providing individual therapy address what is important to the child. Often, parental concerns are concerns for children as well, and will end up being discussed in some way. But these concerns often get addressed from a different angle, based upon the child’s concerns.
“Why isn’t my child better yet?”
Therapy takes time. Many parents and clients wish this weren’t so. They want a quick fix. They want therapists to use regimented approaches, such as Cognitive Behavior Therapy, and teach children how to change their negative thinking, or how to modify their behavior in socially preferred ways. Know this: It’s often very difficult for therapists to use this kind of directive approach, especially with children, teens, and young adults, and especially in the early stages of therapy.
Why is this? For one, younger children are motivated to have fun, and to learn and grow through play and the arts. Talking through concerns often isn’t developmentally appropriate. And because teens and young adults are in developmental stages where they are defining their values and what’s important to them, it’s essential that child and family therapists follow their lead.
While you as a parent may see things you’d wish your child would change, they may not be on the same page as you about this, and may not be motivated to change those things right now. Child and family therapists start where the child is, listen to their goals, as well as parents’ goals, and help the child grow at their own pace. Pushing a parent’s agenda often backfires and makes it less likely the child will want to open up, seek help, and change.
Talk therapy and directive approaches like Cognitive Behavioral Therapy also may not be helpful (at least initially) when a client (of any age) is overwhelmed by emotion and is experiencing a fight/flight/freeze state or shut down. Strong emotions stored in the body often prevent people from using their “thinking brain,” and working through challenges logically. Once therapists help clients find a way to regulate their emotions, logical thinking becomes more possible. This often takes time. Suffice it to say, healing is usually not as simple as pulling oneself up by one’s bootstraps.
Therapy is a process. Just as an artist creates a painting, or a scientist tests a scientific theory, a therapist and their client engage in a process that includes observation, making decisions, taking action, integration of sensory information, asking questions, and solving problems. It is hard to say exactly how long this process will take because, just like with artwork and scientific theories, each client is unique and has their own challenges. Patience and openness to the process helps a client grow.
After therapy ends, and your child grows older and new challenges arise, they may want to return to therapy to do some more work. This does not mean that their previous therapy was unsuccessful. It means that they are ready to tackle new challenges, and perhaps dig deeper into their concerns.
“What should I do if my child doesn’t seem to enjoy therapy?”
Children may not like therapy for a variety of reasons. Here are a few things parents should know if they sense their child isn’t enjoying therapy:
Be certain that your child isn’t mistaking the intake meeting(s) with therapy. Intakes are not therapy sessions. They are a time for the therapist to ask a lot of questions and to collect information. If your child says they don’t like therapy because they didn’t like the intake, make sure they understand that therapy comes after the intake(s), and after the therapist has created a written treatment plan with you. Encourage your child to try at least 3 actual therapy sessions before they make up their mind.
Let your child know it is natural for therapy to feel awkward at first, and it will take time for the therapist and child to get to know each other. Provide feedback early on to the therapist if something is not feeling right to your child so the therapist can make adjustments if needed. For example, therapists may be able to make adjustments to the therapy setting, or what is done during therapy sessions (such as playing more games, doing more creative activities, moving more, talking less, etc.) to meet your child’s needs.
Ultimately, no one therapist can be the best fit for everyone. If you or your child have provided feedback to the therapist, some time has passed, and it still feels like your child needs another therapist, talk to your child’s therapist about it. They may be able to help you find someone else who better suits your child’s needs.
“I don’t want my child to receive a diagnosis, because I’m afraid that might affect their self-esteem.”
Diagnoses are necessary for insurance purposes, otherwise insurance won’t pay for services. If a family pays for therapy services privately, without insurance, diagnosis may not be required, but children/teens/young adults or parents may still find it helpful.
Receiving a diagnosis can sometimes provide a sense of relief. When a child and/or their parents feel like they’ve gained a better understanding of the challenges the child is experiencing, and learn things they can do to help the child manage or recover from their condition, it feels empowering.
A diagnosis can feel stigmatizing when other people, or society-at-large, paint a negative picture of mental health challenges, and children and parents internalize these messages and feel like there’s something wrong with them. This can lead to feelings of hopelessness, guilt, and/or shame. Children or parents may feel resentful. They may not not see the opportunities that lie ahead. If they’ve started therapy, they may want to stop therapy altogether.
At these times, it may be especially important to talk to a therapist who can help you and/or your child identify the “stories” you are telling yourselves about your situation, understand the facts, and shift your perspective. Underneath a diagnosis or the challenges your child experiences lies a strength or “superpower,” that can be harnessed to help them overcome difficulty and reach their goals. Therapists can support children and families with this process.
At Intuition Wellness Center, we specialize in health and wellness services for children, young adults, and their families. If you think you would like some extra support, we’re here for you.