Practical counseling for Children

Treating children who have emotional or behavioral issues is generally more complicated than treating adults because children tend to have more difficulty expressing why they are hurting and understanding their emotions. Additionally, children with some mental health issues such as Oppositional Defiant Disorder are not really open to therapy because part of that disorder is a tendency to blame others for their negative behavior. Knowing what type of therapy, if any, is appropriate for any given child or adolescent is an important area of knowledge for any mental health provider because our goal is to help each child to live happier and healthier lives. Using the wrong type of therapy with a child or recommending therapy for children who likely will not benefit from therapy only leads to minimal treatment progress and frustration for everyone involved.

From my point of view there are four main types of therapy that are used with children with emotional or behavioral issues, and those are play therapy, cognitive behavioral therapy, supportive therapy, and parent training. Play therapy is typically used for younger children who are not very verbal and who have had histories of abuse or neglect. It allows a child to vent their feelings in a supportive environment through their play. This is not just the typical play that is done at home, but is a style of play that can lead to emotional healing over time. I have done play therapy with children with abuse and have seen first hand the type of healing that can occur with this type of therapy. Cognitive behavior therapy is used with children who are better at expressing their thoughts and emotions, which tend to be children who are a bit older, because their cognitive development is more advanced. This type of therapy helps a child to identify thoughts that tend to create and exacerbate emotional issues so that the child can learn to better manage those issues. This therapy can be very effective in a short amount of time for children with social anxiety, panic attacks, obsessive compulsive disorder, and depression. Parent training is typically used to help parents to manage the negative behaviors associated with children who have negative behaviors at home or at school, including anger, aggression, or defiance. It involves teaching parents about why those behaviors are occurring and strategies to help reduce that negative behavior. This is typically done through 4-5 training sessions and occasional follow up appointments to address any ongoing concerns. Supportive therapy is typically used for older children who going through a difficult time in their life and need an unbiased person to talk with and to learn to resolve issues.

Over the course of my career, I have often heard from families who have been taking their child to a mental health professional for 6 months or more and have seen little to no improvement. When I ask what type of therapy is being done with their child, I usually hear that the type of therapy being used is one that likely won't be effective for the particular problem that brought them to therapy. For example, play therapy usually isn't very effective for children with ADHD, or oppositional defiant disorder. And many children with ADHD have difficulty paying attention in talk therapy so they don't benefit from it. It is frustrating for the parents (and for me) to hear about this type of situation because it is time consuming and costly for the parents to have their child in ineffective therapy and gives a bad impression of the effectiveness of mental health treatment.