Therapy for children
Providing therapy for children requires special skills and talent. It’s a whole different process from adult psychotherapy for several different reasons.
First of all, children are hardly ever self-referred – i.e. it’s the adults (parents, caregivers, teachers) who have a problem with the child and bring him or her in for psychotherapy. Therefore, as the first step, it is the job of the counselor to get the child motivated to meaningfully participate in counseling, and to do so while maintaining a delicate balance of sympathy and objectivity.
Secondly, children manifest emotional problems very differently from adults, and it can take careful investigation to get to the heart of the problem. For example, anger, irritability or hyperactivity in children can be a sign of various different issues: depression, past trauma, or anxiety. On the other hand, a withdrawn child might be bottling up anger. And sometimes anger is just anger, and could even be justified by something that is objectively wrong in the environment. All these considerations make the assessment of children a longer and more complex process.
Thirdly, the treatment of a child is quite unlike the treatment of an adult. Since younger children’s language capacity, worldview, and judgment operate on a different level, traditional “talk therapy” is rarely useful with them. The solution? “Play is the work of children” -- and this applies to therapy as well. In my experience, play therapy is the best method to work out children’s problems. When used by a skilled and experienced counselor, therapeutic play can move a child from symbolically processing their issues to verbalizing them, which is already winning half the battle -- while maintaining the fun, enjoyable atmosphere of the sessions (important in motivating the little one to continue attending the appointments).
And lastly, the problem might be that there is no problem at all. With the child, that is. Often the child’s emotional or behavior difficulties are a justified reaction to trouble or loss in their environment. Loss of a loved one; a bully at school; inconsistent or troubled caregivers; conflicts between parents; etc. If the parents bring a child to me, I know they care about him / her very much, but may need help themselves to become part of the solution.
Counseling for teenagers can be similar to adults, in the sense that their cognitive abilities make them suitable for talk therapy. However, the problems they commonly exhibit – for which they, or their parents seek therapy – are usually unique to the adolescent developmental stage.
Teenagers are in a time of their life when they are trying to formulate, establish, and practice asserting their adult identity: their value system, career ambitions, hobbies, social life, and style of communication. All this time, however, they are usually still living under the same roof with their parents, as their dependents – which can create an even more intense drive in teens to differentiate themselves from their mother and father. Therefore, the teenager’s efforts to build his or her adult identity often clashes with the parents’ desire to maintain their authority, or the emotional closeness they used to enjoy. This can create a frustrating situation for both children and parents.
A good counselor needs to know how conduct therapy respecting the adolescent’s budding identity and independence, while also honoring their role in the family system and the fact that they are, in many ways, still subordinated to the parents. It is a precarious balancing act and therefore requires special skills and experience from the counselor.
Therapy for teens
Prior to starting my private practice, I worked at a non-public school as a child therapist, with children who were not able to function in the mainstream academic environment. Their problems ran the whole gamut – defiance, depression, hallucinations, delusions, anxiety, mood swings, anger, aggression, autism, Asperger Syndrome, attention deficit, hyperactivity, shyness / social withdrawal, lack of social skills, low self-esteem.
On top of some very challenging mental health conditions, many of the children and teens I treated also struggled with common stressors such as divorce, loss, rejection or serious medical condition of caregiver, death of family member or a friend, sibling rivalry, relocation from another state, abuse, or neglect. During my time at the school, I received many compliments from parents and colleagues for being able to establish positive relationship with some of the most difficult children.
Having worked on these cases has truly prepared me to approach any problem a child my have with confidence, empathy, and skill, and to help the families find and utilize their strengths in the healing process.