Children Ages 4-12

Does my child need therapy?

If you’re considering therapy for your child, chances are you’re seeing behaviors or expressions of emotions that are causing you some concern. You may have noticed a change in your child’s temperament, seen worries grow, or observed problems with friends. Or perhaps a teacher has brought concerns to your attention. 

Some children express their distress through physical responses such as nail-biting, tummy aches, and headaches that can’t be explained by a visit to your family doctor.

The choice to consult a therapist is completely yours, but if you’ve noticed these behaviors or expressions becoming more frequent and intense, lasting for longer periods of time, and you feel the behaviors are not age-appropriate, you may consider consulting with a therapist as one option. Sometimes children grow out of certain behaviors over time; other times the behavior may signal a greater concern that may affect your child as time passes.

What should I tell my child about therapy?

If you believe therapy could be helpful to your child, you may want to explain the process to your child first. You might tell your child that you know there’s been something that’s been bothering him/her lately. You can explain that you’ve found someone who works with children and is an expert at helping kids with growing up. You may mention that the person has games, toys, and music, and say you’ve made an appointment for both of you to meet this person.

What happens in a child therapy session?

Child therapy differs from adult therapy in several ways. In child therapy, there will be less sitting and discussing feelings, and more interaction with a caring and knowledgeable adult therapist. The interactions may include warm conversation, play or art experiential activities, listening or singing along to music, playing games, or reading storybooks. The child therapist will be curious about your child’s interests, which will guide the therapy.

Since children often have difficulty expressing themselves in words, the child therapist will use the language that the child is most comfortable with - the language of childhood. This often includes movement and play. This is why your child will often respond to your questions about what happened in therapy with a remark such as, “We played.” Be assured that play is a rich source of information about your child and his or her concerns. The therapist will observe, notice, respond, and process with your child in order to address those concerns.

At times the therapist may direct the activity and suggest focusing on a particular feeling that has come up in the session; on other occasions, the child may be permitted to take charge of the activity. The therapist creates a safe and predictable space for the child to express feelings. The child begins to trust that his or her expressions are valued and an alliance is formed with the therapist. From this alliance, the child feels safe to notice and appreciate feelings, express those feelings without fear of recrimination, and make decisions about moving forward in ways that match what it is the child wants for his or her life.

What is trauma and how does the child therapist address trauma?

Events and circumstances in a child’s life are often beyond the control of the child. When we speak of trauma, we often think of child abuse and neglect, alcohol and drug use, domestic violence, accidents, and serious illnesses. But when there is a divorce, bullying, loss of a family member or pet, a move to a new home or city, troubles in school, or employment and financial concerns, the child may respond with fear, worry, anxiety, disappointment, and distress. The child may oversleep, or have sleepless nights. Some children express their feelings outwardly by misbehaving while others keep things inside. Any of these may be a sign of trauma.

A traumatized child needs four things in order to heal:

1. Safety – a child needs to feel freedom from harm, pain, and distress.

2. Predictability – a child needs, and responds to, routine, order, and schedules.

3. Mastery – a child feels better able to confront life’s challenges when he or she feels some control over situations. Drawing on existing strengths, and learning new ones, offers the child a sense of being the expert in his or her own life. 

4. Joy – a child yearns to play, explore the world, use his or her gifts to grow and enjoy life, and see the wonder around us all.

Child therapy focuses on these four needs of the child. The therapist first creates a safe and predictable environment, then helps the child to recognize and access skills and abilities that may have been hidden by the trouble that has come along. As a child relaxes into the security created, feels honored and valued, and begins to feel some control over life, he or she will regain the joy that is childhood.

What can I do at home to support the therapeutic process?
Parents and caregivers are integral members of the counseling process. Your therapist will view you as a major resource in work with your child, and the therapist may want to consult with you often in the process. This may take place in separate sessions, family sessions, short consultations as you stop by the center for your child’s session, via email, or through phone calls or texts.

In addition, use of the four principles above can be as helpful at home as in the counselor’s office. Here are just a few ways you might support the therapeutic process:

1. Safety – despite the distress you may also be feeling when facing a crisis at home, whatever you can do to create a safe space for your child will be key to his or her well being. Talk to your child and address fears and worries that come up, hold your child’s hand, give your child hugs and reminders that you are there, write your child a note, and tell your child he or she is loved and safe with you.

2. Predictability – children who are distressed are particularly in need of routine and order. As much as possible, keep the child’s schedule for meals, bedtime rituals, school, church, weekend activities, sports, and visits with family. This will help your child to understand that whatever trouble has appeared and caused differences, there are some things that your child can count on remaining the same. 

3. Mastery – one of the ways you can help your child through whatever is causing distress is to focus on your child’s strengths. Ask your child for his or her advice, focus on a particular quality or skill that your child possesses separate from any of the concerns you have. You might consult with your child about schedules, ideas for family outings, even what to prepare for dinner.

4. Joy – children love to play as play allows them to both escape troubles and address troubles in their own ways. You might ask your child what game might be fun for you to play together. Or begin with just a pile of blocks, a walk in the outdoors, or paper and markers, and see what happens. And importantly, allow your child to play alone in your presence. Without any demands made on the child, he or she can feel the safety of your relationship, and then become absorbed in a game, a book, a painting, a fantasy of his or her own creation.

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