Children and Adolescents

Kids are people, too, and everything I’ve said so far about psychotherapy with adults applies to them as well. Still, they do need some special handling. At the most obvious level, kids rarely enter psychotherapy because they want to; instead, someone around them says "This kid needs help". Thus, resistance is likely to be much higher. It may take more sessions to see progress than it would with an adult. Also, the therapist will need some extra charisma, charm, and a thicker skin than does a therapist who sees willing adults. This is not to imply that children must be fooled. Quite the contrary. Children detect and reject phony appeals faster and more ruthlessly than do adults. By the same token, however, they respond eagerly to honesty and candor. Sometimes such qualities provide all a child needs to get unstuck and resume his natural development.[Claire, Mike]

With children, the therapist’s input sometimes feels very wrong to parents or guardians (Claire). How then can you choose a psychotherapist? First, seek the credentials you want. There are therapists who specialize in children. Go to people in your community whom you trust and who may themselves work with children; ask them who they can recommend. Then meet the therapist and see if you can imagine your child warming up to him.  

Once your child is involved in treatment, it will be important to keep an open mind. You may find that you want to dismiss the therapist as a quack for trying to blame parents for everything, for not being on your side. Or, the therapist may seem overly harsh and your natural instinct may be to rush in and save your child from this nut you foolishly thought might help. But consider: You hire a therapist because your child is suffering (and/or insufferable). Even more than in adult psychotherapy, the therapist will accomplish this goal in part by forming a relationship with the child, quite possibly the one you yourself would like to have. Try to remember that a therapist, no matter how close to your child he becomes, is not really in danger of taking your place. Keep in contact with the therapist, especially if you are uncomfortable with what he is doing.

In the best of treatments be prepared for a possibly bumpy ride. One of the unpleasant facts of psychotherapy with children is that a child may indeed need help because of something going on in the family. As this material comes out in sessions, the child may become different at home, and not necessarily in pleasant ways. He may for a time be angry, sad, argumentative. If there are indeed destructive interpersonal patterns in the family, you the adult may well find yourself resenting the therapist and even the child. Hard as it can be, try to keep an open mind and to talk to the therapist about what is happening. A child is part of a family group and when one member of any group changes, all others will have to adjust. For example, consider a youngest child who gave everyone in the house a person with whom to enact their need to feel wanted, needed, loved, important. If during the course of treatment the child becomes more independent, other members of the family are now going to have unsatisfied needs. This can cause more tension, unhappiness, and dissent among any or all members.

On the other hand, there are times when it’s not resistance that causes your negative perceptions of your child’s therapist. There are therapists who do side unreasonably with the children, who don’t explain things to parents, and who are simply incompetent. Just as in adult psychotherapy, you should be able to understand and appreciate the reasoning behind a therapist’s apparently strange notions and practises. You should see progress or understand why it’s not happening. If the therapist can’t or won’t explain all this, do one of two things: Either commit to continuing on faith for a few more sessions in the hope that things will soon become clear, or find another therapist.


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