Child Therapy

Working with children is different.

When people think of therapy, they imagine sitting in a comfortable chair across from a kind person who asks them direct questions about their current struggle. What’s wrong? When did it start? Did you notice that anything makes it worse or better? What have you tried so far? Are the people in your life supportive? Any recent stress or trauma?

As you can imagine this approach is virtually impossible with children!

Children are not miniature adults.

What child says to their parent, “Mommy, I’ve been feeling anxious and unsettled. Third grade is harder than I thought. I’ve been trying to do my deep breathing, but my friend Jill interrupts me every time. My math lesson is taught way too fast. I don’t know what to do. Perhaps I need therapy.”  

Sounds absurd, even comical!

Children don’t know why they are upset.

Children do tell us something is wrong through tears, hitting a sibling, clinging to us, screaming, refusing to do homework, or being unable to sleep over at a friend’s house.

They might even have an idea of what the cause of the upset is – my brother rearranged my doll house people! But what they can’t tell us are the deeper reasons they are crying so often, scared all the time, or so quick to anger.   

So…how are children treated in therapy?

Children get better when they have a safe space to express their emotions. The language of a child is play. Through their play they “talk” to a therapist who speaks “child.”  

An 8-year-old boy I’ll call Tom came for play therapy due to anxiety. In his play, he often created scenes with Playmobil toys that were scary. I remember one session where the family home was invaded by a robber, and mom and kids were terrified.  

Tom was unable to resolve this scene in his play – he was stuck in the terror of the scene. I altered the scene by having mom call the police, who arrived on time, arrested the bad guy, made sure mom was ok and that everyone was safe.

This session contained Tom’s anxiety and also showed him that there are real world solutions to scary situations – and that help is just a phone call away.

Play Therapy alone won’t fix everything.

There are always things going on in the environment that are affecting the child. Without meaning to, and out of great love, many parents make mistakes that keep the problem humming along. 

In Tom’s case, when he was afraid to go play at a friend’s house, his Mom was worried about him. She made sure to pack his favorite toys, telling him she would be just five minutes away at the grocery store when he was playing, and that he could text her if he felt bad.

Although she meant well, all that preparation gave Tom the message that he probably would get anxious and would not be able to handle it. He lasted about 15 minutes at the friend’s house before he became very distressed and called Mom who took him right home.

So Mom needed some coaching on a different way to handle a situation like this so that Tom would be able to enjoy his play date, and she could relax. Eventually, we got there.

Treatment needs to address as many causes as possible.

Typically, parents need some coaching on how they are parenting. Sometimes parents are just as anxious as their anxious child, or just as angry as their angry child. When that’s the case I treat the parent as well; sometimes I treat the parent and child together if we are learning new coping skills like long deep breathing or how to relax our muscles.  

A mom I’ll call Barbara was very stressed – her son John had a severe medical problem that caused frequent migraines. Her other two kids were deeply affected by John’s migraines which upset the whole household every time they happened. 

In addition to helping mom learn how to set limits on naughty behavior, I taught them long deep breathing. All four of us laid on my office floor, put stuffed animals on our bellies, and learned how to breathe from deep in our core. All three kids loved it, and the whole family benefitted.  

If we can’t address everything together, I will create a treatment team.

Sometimes a child needs more support at school, so the school counselor or principal can become part of the team. If we need an occupational therapist, we will add one. Other times we can get a coach on board to help as well.

If a parent is really struggling, I may suggest individual therapy for the parent. In some instances, I may refer you and your child for a medical evaluation as well.

These other therapists can become part of a coordinated team to help a child, his/her parents, and the entire family.