Understanding the Clinician’s Perspective of Child Therapy & What Caregivers Can Expect
When you’re considering therapy for your child, you might be wondering “How will my child be engaged in therapy? How will I know if it works? Is this even something I should consider for my child?” If you have those questions (or others!), then you’ve come to the right place.
Working with children is a whole different world. Working with children in therapy requires creativity and adaptability and willingness to follow the child where they lead. Therapy for children looks a little different than therapy for adults. Oftentimes, young children can’t sit there and talk to the therapist for an hour–they’ll talk, sure, but that sort of back-and-forth conversation in what we typically associate with therapy is not going to be the best way to help them and meet them where they are at.
Below, you’ll find the biggest take home points I think about when working with children that I want parents/caregivers to know about the clinician’s role and what to expect during therapy.
- Utilizing the therapeutic space in the best way possible. Engaging a child in therapy will involve creativity on the part of the therapist and often won’t look like the traditional “talk therapy” we think about. When working with children–or really anyone–we meet the client where they are at. For a child, it will likely involve using the first few sessions to build rapport through basic emotion identification and getting a sense of what the child currently knows related to skill-building. This helps the client get used to the therapeutic space and to the clinician. Children also learn well through play. Games like Uno, Candyland, Pop-It, etc are all great ways for the clinician to engage the client in basic skill-building.
Utilizing the therapeutic space can also involve physical movement. Kids love to move around, and sometimes the therapy space has to accommodate that. This can look a lot of different ways. Games as simple as Simon Says and Freeze Dance teach autonomy, consequences, and reinforcement to following the rules. These games also allow the client to move around the space and let out energy, in which they can be thoughtful of following directions and with their body movements. Especially with younger children, using games and activities to help the child with the skills that they’re in therapy to build and learn, helps make the therapeutic space a welcoming and calm place to be. The therapist can also work with the items in the space to show a child who learns best visually or tactically how to think about different concepts that can help them both emotionally and behaviorally.
- Willingness to use the child’s own language. What do I mean by this? A lot of times, clinicians think in “big scary words” that don’t work well with kids. Try to explain “cognitive behavioral therapy” to a 5 year old; it doesn’t work so well! Children have fascinating ways of explaining their problems to us as clinicians, so something that often comes up in the therapy room that might also appear at home is the use of creative language or analogies that a kid uses to describe what they’re feeling. For example, if a child thinks of their brain as a “dinosaur” and that the “dinosaur comes out when they’re angry”, this is usually their way of telling us, the clinician, and you, the parent, that they have at least a surface level understanding of what they feel when they’re upset. Children have a way of thinking about themselves that works for them, so it is important to allow them to use what works. The clinician’s role with this can be to work with the child to discover and name their neutral self as well. Examples could include: butterfly, bird, turtle, etc (whatever the child comes up with that they can positively represent as their neutral selves). When they think of this other name for their regulated self, the therapist will create ways to use therapeutic skills that are easy for the child to remember and understand.
Parents/caregivers: this is something to consider as well at home. Using the skills and accompanying language at home and reminding the child how to regulate back to their neutral–butterfly, bird, etc–self will help with consistency that will foster growth with the therapy. This also shows them that you are understanding and learning and observing their behaviors in a way that can help them feel more heard outside of the therapy space.
- Knowing that progress is a marathon, not a sprint. Progress ebbs and flows. This is something I like to remind parents and caregivers (and myself) when working with children. A lot of the time, there is the expectation that therapy is going to make the problems go away or that things will improve immediately. The reality is a lot more complex. Therapy is very much about collaboration. There is collaboration between client and clinician. There is also collaboration between parent and clinician. Parents, we want to ensure that you are familiar with and understanding the skills that the client is learning in session. So for instance, if I am showing your child a particular skill that I want them to use in therapy, I will also make you aware of the skill and how to practice it at home with your child. I encourage use of the therapy skills outside of the therapy room as one of the best ways to see that consistency, just like with creative analogies as mentioned previously.
On this note, it is also important for you as the parent/caregiver to know that encouragement is key. If a child doesn’t use a particular skill in a difficult moment, that’s ok. We all have moments where we don’t react in the best way, but we can learn and move forward from those experiences. When I reflect on this with the client, I like to address the difficult experience (to share as much as they are comfortable), validate, and see if they can identify potential triggers or warning signs. Helping the client learn how to listen to their warning signs and process how they can do better will encourage growth. This leads me into my next point I will address below.
- Learning from each other. As much as clinicians teach the client skills in therapy, we are learning from the clients and so are you, the caregivers. I am a firm believer in “communication is everything”. Sometimes kids don’t like or even know how to verbalize what they’re feeling in a difficult moment. If you’re observing them and see, for instance, that their fists are clenched, express that. Tell them, “I see that your fists are clenched. What are you feeling right now? Would it be helpful to take a break?” Maybe they don’t realize it. Maybe they do. Either way, it is a good area to have a conversation with them about it to show that they have that support from you and are not going to necessarily get in trouble. They might become more open to coming to you first in the future!
- Modeling the skills. Often in therapy, a client needs to see modeled behaviors and verbalizations for something to be effective. In therapy, we do a lot of observations as clinicians like mentioned above. Within these observations, we have to think about how to use these skills ourselves. Along with the idea of learning from each other, what I will do to model a skill is verbalize how I’m going to use that skill. For example, I will notice how I feel and verbalize that in the most effective way possible. I might say, “I’m feeling tired today. I can tell because I’m yawning a lot. Let’s take a second for both of us to come back to the present moment.”
These two points really go together because with teaching comes modeling. Teaching these skills to both the client and the family is a core part of my methods as a therapist. As a parent/caregiver, you can use these techniques yourself in order to facilitate more consistent use with the clients. Something else that’s really important: if you are able to verbalize your own feelings (i.e. feeling tired) and what you need in that moment, it not only will show your child how other people use the skills but it will also allow them to see the validity of their feelings.
Final Thoughts
The idea of therapy for both caregivers and young clients can be really scary, but it doesn’t have to be! The clinician is here to help guide the client through the difficulties they are experiencing and collaborate with them to learn the skills to navigate difficult moments. The end goal might be that they won’t have to come back to therapy at some point in the future. Clinicians strive to get the client to a place where they can use their skills on their own and have an improved quality of life.
Parents, I applaud you for taking this next step on what can be a scary journey. I hope that learning these points will help ease some anxieties and concerns around seeking therapy for your child. We always want what’s best for our youth, and sometimes having a little bit of that extra support in the therapy space can make a big difference.