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Talking to Kids about Coming to Therapy

When I am first contacted by a parent about bringing their child for therapy, I routinely ask, “How does s/he feel about the idea of coming to see a therapist?”  It is not uncommon for the response to be: “Well, I haven’t told him/her yet.  Got any suggestions?”  The truth of the matter is that there is nothing natural about kids going to see an adult to discuss their feelings.  Not much of a precedent exists for that kind of relationship in a young person’s life.  True, kids go see medical doctors routinely, but therapy is a different kind of relationship altogether.

Sometimes, clients show up for their first appointment having been told a variety of half-truths to get them to come in.  Some kids report that they were told they just had to see me once.  Others say they didn’t know where they were going when they were picked up from school.  In some instances, kids tell me they were told they were going to the store, or out for ice cream.  Imagine the awkwardness that sets in when we sit down with that expectation in the air…I am clearly not the ice cream man.

I don’t blame these parents, though.  It can be challenging to broach conversations about family problems, and some kids are steadfast in their ability to dig their heels in when they don’t want to do something (which can be one of the things that leads them into a therapist’s office in the first place).  I encourage parents to think about how they deliver other kinds of news to their children, and also to think about how rules get set in their family around parental expectations.  That said, keeping the following tips in mind may help guide the conversation.

Be direct but understanding.

Even on the East Coast where psychotherapy is more widely accepted than in other areas of the country, the misperception that therapy is for “crazy” people still exists.  Often kids resist seeing a therapist because they take it to mean that there is something inherently wrong with them.  And unlike medical problems that can be framed as the result of an accident or injury—like a faulty part on a car that the mechanic fixes—it’s easy for kids to see the challenges that bring them into therapy as character flaws.

It’s important for kids to be clear about who they’re going to see and why, and to have this explained in developmentally appropriate terms.  Very young children can be told that they will be meeting a grown-up who helps kids talk and play about their worries, mad feelings, or other problems.  Older children frequently benefit from clear explanations in which the problem is articulated.  For example: “We’ve been having some problems communicating lately when you don’t get what you want.  The therapist might be able to help us find better ways to handle those situations.” Adolescents can often get on board after hearing that their parent understands they have a lot on their minds, and talking to an adult about some of it will set the parent’s mind at ease, allowing the parent to be able to give them a little more space and not be so “in their business.”

Help your child feel less alone.

No one enjoys feeling like the problem in the family.  This can be counteracted by letting your child know that the whole family will be working on new approaches and new ways of communicating—that the parents have their own work to do on the issue(s) at hand. Similarly, I find that once kids come to my office, they can be tremendously reassured by hearing about confidentiality.  I let them know that it’s no one’s business that they come to see me and that I am bound by law not to tell anyone.  At the same time, I also tell them that the odds are good that I have seen other kids from their school at some point—perhaps even kids whom they would never suspect were seeing a therapist.  Marketing experts tell us that social support can be very reassuring, which is why testimonials are a popular advertising tool.  We’re much more likely to want a product if others we identify with are using it too.

If you’ve ever seen a therapist before, it can help your child to hear that, and to hear what you found beneficial about the process.  Often, busy teenagers can also resonate with the idea that their session is a time once a week that is just about them.  Unlike other relationships in life, the therapy relationship is one in which the client doesn’t owe the other person anything—not to ask how their day was, to hear their problems, or even to be polite.  Instead, it’s a time in which people can talk about the things that are truly important to them.

Plan some together time afterward.

Frequently, kids from larger or busy families come to appreciate that the trip to the therapist’s office, especially if they come with a parent and without siblings, is a rare time focused on them.  They can get some time alone with you.  Take advantage of this window when possible—plan to have a quick meal together afterward, stop by a store your child enjoys, or grab a snack.  Take a break from discussing serious issues, and from your cell phones, and enjoy each other.  It’s a great time to recognize the hard work of engaging in therapy and to nurture your child, and your relationship, in the service of creating new experiences.

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