This blog has been updated from the original July 2020 post.

As a San Diego Child Therapy Specialist parents often ask me how to talk to their children about coming to therapy. This is especially true if the child worries a lot, or dislikes new or unfamiliar experiences.  

I will never forget one terrified, little girl who came to see me years ago. She clenched her mother’s arm down the hall to my office.  She was like a deer in headlights as her mother directed her to sit up straight in the chair.  

Initially, her voice was quiet and shaky, and her mother began to scold her for not speaking up. This was anything but an ideal way to begin therapy. I coached Mom and had her take a seat in the waiting area. Then I was able to alleviate much of the girl’s fears simply by beginning to connect with her gently, offering art materials she felt comfortable with and sitting together at a table. Eventually, she realized being with a therapist was not as scary as she had imagined.

Talking to children about participating in child therapy is like many other things we have to speak to our children about.

Kids often take their cues from adults.  If we present therapy as a place where a child must talk to a therapist, a child can feel a tremendous amount of pressure to not only please their parent but also to talk to a stranger about something that is already difficult to put into words.

If we are tentative and worried when we talk about therapy, which can be natural because we have concerns about our child, he or she may believe there is something to worry about.   If we appear to be evading questions, they may feel we are hiding something from them.

Try to approach the subject of meeting with the therapist as calmly and matter-of-fact as possible.  Provide enough information to help them feel more at ease. Additionally, speak in ways that are developmentally appropriate for your child.  

You know your child…but here are a few suggestions or starting points if you are planning to see a child therapist in San Diego.

• “We are going to visit a therapist”.

• “A therapist is a helper”.

• “A therapist is like a teacher or a coach. They will help you learn new things”.

• “A therapist listens to kids if they want to talk about things that are going on in their life, like with family, friends or with school”

• “You can talk about whatever you would like, happy things, sad things, bad things, or things you have worries about.”

• “In therapy, kids get to do things like create art, listen to books, and play games”.

Therapists who enjoy working with children, generally design sessions to be child-friendly. 

Learning from you, the parent, what type of toys, activities, and games your child likes, is the beginning of designing those sessions and connecting with your child.  Below are some activities you might want to highlight for your child if they are activities he or she already enjoys that would add to positive anticipation of coming to therapy.

Only share about the following activities after you have spoken to the therapist about the type of experiences the therapist offers.

• Construction: Working on three-dimensional objects with building blocks or other materials.

• Playing games. Therapy-focused board games, as well as traditional games.

• Books: Read and listen to books that highlight a theme or goal in therapy.

• Art*: Opportunities for painting, drawing, collage, clay, and other hands-on experiences.

• Music:  Singing and making up songs together as well as playing instruments.

• Make-believe: Opportunities for role-playing with puppets, dolls, playhouses, small figures & toys.

• Show & tell: Bringing a favorite stuffie or another toy, especially during the first session can be comforting.

Art*: If your child enjoys creating art, seek out an art therapist credentialed through the Art Therapy Credential Board. The ATCB credentialing ensures the educational and professional standards needed to be a qualified art therapist are met and maintained.  This is essential in any mental health field to provide an ethical standard of care and improve treatment outcomes.

With all your best efforts to explain, child therapy may still seem scary to your child. Here are some of the reasons why.

1. They don’t want to talk to a stranger. The truth is, adults don’t want to come to therapy for the very same reason! This is the reason why one of the most important parts of therapy is establishing a trusting relationship. Then your child is not talking to a stranger.

   I find it helpful to reassure clients that what they tell me in therapy stays in therapy, with a few exceptions. When working with children, it’s a fine line. If a child believes that the therapist is telling their parents everything they say in therapy, the trust is broken. However, as a parent, it’s important to understand the process, and learn what is being talked about/worked on in general during sessions.  Ideally, your child engages in therapy and is excited to share what they are learning or feels safe enough to open up to you after sessions. Usually, having a parent cross-examine their child after a therapy session backfires, and closes up a child from wanting to talk about their therapy session.

• “While you can talk about whatever you want, the therapist will not make you talk about anything you are not ready to talk about”

• “The therapist will ask you questions because they want to get to know you”.

2. They don’t want to go to the doctor. Therapists have different degrees and titles. If a therapist has a Ph.D. and carries the title of a doctor, your child may believe when you tell them they are going to see “Dr. Brown”, that the possibility of a shot, blood draw, or bad-tasting medicine will be part of the visit.  It can be helpful to let them know that “Dr. Brown” is a different type of doctor. You can explain that there is not an examination table to sit on, no scales, no shots. Additionally, a Medical doctor may need to touch a child to listen to their heart and lungs or look in their ears, while a therapist does their work by listening to your words.

3. They are afraid they are sick. A child may be concerned that they are sick. This can be a legitimate concern if your child has anxiety, and experiences symptoms like stomachaches, headaches, shortness of breath, rapid heart beating, or other issues. If your child has been examined by a pediatrician and declared healthy, it’s important to explain to your child that their doctor checked everything out and believes they are strong and healthy. Again, you know your child best and your own words will be the most authentic, but here are a few suggested words.

• “Sometimes, when our tummies hurt, it’s not because we’re sick. It can be because we have feelings deep inside that are hard to talk about”

• “A therapist can help you figure out those feelings that are inside”.

4. They are afraid they are in trouble. It is also important for your child to know they are not visiting a therapist because they are in trouble. Sometimes what initiates contacting a therapist is a teacher/parent conference, having difficulty in school, or a call from the principal’s office.  Your child needs to know they are not bad or broken.  Sometimes family therapy that involves multiple family members can help alleviate a child’s feelings of being the “bad” one.

5. They had a bad experience before with a therapist. Sometimes kids have seen a therapist or counselor once before, and perhaps that person was not able to connect with your child all that well. Or maybe that therapist really didn’t know how to connect with children because it wasn’t an area of specialty.  Your child may have concerns about more of the same, which may have been an adult talking at them and it was boring.  This is the number one reason you want to seek out a therapist who does specialized work with children. They will know how to engage your child and make it fun.

Preparing for the First Session with a Child Therapist.

Parents sometimes wonder how far in advance they should talk to their children about coming to therapy.  This really is dependent on your child, but for most, it’s better to not just spring it on them at the last minute.  Prepare yourself, and meet with the therapist in person (or via video) before your child’s first session. This will give you information about the office, what the therapist is like, how long sessions will last, etc. Also, after meeting with the therapist you will have a better idea of the goals set for therapy, and what the process will look like, to alleviate your concerns.

Then you can talk to your child and give them time to think about it and to ask you questions. They probably will have concerns, and you can address the concerns and talk about the process of therapy with more confidence.  

•   “What concerns do you have about going to meet with a therapist?”

The therapist may also have photos on their website of the waiting room, the therapy rooms, and the therapist. The photos can help prepare your child, as they can start to become familiar with where they are going and who they are meeting.

No matter how it goes, know that choosing to reach out for help for you or your child, takes courage.  It’s important to find someone that both you and your child can connect with and trust.   If the therapist is not a good fit, or is not genuinely, connecting with your child, then talk to the therapist and ask for referrals.

Free consultation for a San Diego Child Therapy Specialist

If you are looking for a child therapist to work with your child, I’m a Therapist in San Marcos, CA.  Click here to visit my contact page where you can check my availability, and book a free, phone consultation.

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