By Gloria Gilbert, Ph.D., Child and Adolescent Psychologist, PCS Staff Psychologist
The decision of whether to bring your son or daughter to therapy can be a difficult one, as is the choice regarding which therapist would be the best fit for your child or teen. As a child/adolescent psychologist, I’d like to share my “process” of beginning therapy with a young person, in the hopes of “demystifying” that process and increasing parents’ comfort level and understanding of how therapy for kids “starts.”
I find it most helpful to have an initial session with just the parent(s) to obtain background information, to learn about the parents’ concerns for their child, and to identify what goals they might like for their child. The next session is then for the child to meet with me individually, where I explain what a psychologist is (e.g., “a Feelings Doctor”) and how I help children and teenagers. I also share about how, what the young person and I talk about, can be “private,” unless it involves anything about the child’s safety; in that case, we’d need to tell mom or dad or another adult. Then, depending on the age of the child, we might play a game or two to “break the ice.”
At this point, I usually give young people a choice about whether they’d like to tell me about themselves, or to allow me to go through a series of questions I have prepared (usually, kids prefer that I ask them questions). The questions start out “light,” including inquiries about what they like to do for fun, about their school and friends, and about their family. For younger children, I might ask them to draw a picture of their family as they tell me about family members. The questions also allow me to discover what in their lives makes them feel worried, scared, sad, and mad. The session closes with an invitation to bring mom or dad into the session. The child has the option to share about what we did and/or talked about. The goal of this first session is to allow the child and me to get to know each other, and for the child to have a positive first experience with therapy.
At the next session, I usually present an activity I have termed, “My Problems, Bothers, Worries, and Unhappy Memories Page.” From my own life, I draw pictures to represent some of the problems, bothers, worries, and unhappy memories that I experienced in childhood. The young person then has an opportunity to complete his/her own “Problems” page. I often find that children can identify as many “problems” as is their age. Next, I assist the child in identifying how each problem makes him/her feel; to rate each problem on a scale from 0 to 10, with 10 being the most bothersome; and to draw lines connecting problems to discover possible themes or patterns. I find this information to be so helpful in understanding, from the young person’s perspective, what are or have been the biggest challenges in his/her life. Often, children are interested in sharing their drawings with their parent(s), and I have been told by many parents how informative and helpful this information has been to them.
From there, I explain to the child how, when we have many things in our lives that bother us or cause us “yucky” feelings, those negative memories take up room in our brains, preventing us from being able to have good and happy feelings. My job is to help children learn to better cope with those negative memories or experiences, so that they can have more room in their brains for good and happy feelings.
Lastly, I assist the young person in identifying his/her own goals for therapy. While parents certainly can offer input into these goals, I feel it is critical that the goals be generated by the young person…if they are going to be coming for therapy on a regular basis, they need to have it be worth their while to work on issues that are important to them (not just what’s important to their parents)! Once a young person identifies his/her goals, these are shared with mom and/or dad, and a plan is made for the frequency of sessions and the estimated duration of treatment, as well as what kinds of therapy techniques might be used.
In sum, this process allows me to get to fully know the child, to understand his/her struggles, and to discover how the young person would like his/her life to be better. Often, this process can “open the door” toward improved communication and connection between child and parent(s) as well. It is always a privilege and honor to guide a young person through this process!
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