Working with Your Child
As a parent, this may be the first time you have taken your child to a psychologist. I appreciate the opportunity to work with you and your child. I am always open to questions and comments.
You are the expert of your child. Though I have many years of training and working with children and families, each family is unique and part of the process is getting to know your child and family. I spend time talking with parents about child development and parenting, and my position is not one of judgment but one of support.
How does this work?
I will gather history from you, request the completion of behavioral checklists about your child, and may request to speak with your child’s school and/or doctor. There are some topics that may not be appropriate to discuss with your child in the room, and I refer to this as “adult information.” Little children have big ears, so I prefer to have some discussions while they are in the other room. We will discuss whether you are comfortable with your child in the waiting room, and very young children will need an adult or older child to accompany them. You may always ask to speak with me privately. Though this is less of an issue with older adolescents, there still may be times when it is best to speak privately.
Typically it takes two sessions for the initial assessment. Therapy may include consultation with parents, individual therapy with the child, and family therapy. I may ask your child and family to work on specific tasks between sessions. There is often a great deal that can be accomplished between meetings. Initially, we meet weekly, and as your child improves on treatment goals, sessions will be spaced out to every other week or longer. Meeting less frequently while phasing out treatment tends to decrease the rate of relapse. Your goals for therapy will determine the course. If you decide to end treatment at any point, it is important that I have time to say goodbye to your child, discuss areas addressed, and any recommendations.
Children need to feel safe to share information:
My goal is for your child to feel safe and comfortable enough to share any concerns. It is important that your child know he/she will not get in trouble for sharing things with me and not feel guilty for sharing. Consequently, I will only discuss specific information with you if I have your child’s approval (ages 8 and up). However, if your child shares information that I believe could or has been dangerous to him/her, I will disclose this information.
Your child may share anything we do or say in individual therapy. The information is not a “secret” rather, it is personal information they may share, but also have the comfort of knowing I will not share specifics without permission. The boundary of knowing he/she can tell anything that we do or say in therapy is to help with empowering the child and dispel the idea of “secret” information. The goal of therapy is for your child to feel safe enough to address any issue.
Confidentiality with adolescents. Your child will likely be much more open in therapy, knowing I will not share his/her information without consent. I may be told of behavior I believe to be risky and not in your child’s best interest, such as experimenting with alcohol and drugs, sexual activity, breaking family rules or laws, however, if I do not believe your youth is in imminent danger, I will keep this information confidential. You may be assured I will be addressing these issues in therapy. I have found support and education to be very effective in addressing these issues. Limits of confidentiality will apply if I am concerned for their imminent safety or in cases of reported child abuse.
Often I will do a 10-15 minute check-in with parents (more time if required) and spend the remaining time in individual therapy (1 to 1) with your child. This time provides me an update from you, answer any questions, and I will discuss the general areas we are addressing. We may do a check-in together at the end of the session if needed, or I may use the entire session to meet with you and your child. (Depending on the case, I do not always check in with parents of adolescents. However, the parent is always welcome to share any concerns or information.)
I use a combination of talk, mindfulness practices, play therapy, and in some cases, EMDR, with a greater emphasis on play therapy with younger children. Play helps children become relaxed and is an effective avenue to express thoughts and feelings. Many thoughts, emotions, and situations can be addressed in play therapy. I typically will structure play or activities for the first 20 minutes, then let the child direct the play during the last 15 minutes. Sometimes children will tell their parents that all we did was play. I view this comment as positive, for that suggests they are comfortable and they may be unaware of the work they are doing.
Given there never seems to be enough time in a day, sometimes parents are tempted to run errands during their child’s individual session. However, it is important your child knows you are waiting for him/her in the other room. And I never know when we might want to include you in the session. Though my door is closed during therapy for privacy, you, as the parent, may enter any time you feel the need. (Some adolescents drive themselves to therapy. I do not require parents to be present for youths 14 and older.)
It is fine to ask your child how the session went, but it’s important to be general and limit the number of questions. If a child feels pressured to talk about what they discussed in therapy, this may reduce their willingness to share in therapy. This can be especially worrisome for the child if his/her parents are divorced, and the child has been sharing feelings about the divorce. Remember, children may share anything we do or say in therapy. You may notice how much they spontaneously share. It is important for children to learn the identification and expression of thoughts and feelings. My hope is your child will become more open as therapy progresses. As a parent, it is your role to encourage your child to be very open in therapy.
As children are working on issues, they may act out more before improving. This is often the case when working on limit setting in the home. Sometimes children really like therapy at first. They get to play and have my undivided attention. However, as issues arise, they may become less interested or even not want to come to therapy. Sometimes this is to avoid addressing difficult areas. Other times, when children are doing much better, they begin to lose interest in therapy. The above situations are not uncommon, but if these occur, please share your observations so we can address them in therapy.
Please feel free to provide me feedback and ask any questions about the therapeutic process. Your thoughts and comments are always welcome.