Some 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 my best ally.  Although the teen is my client, it’s imperative that there’s mutual trust and respect between myself and those parents.

Confidentiality laws make this tricky, especially when working with pre-teens and teens.  Technically speaking, as long as I’m confident that the child I’m seeing isn’t a danger to themselves or anyone else and isn’t IN danger, as the therapist I have discretion about what should and shouldn’t be shared with the parents. My own opinion and experience, however, bear out that involving the parents is an important piece of the work with teens.

In many circumstances, this means that if the child is not in danger, the best approach does not involve telling the parent or parents details of what’s discussed during therapy.  I need to build trust with a client and part of that trust depends upon privacy and confidentiality.  After all, if the child could confide comfortably with the parent, they might not need me.  But I do find that a team approach in working with teens and pre-teens can be really 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 usually 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, usually in the client’s absence but not always.

Like all therapies, however, things can go south when communications go awry and, let’s face it, teenagers aren’t usually the best at communications. 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 it being their fault that I have problems. 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 in 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.

  1. Feel free to leave me a message at the tone.  I always laugh when friends tell me that, because of my vocation,  they were nervous when we first met.  Contrary to popular belief, we aren’t mind readers!  So if you don’t tell me something you want me to know, I might not know it.  This is also true about your child.  If your child is hiding some of their behavior from me (like smoking pot, for instance), I won’t necessarily know it – although I might suspect it. Please, if there’s something you want me to know, tell me!
  2. Everyone’s feelings are important.  But they might not be comfortable.  As hard as it is for we adults to sit with our 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 how to cope with or change them, it means your child is confronting this every week.  When your child complains about this, it’s important to normalize their experience.  Encourage an older child to let their therapist know about what’s happening so that they can work together to adjust the depth or pace of the therapy.  If they are too young to do so or too embarrassed, reach out to the therapist yourself so they can raise the issue with your child themselves.
  3. Therapists are humans, too! This means we make mistakes, miss cues, disappoint our clients, and get distracted by our own agendas on occasion.  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 rift in the connection.  In fact, a therapist acknowledging and apologizing for a misstep can deepen the work and the connection between 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.  It’s also an opportunity for them to see that everyone makes mistakes and how important a sincere apology is.
  4. Therapy isn’t necessarily a quick fix. Sometimes issues can be resolved quickly and sometimes they can’t.  If you’re wondering whether things are moving forward, check in with your child’s therapist.  It’s entirely possible that they are seeing improvements in your child’s processing and understanding that haven’t yet transitioned into noticeable changes in their behavior.
  5. Therapy as 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 me as part of a consequence for poor behavior, I become inducted into the family power struggle for compliance with the parents’ expectations.  Clearly, it goes much better if the child agrees to therapy but when they are dragged kicking and screaming into my office, there’s honestly not much I can do with them without the family being involved in the process.  When behaviors and resistance to treatment are extremely risky, I suggest some time in a residential program to contain their feelings and behaviors more completely.
  6. I promise I don’t believe everything I hear about you. Please, please don’t believe everything you hear about me! (Unless it’s good, of course!) I’m always bemused to hear how my words get lost in translation or how my intentions get completely misunderstood.  I suspect you might feel the same way if you were privy to how your conversations are re-told to me.  If your child is old enough, please send them back to me for a reality check.  It’s part of their recovery to do that!  If you’re more comfortable checking in with me first, by all means, do so!
  7. Your child might ask you to end their therapy for them.  It’s really best if you don’t.  Part of therapy is the termination 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 with the therapist the hard work they’ve done.  If your child engages in a conversation with their therapist about why they want to suddenly terminate, it might turn the therapy around (see point number 3) so that it becomes more useful and accessible for your teen.  Even if your child decides to terminate after that conversation, they can do so in a manner in which they can take some pride.  It also helps them create a reality based narrative about their therapy.  In my experience, clients who run from the termination process have a harder time getting help 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.