What To Expect When Your Child Starts Therapy

In this article, Carrie Manning, therapist at Reach Counseling, discusses how to get your child started in therapy and what you can expect.

Many parents or guardians contact my office with worries about their child. They notice that their child may be experiencing symptoms such as increased worries or fears, behavior challenges, anger outbursts, or other concerns. While it can be intimidating for parents to reach out to a therapist for the first time, a licensed and experienced therapist can help parents navigate this process.

Getting started

After a parent contacts my office, I set up a consultation call to discuss their main concerns. We can also discuss insurance/financial options, and evaluate if my counseling services will be a good fit for their needs. If I am not the right therapist for their needs, I will try to connect them with other local therapists and resources.

Once the parent decides to proceed, we will set up an intake appointment.  I will send intake and consent paperwork to complete online before the session.  We will verify their benefits before the appointment if they are using insurance. 

The first intake session

If the client is under age 11, the intake appointment would be only with the parent(s) (the child would not be present). If the child is a preteen or teen, they will attend with the parent.

During the intake session, I will get to know the client better, learn more about their history and presenting problems, assess the situation, and work together to start forming a treatment plan. We would then schedule a second session to begin individual therapy with the child or teen.

What does therapy for a kid look like?

I tailor my counseling sessions around the needs of my client, which are different for each child.  However, I can share some examples for each approximate age level and what you might expect.

Ages 4-10 - Play Therapy*

I will greet the family in the lobby and have the child come with me to the playroom for the session. Usually, I will “be the boss” at the beginning of our session and have the child participate in a game or creative/art activity.  Afterward, the child will have a turn to “be the boss” and engage in child-led play therapy. At the end of the session, I will walk the client back to the parent and give a quick update/overview of what we worked on during the session. Sometimes, I will have the parent come into the session to do a family therapy activity to help the client with a skill such as improving their communication skills.

*I use a “direct” approach with play therapy, which means I integrate lessons and creative ways to teach clients skills and help them express their feelings and needs in our sessions. For example, we may create a customized feelings chart or play a game to teach a positive coping strategy.

Learn more about Play Therapy from the Parents Corner at the Association for Play Therapy: https://www.a4pt.org/page/ParentsCornerHomePag

Ages 9-12 - Play-based and activities-based therapy

I design counseling interventions around the needs and preferences of my pre-teen clients. During our sessions, we will help them achieve their goals, such as identifying positive coping skills or practicing communication skills. We may integrate activities such as games, crafts, art, sand-tray, and talk therapy.

Ages 13 and up - Talk therapy and activities-based therapy

For my teen clients, I integrate creative and activities-based techniques such as art, sand-tray, and games to help them feel comfortable discussing their thoughts and feelings in our sessions and keep them engaged.

Family Therapy Sessions

Based on the client’s needs and goals, I will conduct family therapy activities to help the client improve their communication skills and to help improve family dynamics and relationships.

Parent Consultation Sessions

For younger clients, I will recommend that we do a parent consultation session usually after every 4-5 individual sessions with the client to discuss the client’s progress in therapy and to assess how the client is functioning. I will provide feedback based on my treatment observations and discuss ways to support the client and their family. These sessions are for the parents only (child not present).  If the parent cannot find child care, we can conduct these sessions via telehealth or phone. For pre-teens and teen clients, I like to have the client involved as much as possible. I will schedule a family therapy session to discuss the client’s progress and functioning, or I can pull the parent into the end of the client’s session to give updates. The parent or I may also request a parent consultation session without the child present to discuss progress, symptoms, and concerns. 

Partners in therapy

I see the parents and clients as co-partners in their therapeutic journey. I want to establish a trusting relationship with my clients and their families to help encourage growth and reach their goals. I encourage parents and clients to let me know if their services are not helpful. If my services are not working, I will provide referrals to other local therapists and resources.

How long does therapy take?

How long a client needs therapy depends on many factors such as the client’s symptoms, environment (school and home), and goals. My goal is to help clients and families find help and relief for their symptoms and challenges as quickly as possible; however, therapy is a process and not a quick fix. 

Stages of therapy

The therapeutic process involves four general stages.  The first stage (2-4 sessions) is the Introduction Stage, where I will be building a rapport with the client and assessing their needs during our sessions. Next is the Goal Development/Treatment Planning Stage, where we will work together to determine a treatment plan with specific goals during a parent consultation or family session.  The next stage is the Intervention Stage when the client actively participates in sessions and works on their goals with the therapist. The length of this stage depends on the client’s progress which is regularly evaluated with parents, and goals adjusted as needed. The last stage is Graduation/Dismissal. As the client gets closer to completing goals, we will discuss a transition plan for graduation and dismissal from therapy. 

As children and teens move through developmental stages and encounter future stressors, the need to return to therapy may arise. I hope to build strong relationships with families so that they feel like they can come back and receive extra support to get through difficult times.