Psychotherapy 101: Therapy for Your Kid

There may come a point and time when you feel the need to take your child to a psychotherapist.  If you’re in this situation and you’re considering making this move, you, as a parent, need to consider some important things before you start this process.  The first part of what every parent needs to understand is that their limited in their ability to control and change their kid.  What I’m going to share may sound like bad news, but it’s not.  Instead, it’s the reality of our situation.  And when we better understand the reality of any situation, we can always find a workable solution and path to improvement.  So let’s get started.

Nobody Can Control or Fix Another Human

This is the first point that you will need to drill into your memory so that it permeates everything that you say and do.  We cannot control another person, we can only influence them or manipulate the circumstances around them through our own efforts.  Why?  Because each of us has a will of our own that nobody else can touch.  Our choices are our choices and they cannot be anyone else’s.  This means that change is up to them just like it’s up to you and me.  This is true for a 5-year-old and a 75-year-old person.  If you doubt this, just look into your own life.  Haven’t there been times when you’ve known that it was best to choose one course of action but you went a different route anyway?  No matter how small the situation or decision, we’ve all done this and it’s no different with our kids.  If they want to stubbornly hang onto a choice, they might go to the ends of the earth to stick to it, regardless of what everyone has told them.  If they change their mind, well…they changed their mind in response to something (e.g., a thought, undesired outcome, etc.).  And it’s precisely when they change their minds that parents and adults make the mistake of believing that they can control their kid or the other other person.  So we mustn’t think, ever, that our actions have the potential to change another person.  Sure, you might be able to overpower your child physically because you’re much bigger than them, but you can’t control their mind or what they choose in the end.  If you could control other people’s choices then they would be nothing more than programmable robots.

“If my kid could only….things would be fine!”

Whether it’s in the context of the family, work or a group of friends, we often tend to think that a single person is the source of our problems.  If they could only change or somehow be different then everything would be okay.  While there are cases when a single person is the source of a problem in a group, it’s more common that the individual is expressing a problem in the group or family.  When it comes to kids, it’s almost always the case that something is off balance within the family and that their behaviors are symbolic of the problems in the family.  Sure, the child might be having a hard time with a specific issue, but their ability to cope with the situation links back to the family.

For example, I worked with one adolescent who had the hardest time dealing with any disturbing or unwanted thoughts, feelings or situations.  When these would occur, the kid frequently went into a behavioral tail-spin…also known as a severe tantrum.  As I got to know this kid and his family, it became clear that one of her parents had an extremely difficult time withstanding any emotional upheaval, especially from the son.  As a result, this parent quickly took action to change their son’s circumstances so that he would feel better.  What this taught the son was that when he didn’t want something, the world would change for him.  In this context, the boy’s emotional instability and behavioral outbursts made complete sense.  His inability to manage difficult situations had been retarded because one of his parents did the work that he needed to learn how to do.  He also learned that when he increased the intensity of his emotions and behaviors, the one parent would freak out and do whatever he wanted to calm the situation.  This went on for years and when this boy and his parents came to me, it was very clear that the boy’s actions reinforced the parent’s actions, and vice versa.  If change was going to happen for the boy, the parents also needed to change their ways.

So even though it might make sense to us, in the moment, that another is solely responsible for our problems, relationships are a two way street.  This is why we need to focus on our responses to them and our role in the situation, no matter how big or small.  When a parent decides to enlist the help of a psychotherapist and believes that the therapist can fix the problem (aka, the kid), this is the first issue to discuss.  The truth is, we can’t force anyone to “get fixed” or to “stop being the problem.”  Why?  You guessed it again, their will is outside of our control.  So what do we do then?  That’s a great question, and the answer is that we focus on how we can change, regardless of whether or not the other person decides to change.  And this means that the problem is in the “we,” not the “them” or “you.”

Control, Cause and Effect, and Influence

It’s often the case that parents come into my office and want me to give them a secret way to deal with their kid in order to “make them” do something.  Parents often come to believe that they have control over their kid’s actions because they’ve witnessed a change in the kid’s behaviors when they change their tactic with them.  Therefore, they come to believe that their actions have controlled the kid, but this is only an illusion that our mind is giving us.  As a result of this false and incorrect belief, the parent implements the tactic again with the hope of achieving the same level of cooperation or to get the same response.  It might work a few times but at some point it’ll start to fail.  What’s not uncommon is that the kid will adapt to the new tactic, learn its nuances, and start to exploit it as time goes on.  For example, I’ve worked with numerous parents who have provided rewards to their kids for doing very basic things like taking out the trash.  What ends up happening?  The kid learns that they should get something from the parents any time the parent asks them to do something.  It’s at this point that the kid will turn to the parent and say, “What are you going to give me if I do this?”  Or the kid might say, “I’ll only do ____ if I get ___!”  Originally the parent thought that they found a new technique to get their kid to comply but the kid turned the situation around and now has control over the parent!

Our kids are bright, they’re quick-minded, and they quickly figure out how adults work.  All of this is because their ability to change and learn is faster than adults.  It’s also because the kids have less power and authority.  When any of us have less power and authority compared to another, we often master loop holes and rules in order to manipulate them into getting what we want.  Adults do this at work, with taxes, and when they try to get deals on things that they buy.  Kids do this with, well, everything!  When you put parents and kids together, the result is a battle of wits and ultimately, a battle for control.  Yet, nobody will ever win because nobody can control anybody else.  But what about those big consequences, like taking away their beloved cell phone or car, that you threaten them with?  You seem to have control them right?  Absolutely not.

All of us, adults and kids alike, face possible consequences in response to our actions all of the time.  For example, my boss can give me deadlines, but whether or not I meet them is up to me.  If I know that they’ll definitely fire me if I miss a deadline and my job is really important to me, I’ll most likely meet that deadline.  You might think that they’re controlling me in this situation but they aren’t.  Why?  Because I don’t want to lose my job and experience problems in my life.  Consequently, I choose to meet the deadlines and a result, I get to keep my job.  I could have just as easily decided to miss the deadline if I didn’t care about losing my job.  Therefore, it’s always that nobody can control my choices no matter the situation, just like nobody can control you.

“So what can I expect to see happen when my kid goes to therapy?”

Nothing.  You can’t expect anything because change is up to the kid, and by now you understand why this is absolutely true.  If they decide to use therapy, then they will use therapy and they will change because they’ve decided to change.  If they choose to reject therapy, they will reject therapy.  Yet, change is inevitable so you can just give them time and space to figure things out on their own.  However, if you want to increase the chances that they will use therapy for themselves and in a helpful way, then you need to focus on how you offer it to them.  Everything that I suggest comes down to you, the parents, giving them the space to have their own experience and to keep your nose out of their therapy sessions.  If they want to let you in, it needs to be on their terms and not yours.

Approaching a Kid About Therapy – The Easy Scenario

If you can avoid it, don’t force your kid to start therapy.  Ideally, you want to offer it to them as a helpful resource, and then they can decide how they want to use it.  When I was 10 years old, my father asked me to give therapy a try.  He told me that he wouldn’t force me to go if I didn’t like it after the first session but that a lot of people found it helpful.  He said that he would let me choose from a couple of therapists and that I didn’t have to go again if I hated it.  Whether he was aware of it or not, he approached the situation skillfully.  I don’t know if he was advised to do it this way, if it was blind luck, or if my father just had a great intuition about the situation, but he handled it impressively.  By giving me choices he gave me the space to feel that the decision was truly mine.  This helped me be completely open to the experience.  If he had forced it upon me in an attempt to change me, I would have related to therapy as an extension of him trying to control me.  If a kid feels this way, they’ll frequently resist whatever they’re being confronted with just because they’re reacting to you and their loss of control…and this will almost always result in therapy being corrupted before it even starts.

What’s also important is the relationship between the kid and the parent who is approaching them about therapy.  If my father and I had a very negative relationship where we fought for control all of the time, his approach wouldn’t have mattered because my defenses would have been up before he started.  I would have fought his suggestion stubbornly and without any rational reason.  So know that who approaches the kid about therapy is just as important as how it’s presented.  Also, make sure you give your kid as many choices about therapy as possible.  If you have a good relationship with them and you need to force therapy on them, it’s very helpful to apologize for having to do this.  By apologizing, you’re empathizing with them and how the situation sucks.  This can go a long way to repair the relationship.  Then, be sure to find as many ways that they can choose things throughout the process leading up to the first session.  And let them know that you’re not going to be nosey about their experience in therapy or ask them what they talked about.  If they want to, let them do the research when finding a therapist or ask them how they’d like to choose one.  Do they want your help?  A little?  A lot?  If they refuse to be involved, you can let them know that you’ll pick someone, but that you’d much rather them do the choosing.  Give them a little time to process your comments and they might come around after a few days.  In the end you can identify a few therapists and see if they want to pick one.  But what about the situations where a kid won’t go?  What do you do when they fight the situation every step of the way no matter how you approach them?

Approaching a Kid About Therapy – The Difficult Scenario

If you don’t have a good relationship with your kid or if the majority of your interactions become intense quite quickly, the final result of this situation might be that your kid doesn’t enter into therapy…but that’s okay.  Despite this, there are several things that you can do to help the situation, but this MUST occur before you approach your kid.  Your first task is to make sure that you’ve read the previous section, “The Easy Scenario,” and have spent some time reflecting on how you can approach them, wholeheartedly, in that way.  Next, we need to take a look at how you and your kid battle for control.

Sometimes relationships patterns are so engrained, repetitive, and highly reactive that they kick into gear regardless of the topic or issue.  Both of you might react with such intensity to the simplest situation that it makes any positive interaction nearly impossible.  I could lie to you and say that there’s a simple fix…but the reality is that you’ve spent a long time getting to this painful place, and it will take consistent effort and a bit of time to change things.  However, the one who will need to change the most is not the kid but you,the parents.  Therefore, it doesn’t matter all that much if your kid sees a therapist, but we should still offer therapy to them as a choice.  And when you offer it to them, let them make as many decisions about the situation as possible (as I’ve noted in the previous section).  Also, give them several days to think it over and be sure that they know you’re not going to spy on their sessions or drill them or their therapist after the session.  It’s for them to use or not use, and how they use the sessions are completely up to them.  If you want them to attend, you’ll need to stay out of their business…and you have to follow through on this.  Plain and simple.  Many, many parents struggle with this part and even when they try to give space, they aren’t able to.  This is because the habit of being in their business or trying to control them is so habitual that the parents aren’t even aware of it and the damage it’s caused.  I see this all the time in my work with the parents.  These parents don’t have bad intentions and they have a hard time seeing how knowing every detail about their kid is a bad thing.  If you’re identifying with what I’m saying, it might be best for you to start with a family therapist first, for you, and then move on to your kid.  And if your kid continues to reject any offer of therapy, then you absolutely need to go to a family therapist because change can and will happen with you.

Selecting a Therapist

This can be a very tricky task, especially since therapists aren’t generally good at marketing themselves.  What I mean by “marketing themselves” is that many therapists don’t often develop enough online information that can help you get a feel for what they’re like.  As a result, you end up with a list of names from your insurance company and the therapist’s basic information.  Do as much research online as you can, but sometimes it’s better to go with a referral from someone that you know and trust.  As you begin this digging, keep the following checklist in mind:

  1. Does the therapist have experience or training in working with kids?
  2. Do they have experience and/or training in family therapy? (e.g., LMFT)
  3. Do you want a therapist with a Masters or Doctorate degree?
    • A Ph.D. is primarily trained in research; a Psy.D. is primarily trained as a therapist who uses research; Masters level therapists can vary, check out WebMD’s page to get a better understanding of these.
  4. Do you know if your kid wants to work with a male or a female?
    • You may want to have one or two of each and provide your kid with options.
  5. Ask your kid if there’s a characteristic of the therapist that’s important to them (e.g., race, culture, religion, sexual orientation, etc.).
    • Go with what they prefer and without your suggestions or influence. If they have more influence on the choice, they’ll be more open to therapy.
  6. Age might matter to you or your kid, but try to be flexible and open-minded.
    • Don’t let the age hold you back, but if your kid has a strong preference you may want to go with it. 
  7. Is insurance and cost a limitation for you?
    • Many therapists work on a sliding scale, so don’t count a therapist out if you’re financials are limited.

Do a bit of work to figure out what might be best for your kid, and follow their lead as much as possible.  It can be a tough decision to make so be sure to ask around for suggestions from friends, family members, school administrators, and possibly colleagues (if appropriate).  The worst thing that can happen is that the therapist isn’t all that good, your kid doesn’t like them, and you try another one.  Be sure that they give the person a couple of sessions to see if it’s a good fit.  If they’re never satisfied with a therapist, they’re probably not ready to start therapy, but ask them what they’d like to do.  Again, if they don’t go then you should still go see someone.

Parents MUST Attend Family Therapy

As I’ve mentioned, many times people think that just one person is experiencing problems, but the truth of the matter is that the entire family is struggling.  Humans are deeply interconnected and nearly all that we do involves other people, directly or indirectly.  The most involved relationships that we have are within the family, and since our kids have less authority and responsibility than adults, it’s necessary for parents to be involved in family therapy to support a struggling kid.  I’ve found that it’s particularly helpful to meet with parents without the kid.  In fact, I let the kid know that if they ever want to join a family session then they will lead the topic of conversation.  If they don’t want to join, then they don’t need to.  As we know, a family is a unit of deeply intertwined people and if only one person is changing, it will be harder for everything to get better.  It can still happen but the process is more difficult.  When multiple family members learn how to work better together and to address their own hangups (which we all have), then everything tends to improve at a quicker rate.  Yes, there are growing pains and anxieties that come with change, but after a while everyone adjusts.  So start therapy with whoever is willing to participate and allow others to join if and when they’re ready.  If you’re adamant that your kid is the problem and that they need to be involved in therapy, you’ll need to first address this with a family therapist because your fixation is a symptom of other problems.  I know that me saying this might upset you, but it’s important that you know the truth of the matter.

Now, I’d like to add that there are times when a kid has a biological issue that results in specific problems that did not originate from family dynamics.  The situations are very rare and occur when a kid has a severe biological, neurological or genetic abnormality.  The bast majority of issues are the results of a combination of biological and environmental influences.  So while we might not think that family therapy is necessary in the rare case that our kid has a biological problem only, I still strongly advise it.  This is because parents need, at least temporarily, the support of a professional as they learn how to better manage the stress of the situation.  Many parents have a hard time dealing with the demands of a child who is suffering and their marriage, or other family relationships, can degrade as a result.  Seeing a family therapist can help keep the health of the family as high as possible when facing difficulties.  It can even help save a marriage.

Parents are Not Trained to Be Parents

Unfortunately, most of us go our entire lives without receiving extensive training and education on human psychology, parenting, and relationship dynamics.  As a result, it makes sense that many people struggle when they become parents.  What makes the situation even more challenging is that you didn’t get a rule book or manual for how to raise your kid when they were born!  Yes, there are often guidelines, but these change depending upon who you talk to and which research study you’re looking at.   Not only that, every family has a different mixture of culture, unique stressors and personalities.  What a mess!  It’s for all of these reasons and more that parents need to be involved in family therapy to support their struggling kids.  In these sessions, you’ll learn about your family patterns, reflect upon how your individual backgrounds have influenced these, and learn how to work together to make positive changes.  You’ll also figure out your individual obstacles that are getting in the way of you changing.  The more willing parents are to make their own changes, the better off the kids will be and the happier the family can become.  What’s more is that parenting can put a HUGE strain on your intimate relationship.  A good family therapist is going to keep all of these things in mind and support the entire family so that everyone is better.  Sounds like a good thing doesn’t it?!

The Boundary Between Therapy with a Kid and with Parents

A good family therapist will be able to maintain a good working relationship with each member of the family.  Individual sessions will not be discussed, by the therapist, with other members without express permission and purpose.  Even then, this “triangulation” should be extremely limited.  This is because it’s important for each person to share what they’re thinking and feeling with other family members directly.  It’s not the therapist’s role to be the conduit between family members between sessions, and it’s extremely unhealthy if the therapist functions this way.  So, how do we balance all of this?  First, let’s identify the different types of sessions and how their used.

  • Individual Sessions
    • Support the individual, explore deeper issues/experiences within the person, sessions are guided by the client’s agenda, therapist doesn’t speak for people not in session.
  • Parenting/Couple Sessions
    • Support the parenting and/or marital relationship, sessions are guided by ongoing and recent problems, communication and mutual understanding are enhanced, both are encouraged to change, and blame is not tolerated but responsibility is emphasized.
  • Family Sessions
    • One or more individuals want to address an issue and the session is guided by this, communication and mutual understanding are enhanced, blame is not tolerated, individual responsibility is emphasized, all are encouraged to change.

Individual sessions, be it with an adult or kid, are “owned” by the individual.  These sessions need to be “owned” by the individual and private so that they can voice anything and everything.  This freedom is only made possible if the individual knows that what is said in the room stays confidential.  When the person knows this, deep down, they will feel safe enough to share honestly and openly.  And they’re more likely to take the risk to address what’s really going on inside of them.  If parents or anyone else tries to invade this privacy, defenses will go up.  If privacy is invaded, then therapy sessions will no longer be helpful.

Sessions with multiple members are meant to address the relationships between the individuals.  It’s not helpful to get people on “your side” during the session or after it.  This only results in people ganging up on one another and therapy will degrade.  Everyone will start to feel unsafe and if this continues, sessions won’t be productive.

Final Thoughts

As parents, take care when approaching your child about therapy and keep in mind that your relationship dynamics will influence their response.  Also, you should meet with a family therapist regularly (weekly, biweekly) regardless of whether your kid is in thereapy.  I once had a parent say to me, quite eloquently, “so you’re saying that if we succeed, our daughter can succeed.”  This is exactly right.  In therapy, parents can learn how to best support your kid and the entire family.  Parents can also learn how to take better care of themselves.  Lastly, know that your kid needs space if they end up working with a therapist.  Feel free to ask them if the session went okay, but make sure that they know they don’t have to share anything with you unless they want to.  A big part of them growing up is learning how to experience situations for themselves and to figure out what they want to do with their problems.  If you’re always getting in the way, then they learn that you won’t let them learn to be independent…and this creates a very negative cycle where little or no change occurs.

As always, drop a comment or send me a note through my website contact form if you want to ask any questions.

 

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