When you see your child struggling with their emotions and behaviors, you may start thinking to yourself, “I wonder if I should bring my child to a therapist?”. The following guidelines are meant to help you as the parent think through this decision as well as choose the best therapist for your child and situation.
How do I determine if my child even needs a therapist?
I always encourage parents to look at how the difficulties their child is experiencing is affecting the child’s level of functioning. The higher the level of difficulties the child is experiencing the more likely they would benefit from the help and skills of therapist could provide. For instance, let’s say your child had a grandparent who died. After something like this occurs, it is not unusual that there is a period where a child will grieve the loss of the family member. This is to be expected.
If it is six months later though and your child still has difficulty sleeping, seeks frequent reassurance from you, or appears to be more sad, this would indicate that the child is struggling in the adjustment after the death of the grandparent. More help appears needed.
Types of therapists
Most therapists who work with children and families tend to have a Masters degree and varying experience working with youth and children. After a therapist receives their Masters degree, they usually have to work for 2-3 years under a fully licensed therapist before they themselves can become fully licensed.
Fully licensed therapists usually fall under these two categories:
Licensed Psychologists. Licensed psychologist usually have a doctoral degree and provide therapy and/or psychological testing for clients.
Fully licensed therapist. There are a few different types of fully licensed therapists with a Masters degree. The names for these will vary slightly from state to state but in general they will either be a licensed marriage and family therapist, a licensed clinical social worker, or licensed professional counselor.
I will mention psychiatrists to help clarify their role. Many parents confuse the term psychiatrist and psychologist. A psychiatrist has a medical degree and can prescribe medication. A psychiatrist will rarely do therapy services. Their primary role is to diagnose, prescribe and monitor the use of psychiatric medications their clients are taking.
A psychologist does psychological testing and may provide therapy services as well. In most states they can not prescribe medication. Currently, psychologists may prescribe in five states: Iowa, Idaho, Illinois, New Mexico, and Louisiana, as well as in the Public Health Service, the Indian Health Service, the U.S. military, and Guam.
How to choose the right therapist
First ask around. Friends or coworkers may be aware of therapists who they have found helpful or those you should stay away from.
I think one of the best places to ask is the school counselor or social worker at the school your child attends. While the school staff usually cannot specifically recommend a particular clinic, parents I work with have found good success by asking this question. “If your child was dealing with this issue, which wonder to therapists would you take them to?”. School staff interacts frequently with therapists in the community. They are often very aware of which ones are spoken well of and which ones are not.
The other option is to call your pediatrician or healthcare provider or even your insurance company. Often these entities will have frequent contact with therapists and be willing to let you know who they feel do good work.
If you were to call a mental health clinic, most the time your child will be assigned a therapist based on the population that therapist serves as well as their current availability to take new clients.
I would strongly encourage you to talk further with the agency you are considering bringing your child to and have a talk with the intake staff about your child and their particular needs. The therapist who has openings may not be the best fit for your child. It is important to look at what areas of specialization the therapists have in the clinic as well as what age they serve. Ask the intake staff which staff might be the best fit for your child.
Think through the questions you would like to ask the therapist. Write these questions down. I can guarantee if you do not write them down, you will have trouble remembering more than two or three of your questions when calling a clinic.
Here are some sample questions:
What is your experience working with children with (the problem your child has)?
Describe in general how you treat children for this problem.
What is your philosophy about involving parents in treatment?
How frequently would my child be able to see you? How far out are you scheduling?
The first meeting
A lot is riding on the initial session. Usually, the initial session is a more in-depth assessment of the current problem and its impact on your child and family. Usually history is also gathered to help make sense of past events in your child’s life and current functioning in areas like school, sleep, and energy levels to name a few.
Although the first session can often be more information gathering rather than offering specific help, you can still get a good sense of the therapist and their ability to connect with you and your child. Make sure you address any potential concerns you have early in this process. A good therapist will be open to the feedback you provide to them and make some adjustments on how they are doing things so long as it is not disruptive to the therapy process.
Most change in outpatient therapies occurs within the first eight sessions are so. After 8 sessions, change tends to flatten out. If you are not seeing progress within the first eight sessions, you probably want to be having another conversation with the therapist and talk through this. It is tempting just to take your child to another therapist. Although this could help, it also means starting over and going through the whole process again of engaging in a new relationship. You would likely be better off first finding out if the lack of progress could be changed at all through your discussions with the therapist.
The bottom line is that choosing the right therapist for your child can make a significant difference whether therapy can be helpful. You would be wise to take the time necessary to determine what therapists would be the best fit for your child. Do not be surprised if the therapist may also ask you to change your behaviors as part of treatment. This is to be expected and is not unusual in the treatment of children. In fact, therapy for children is far more effective when there is a strong parent/family involvement.
Isn’t that what you really want anyways---your child to get better?
If you have further helpful tips you have found in choosing the best therapist, please leave a comment below.