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Psychotherapy for children and adoelscents refers to techniques used to help children who are experiencing difficulties with behavior, thinking and emotions. There are a number of different types of therapy, but each relies on the communication and the helping relationship between the child, the family and a therapist.
The child's parents or school teachers may observe the child exhibiting emotional, learning or behavior problems that interfere with his or her adjustment, success and self-esteem. It is normal for children and adolescents to go through short periods of unhappiness or difficulties with family, friends or school.
However, when problems are severe, or persist, it's time to get an assessment and professional help.
In other cases, problems may develop more slowly, and not in response to some distressing event. A psychological assessment will help you to judge the extent of the child's emotional or behavioral problems, the causes of those problems, and lead to recommendations regarding whether treatment is indicated, and if so what treatment is recommended. An assessment with a psychologist can help to clarify the situation, determine if professional assistance is needed, and develop a plan of action. Depending on the issues, services such as individual child therapy, family therapy and/or parent guidance, may be helpful. During an assessment, I will meet with you to discuss any concerns or worries you have about your child or adolescent. I will help you to form questions to be addressed by the assessment. I may also ask your permission to talk with others (e.g., teachers, previous therapists) who have information about your child's situation, or to observe your child in the school or at home. Next, your child will spend several sessions with me doing psychological tests. In the latter part of the assessment, I typically schedule a session with everyone in the family present, so we can see how your child acts in this environment. At the end of the assessment (usually within 4-6 weeks of the start), I will meet with you to discuss the results of your child's testing, and how they relate to your questions. I will provide you with a letter or a written report summarizing your child's assessment results. I will also meet with your child to let him/her know the assessment findings. Last, if you wish, I will meet with personnel at your child's school to explain the results. Many parents ask questions about their child ("Why is John so angry?", "Does my child have a learning disability?). Other questions have to do with a child's place in the family ("Why does Marie always get sick when we are having marital problems?") I never begin an assessment until you and I agree about the goals of the assessment. As part of the initial assessment, I will first determine whether there is a need for psychotherapy. If there is no such need, I will offer some guidance, and I will tell you that psychotherapy is not needed. A treatment recommendation will be based upon your child's current problems, history and environment. Psychological testing may be useful to pinpoint the nature of a child's emotional, behavior or learning problems, or to differentiate between different diagnostic possibilities to explain your child's problem. Therapeutic assessment is an innovative approach to psychological evaluation, which relies on collaboration between the assessor, client and family, as they work collaboratively to help clients and families re-conceptualize their lives and move forward in their healing. Assessment is used as a brief, focused psychotherapeutic intervention, either to get therapy moving in a positive direction. Benefits to clients include accelerated symptom change, increased hopefulness about their problems, improved self-esteem, increased satisfaction with assessment, and better compliance with treatment. In traditional assessment, psychological tests are used for diagnosis, treatment-planning, and treatment evaluation. The emphasis is on the collection of standardized data by an "expert", who compares this data to norms and conveys conclusions to the patient and/or to a treatment provider. In therapeutic assessment, psychological testing is more than just the collection of useful data. The goal is to make the assessment a positive and useful experience for the client, and to help create positive therapeutic changes for the client and to enhance the impact of future psychotherapy. For more information on therapeutic asssessment, click here.
The Assessment
Therapeutic Assessment
Treatment
Psychotherapy can help children and adolescents in a variety of ways. They receive emotional support, learn to understand and regulate (modulate, manage, control) their feelings, learn to resolve conflicts, and try out new solutions to old problems.
In younger children, playing, drawing, building and pretending, as well as talking and listening, are important ways of sharing feelings and resolving problems. By observing and interpreting the use that the child makes of these communication techniques, it is possible for the therapist to help the child understand some of their feelings and to come to terms with their environment.
Older children and adolescents prefer to explore their feelings and thoughts through verbal means.
The family is always involved in the treatment of a child. Parents receive guidance as to how to deal with the child's behavior, insight into the meaning of the child's problems, and a chance to explore their own feelings about the child's difficulties.
With an older adolescent, family involvement becomes an individualized issue; as teenagers are very sensitive to issues of privacy, and autonomy. Most often the family is seen, but less frequently than with a younger child or adolescent.
Treatment sessions last 50 minutes. The frequency and number of sessions needed depends on the child's needs, the complexity and severity of his or her problems, and the stresses experienced by the child and the family.
The trusting relationship that develops between me and your child or adolescent is very important. The patient must feel comfortable, safe and understood. This type of trusting environment makes it much easier for the child to express his or her thoughts and feelings and to use the therapy in a useful way. I work to develop trust, comfort, a feeling of safety with parents and families, as well as with the child or adolescent who is the identified patient. Before the first visit: Check your mental health benefits with your insurance company. I usually meet with the child's parents prior to the child's first visit. With an adolescent, it is often beneficial for the first visit to be with the adolescent alone or with the adolescent and the family. Make a list of your concerns and questions. I will then meet with your child once or twice to evaluate him or her, followed by a feedback/planning meeting with the parents. Several days before the child's first appointment, tell your child that he or she will be going to a psychologist (or feelings doctor, for a young child). I will help you to develop a more specific explanation for your child which is tailored to his or her developmental level and issues. Be honest with your child about the reasons for the visit. Again, I will help you to come up with age-appropriate ways to explain these reasons, if you are uncertain. Initially, your child may not want to go to a psychologist. You should ask your psychologist for suggestions about how to talk with your child about their feelings about going to the psychologist. After your child's visit: Some children will talk about their visit. Others, especially teens, may say very little. Don't push, criticize or cross examine. Psychologists usually meet with parents after the initial evaluation to discuss their impressions and recommendations. They may need more than one visit with the child, may need more input from you, or may recommend psychological testing. National Institutes of Mental Health: Child and Adolescent Mental HealthThe First Visit
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