How to Prepare for and Support your Child in Therapy

Authors: Christina Leggett and Thania Siauw, Psychologits

Parents and caregivers often bring their child to therapy for emotional, social, and behavioural support. Working with children often involves working with their caregivers as well as their families to ensure the best possible therapeutic outcome. Your relationship with your child and the way that you respond to them can influence their emotional regulation and behaviour.

There are many benefits of therapy for children. Therapy can assist parents and children to learn new skills and ways to communicate in the family, build emotional regulation, and facilitate changes in the brain within a safe, expressive, and contained environment.
Some children may like the idea of going to therapy, whereas others may feel anxious, apprehensive, or unsure. It is important to give your child plenty of notice and information about therapy as soon as possible.

Preparing your child for therapy

• Make sure that your child is in a calm and relaxed state when talking to them about going to therapy.

• Use language that matches your child’s age and developmental stage. Remember that your child, no matter how mature they seem, is not a ‘mini adult’. Their brains are still developing; therefore they cannot reason or behave the way that adults do, especially when they are upset or anxious.

• Acknowledge with your child the challenges/difficulties that they as well as the family are facing. Let them know that as a family you will be getting support to help manage what is happening. Let your child know that many families and children go to access counselling support when things get tough (a little like seeing a doctor or dentist when feeling sick or when a tooth is sore). Let your child know that you will be with them and will be apart of the counselling process too.

• Try to keep your description of therapy simple without overwhelming your child with too much information (e.g. “It is a safe place where you can talk to a support person about your worries, and also do fun things such as painting, drawing, or making things”). It can be unhelpful to tell your child that they are meeting a “new friend” or that they are going somewhere “just to play” – this can be confusing for them.

• Children process information easier and feel less anxious when you tell them about therapy using a story format. Your psychologist may have a book about play therapy that can be read to your child before therapy, or you can purchase one here: http://www.bookdepository.co.uk/Amy- Elizabeth-Goes-Play-Therapy- Kathleen-Chapra/9781843107750

• In the week leading up to your session, give your child plenty of notice. On the day of the session, you might remind them again (e.g. “Remember that this afternoon, I will be picking you up from school and then we are going to go to our play therapy session together. We will be there for about one hour”).

• You may want to establish a special activity or ritual that you and your child do together after each session. This can be particularly helpful if your child is anxious or not wanting to go to therapy. The ritual should be fun and relaxing for both you and your child and is helpful if it is consistent (e.g. you may go out for tea together, make tea at home, play a small game, read a book, draw, go to the park, listen to music, or have a treat together). This will help your child to enjoy the experience as well as feel safe, and is a good opportunity for connection with you. The consistency of the ritual will help your child feel in control, as they are able to predict what is happening. ​

The First session

After the parent intake session and at your child’s first session, your psychologist will meet both you and your child together and talk about what the counselling process entails. You will also do fun activities with your child and the psychologist in the beginning to help you both feel relaxed and comfortable in the therapy room.

If it is okay with your child, you will then leave the room and the psychologist and your child can spend time together one-on-one. If your child does not feel comfortable with you leaving, it is important to let them know that this is okay and you will stay in the room with them. Your child needs to feel safe and in control before you leave the room.

The first session may go for about 30 minutes to one hour, depending on the comfort level of your child.

Art work

After the session, your child may want to show you his/her art work or creation. It is important during this time to use reflective and non-judgmental language. Instead of saying, “Good work”, you could simply notice and reflect on what your child has done, (e.g. “You’ve put a lot of work into that picture”…“I see you have put lots of colour here”, or, “You are really proud of your work”). Be mindful about projecting your own thoughts or interpretations onto your child’s work.

Sometimes children create artwork that might seem unpleasant, and this is because different feelings, including negative ones, may come up during the session. Again, if this is the case, try and use non-judgmental and reflective language (e.g. “I can see lots of black strong lines in your picture!”) about the art work to support your child through this process.
Art work created in counselling should be treated as special and sacred. It can be a good idea to make an effort to keep your child’s artwork in a safe place at home, such as in a folder or box, so that their siblings or any pets cannot damage them.

Talking to your child about their session

It is understandable that you would like to know about how your child’s session went, and natural to ask well intended questions about what happened in the session. As we want to assist your child to feel a sense of safety and privacy in the counselling process, asking specific questions about what was talked about, or what they did in their session is not always helpful and can alter their sense of safety in the counselling. Instead of asking your child detailed questions about their session, you could simply ask, “How did you go?” Your child may or may not want to talk in detail about the session and this is okay. It is important for them to feel safe enough to share or not to share.

Talking to your child’s therapist

It is important not to discuss your child or the session with your therapist during or after the session when your child is listening, to help maintain your child’s sense of privacy and safety about the counselling process. You can organise to have a separate discussion with the therapist without your child present, either in your own session or over the telephone.

Your therapist will be working closely with you as the caregiver and will be in constant contact about how your child is travelling. This is so that you can work together as a team to use the same strategies, tools, and language at home, that your child is being taught in therapy. Counselling will have a more positive outcome if children receive the same message in therapy as well as at home.

Behaviour changes​

It is common for parents and carers to report that their child’s behaviour changes when they start counselling, or throughout the course of therapy. Counselling can bring up lots of different feelings for your child when they begin to work through their concerns, and some of these feelings may be negative and tricky to manage. When children are feeling angry, confused, upset, scared, or sad, they may act out and behave differently at school and/or at home. For example, you may see some old or challenging behaviours arise. It is important to remember that this is normal, and it will pass over time. Your psychologist can help you to use supportive strategies to respond to these behaviours in your child if they arise. Behaviour changes can also be very positive ones, and it is important to acknowledge and celebrate these changes you may see at home.

Expressive Therapies

All our therapists are trained in working with children using expressive therapies, such as play, sandplay, art, and movement. This modality of counselling works particularly well with children. Play is children’s first and natural language, and provides a safe and self-guided way for children to express and process their feelings. Children often do not have the verbal skills to express how they are feeling. The toys and art resources in the therapy room are carefully chosen to engage the child’s interest, and to allow facilitation of creative and emotional expression without verbalisation. If your child has experienced trauma, expressive therapies can be beneficial. Current literature indicates that trauma is stored in the right-hand hemisphere of the brain, which is the side of the brain that is creative and non-verbal. Therefore, through play and art, children are able to express themselves through a medium that is gentle and accessible.

Consistency

Lastly, consistency is important. Counselling for children is most effective when it is consistent and structured. For continuity, it is beneficial to attend your appointments regularly so that a trusting therapeutic relationship can be built between your child and their psychologist. In the circumstance that you make the decision to cease counselling, it is helpful for your child to have the opportunity to attend a closure session with their psychologist, so they can reflect on and reinforce their achievements in the counselling process, and experience a meaningful goodbye.