Play, in whatever form, is a child’s first language. Child therapy involves a combination of structured and unstructured play to help children feel comfortable and communicate their thoughts and feelings. Working with young children also involves careful attention to development and an awareness that skills progress at different times and rates for each person. As such, the first step in therapy is a thorough assessment of your child’s development and what, if anything, is causing them to not progress as expected. While the primary task of child therapy is to encourage healthy social-emotional development, in order to understand and express emotions and get along well with others, children need to develop language and thinking skills. In therapy, children will expand their feelings vocabulary, become more aware of the connection between their minds and bodies, and learn to regulate their emotions more effectively.
Parents bring children to therapy for many reasons. Sometimes, uneven development causes confusion and stress for children, parents and teachers. Sometimes, children struggle with more acute difficulties related to anxiety, emotion regulation, social skills or self-esteem. Children usually share their thoughts and feelings through play or art. For example, they may be more comfortable talking about an imaginary character’s experience rather than their own. Much symptom relief can be accomplished in psychotherapy through imaginary play. But this type of play has other benefits too. Playing interactively requires patience, perspective taking, understanding cause and effect and considering alternative outcomes. Each of these are skills that children also need to be successful academically and socially. Some children enjoy talking, but most are best able to focus and express themselves when their hands or bodies are busy while they talk.
At this age, most children still need to be busy while they talk. Some still prefer imaginary play. Others enjoy art or games. Children are more aware of why they are coming to psychotherapy, and they want a voice in establishing goals. Children need to be respected for the competencies that they have, while also keeping in mind that their cognitive and emotional development may be uneven and that they still need a lot of adult help and supervision. More time in therapy may be spent using motivational techniques to encourage children to establish goals and work toward them. Another focus may be building greater self-awareness and self-esteem so that they feel more confident and able to face the challenges of becoming a teenager.
How treatment begins for adolescents is especially important. Part of the task of adolescence is becoming more reliant on oneself and peers, and less interested in or motivated by what adults think. As such, for therapy to be successful, adolescents need to have a voice in choosing the therapist, modality, and goals. Once adolescents feel comfortable with a therapist, they often enjoy having a safe space to talk about their lives and their hopes for the future.
Parents still need to be involved in treatment, but how those boundaries are managed can be tricky. The adolescent’s individual therapist should communicate with parents periodically, but parent support that requires more frequent sessions or direct guidance is usually provided by a different therapist. In this case, a team approach is used to support the family so that the adolescent and their parents can each have the time and space they need to work towards shared goals.
Adults usually bring themselves to treatment, and thus often arrive with goals in mind. Sometimes, therapy has been tried before. Sometimes, it is the person’s first experience in psychotherapy. Whether an individual has been in therapy before or has arrived with a predetermined set of goals, the first task is determining whether the therapist is a good fit and breaking down goals into manageable parts. If changing a behavior pattern or life circumstance were so easy, then no one would need therapy. But, of course, change is hard because there is some reason we got stuck in our present circumstance and why we are not already doing something different. That is why the initial phase of therapy needs to be spent understanding how the individual came to this place, what has already been tried and why it has not been successful. Most empirically-validated treatment manuals are straightforward and easy to follow, but therapy is an art because the therapist needs to tailor the strategies to the individual. And we each need time to figure how we got stuck and experiment with what works for us.
Consultation services for teachers, administrators, counselors or parent groups can be provided individually or in groups across a range of topics, including: anxiety, emotion regulation, learning differences and behavior management.
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