What Your Child’s Therapist Might Want You to know
There are a few things your child’s therapist might want you to know.
It can be both a relief and a huge leap of faith to leave your child in the hands of a therapist. You don’t know what goes on behind closed doors and it’s very natural as a parent to wonder: What do they say about me? What are they doing in there? Is it working? Why isn’t it working faster? Can I come in?
As a therapist working with kids of any age, parents are important to the process. Although the teen is my client, it’s imperative that there’s mutual trust and respect between myself and those parents.
Consent and confidentiality laws and ethics make this tricky, especially when working with pre-teens and teens. Plus they constantly evolve. Generally speaking, as long as the child in treatment isn’t a danger to themselves or anyone else and isn’t IN danger, that teen is the holder of their own privilege of confidentiality. My own opinion and experience, however, bear out that involving the parents, when appropriate is an important piece of the work with teens in most cases. I disclose to the parents and child in my first meeting that I occasionally communicate with the parents. Other therapists have their own policies about this. At the time of this writing, best practices are that the therapist is required to obtain written consent from clients 14+ in order to speak with parents.
This means that if the child is not in danger, the best approach is to not involve telling the parent(s) the content discussed during therapy. Building trust with a client depends upon privacy and confidentiality. After all, if the child could confide comfortably with the parent, they might not need therapy. But I often find that a team approach in working with teens and pre-teens can be valuable. To that end, I’m very comfortable meeting occasionally with parents to be sure we are all on the same page, that we are working toward similar goals and supporting each other in that process, to fine tune the parents’ approach or communication style with their child, and to give them some feedback. I do this with the full knowledge and consent of my client who often comes up with an agenda that s/he wants me to cover with the parents. If my young client prefers me to not speak with their parent(s), I will refrain from doing so unless required by law. Ask about those policies and work with someone whose boundaries work for you.
Like all therapies, things can go south when communications go awry and, let’s face it, teenagers aren’t usually the best at communication. Additionally, teens can be experts at “splitting,” which is what happens in relationships when one person or group in a triad plays the other two sides against each other. If you’re a parent and you’re reading this, think: I said no to the cookie, so she went and asked dad. But kids are adaptive, so instead of blaming mom or dad, sometimes the triangle is between the parents and the therapist. Think: Therapy makes me confront my problems and I feel worse afterwards, so let’s see if I can talk mom and dad into the therapist being the problem. Or the opposite – everything is mom and dad’s fault, so let’s see if I can talk the therapist into my parents being the problem. Without a working alliance between therapist and parents, it’s easy for one or the other to feel the need to swoop in to “save” their child from the other part of the triangle, but doing so isn’t always the best thing for the client.
Parents can help a child’s therapy in many ways and, in fact, can be paramount to a child moving through their issues quickly and completely. To that end, I have a few suggestions to those of you who have your kids in therapy.
Feel free to leave me a message at the beep. I always laugh when friends tell me they were nervous when we first met because I was a therapist. Contrary to popular belief, we aren’t mind readers! If you don’t tell your child’s therapist something that you want them to know, they might not know it. Counting on your child to follow your agenda in their therapy usually doesn’t work so, please, share with your child’s therapist what you want them to know.
Everyone’s feelings are important. But they might not be comfortable. As hard as it is for adults to tolerate more “negative” emotions such as loneliness, sadness, and anger, it’s excruciating for kids to tolerate them! Since the purpose of therapy is to explore what causes these feelings and learn ways to cope with or change them, it means these feelings come up in therapy. When your child complains about this, it’s important to normalize that AND to let the therapist know that your child is struggling a bit after the sessions. Better yet, encourage your child (if they are 14+) to let the therapist know this so that they can work together to adjust the pace or depth of the therapy.
Therapists are humans, too! This means we make mistakes, we miss a cue, we disappoint, we get distracted by our own agenda, etc. Believe it or not, one of the most important and healing aspects of therapy is the repair between therapist and client when there’s a disruption. In fact, coming back from a bad session with a therapist acknowledging and apologizing for a misstep can deepen the therapy and the connection between the client and therapist. This allows a teen to feel validated in their experience as well as a sense of agency in standing up for themselves, and it’s a chance for them to see that mistakes and apologies aren’t that scary.
Therapy isn’t necessarily a quick fix. Sometimes issues can be resolved quickly and sometimes they can’t. Kids and parents don’t always have an appreciation for the therapeutic process. If you’re wondering whether things are moving forward, check in with your child’s therapist. It’s entirely possible that the therapist is seeing improvement in your child’s processing and understanding that have not yet transitioned into noticeable changes in their behavior.
Therapy as part of a punishment usually won’t work. I love the joke about how many therapists does it take to change a light bulb. (Just one. But the light bulb has to really want to change.) Unfortunately, when teens come to therapy as part of a consequence for poor behavior, the therapist can become inducted into the family power struggle. When the teen agrees that therapy would be helpful, it goes much better. But when they are dragged kicking and screaming into treatment it’s often hard to make any gains. I will add here that some therapists work better with this resistance than others so it’s important to ask about that.
I promise I don’t believe everything I hear about you. Please, please don’t believe everything you hear about me!! Unless, of course, it’s good! I’m always bemused to hear how my words get lost in translation or how my intentions get completely misunderstood. And I suspect you’d feel the same way if you heard how your conversations are related back to me. If your child is old enough, please send them back to their therapist to do a reality check. It’s part of their recovery to do so! If you’re more comfortable checking in with their provider before sending your child in to talk, by all means, do!
Your child might insist that you end their therapy via email, text, or phone call. It’s really best if you don’t. Part of therapy is the termination process and there’s a lot to be gained by it. Endorsing your child’s sudden departure from therapy prevents them from learning how to speak up for themselves, have agency and courage, take responsibility, and learn how to respectfully engage in relationships. It’s grown up stuff to be sure, but teens are supposed to be taking steps toward maturity and the decision to leave therapy is an opportunity to flex those muscles. It allows the time for your teen to speak their minds, explore what did and didn’t work for them, review their progress, and acknowledge the hard work they’ve done.
Also, if your child is uncomfortable with the therapy, going through a conversation about it (a rather mature thing to do) might turn the therapy around (see point number 3) so that it’s more useful and accessible for your teen. Even if your child decides to terminate after conversing with their therapist, they can do so in a mature and clean way. Again, this is important for teens to learn and it prevents a client from feeling shame or embarrassment when they run into former therapists. It also helps them create a reality based narrative about their therapy. I believe clients who run from the termination process have a harder time getting help for themselves when they need it in the future.
If your child is in therapy, I encourage you to maintain contact with their therapist so that you can comfortably express your observations, concerns, questions, and (hopefully!) compliments!
If you or your child want a place to explore the issues you or they are confronting, please call me for a free 20 minute consultation to see if I can help you.