“How do I tell my child that they are going to a therapist?”

This is a very common and appropriate question that parents ask me when scheduling the first session for their child. They might state concerns such as “I don’t want him/her to feel like something is wrong with him/her.” While this is understandable, therapy is usually a lot more anxiety-producing for parents than it is for their child. In fact, most children who come to see me appear relieved to be in my office, and quickly understand my role in helping him/her/their family feel better about whatever it is they are struggling with. Nonetheless, at times children and teens may resist therapy, and these suggestions for how to talk to children about starting therapy can be helpful:

 

When should I tell my child that they are going to see a therapist?            

Because some parents have their own anxiety about their child attending therapy or are simply anxious about their child’s reaction to going, they may be tempted tell the child just before the appointment or the same day of the appointment. This is counterproductive as children often need time to ask questions about therapy and express their feelings about going. While I advise parents to wait to tell younger children about going until 1 -3 days beforehand, especially if he/she is anxious, older children/teens benefit from knowing at least 5-10 days to allow time to process. Of course, if the child is asking for therapy, they should be told as soon as possible as they will likely feel relief to know that help is coming.

 

Many parents find that, with the guidelines below, conversations with their child about starting therapy go better than they anticipate.  If you stay calm, matter-of-fact, and empathic, your child‘s feelings will likely mirror yours. And they might even feel a sense of relief that you made an appointment without him/her even having to ask you to do so!

 

Set aside time to talk about it                       

Parents are often tempted to tell their child during/following an argument or crisis. However, if he/she is angry or upset, it may be hard for the child to process the information. Moreover, if the parent seems angry, the child may perceive therapy as a punishment and be more resistant to attending.

 

For a child who's about to enter counselling, the experience may be a stressful one for them before they even set foot in the therapist's door. Set aside some one-on-one time with them so that you can talk about what to expect. In a simple and compassionate way, parents can tell their child that they notice they has been struggling and empathize with how hard it must be for them. If either/both parents and/or another respected adult has had a similar struggle in the past, they might share it with the child.

 

For example: “Sweetie, we know that you have been having a lot of worries lately. Sometimes we feel worried too and know it can be really difficult. Nobody likes to feel worried all the time.”  You can also stress that seeking support is a sign of strength and health.  To the extent that other family members will be involved in the therapy, you can stress that you/they are seeking support as well. Let them ask as many questions as they need to feel comfortable with your decision and allow them to express their thoughts and ideas. 

 

Be honest about the need for counselling                         

Sometimes parents may feel guilty for sending their kids off to counselling or therapy, partly because of their misconceptions and taboos surrounding mental health therapy. Your child may have also picked up on these cues from your past behaviour or comments toward those seeking or receiving mental health help. 

 

You may want to explain to your child the reasons why people get professional counselling and that there's nothing wrong with doing so. Be honest about your limitations as a parent in helping them get through their pain and grief. If you're also considering getting help, let them know so that they feel more at ease. 

 

Explain the difference between a doctor and a therapist                          

An excellent way of explaining the need to see a counsellor or therapist is to make a comparison between the types of doctors they're already familiar with. For some children, there's a stigma attached to getting sent to see a school counsellor, for example. So, explaining to your child that seeking therapy isn't a form of punishment and that they didn't do anything wrong will help them feel comfortable about going. You can start by telling them that while a medical doctor helps them feel better when they are sick or something hurts, a counsellor or therapist helps fix the way they feel when they're sad or upset about something that's happened in their lives. 

 

Explain psychotherapy – Younger Children                          

Parents can tell their child in a developmentally appropriate way that they have spoken with someone that can help.

 

For a younger child, a parent might say something like: “Sometimes when children feel worried a lot of the time, it helps to go to someone whose job it is to help kids better understand their feelings and worries by playing and talking with them. We know someone named Ms. Cierra who helps kids have fewer worries. We think she will help you have fewer worries and help us understand how we can help you have fewer worries.”

 

You can show your child a picture of the therapist and an information sheet (just ask me for one!) and show the child the therapist’s website.

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Explain psychotherapy – Older Children                                                                                                                 

For older children/teens, the parent can say something like: “I notice that you have seemed really sad and are sleeping a lot lately. I think you should talk to a therapist about ways to better understand and manage your sadness. I have found someone named Cierra that I think you will like. I made an appointment to see her on Wednesday afternoon.”

 

If met with resistance, the parent might tell them that the expectation is that they will attend a few sessions, and then they can discuss with the parent their feelings about continuing. If therapy is non-negotiable due to circumstances such as severe depression or suicidal ideation, parents should emphasize that they love the child too much to see them continue in pain without any help. Parents might also validate that they know it wasn’t the child’s idea and make sure that the child/teen understands that therapy is NOT a punishment, even if the teen has been exhibiting poor judgment/behaviour. Finally, if it is the family seeking therapy as a unit, the parent might say that they have made an appointment with a family therapist who will help everyone communicate with and understand each other better.

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Tell them what they should expect                                                                                                                         

Sometimes the fear of the unknown makes for a worse experience than reality. To ensure that your child is well prepared for their first session with the counsellor or therapist, ask your therapist what you can expect for the first session or request additional information.

 

A child who's aware of what to expect will typically look forward to their first session. You can explain to them that the counsellor will also go over everything during their initial visit. Assure them that they can ask as many questions as they need to until they feel comfortable. Depending on the issue and the age of your child, the therapist may first want to meet with you alone to get some background information about the issues that your child is facing along with some developmental history.  Other times, they may want to meet with you and your child together, or in the case of teens, possibly with your child alone.

 

You will join the virtual appointment and it will notify the therapist you are waiting for them. Often, they will be in a meeting with someone else beforehand and will come to find you at your appointment time.

 

Once you are admitted you will see the therapist come up on video. The therapist will already have your appointment form containing the basic information but may want to confirm some additional details.  This can help to break the ice.

 

From here, different therapists will work in different ways.  Some may have a structured questionnaire that they will go through with you to do a full assessment of the child’s history, your concerns and the reasons that you are seeking therapy.  Other therapists prefer to work in a less structured way, opening with some variation of “What’s bringing you here?” and let the conversation flow from there.

 

In cases where younger children are involved, your therapist may use different approaches to engage the child or family members, for instance, creating a family mural or family sculpture, or through structured play.  This allows children to have the opportunity to communicate in a way that is more familiar to them.

 

Many therapists will view the first therapy session as an evaluation period.  The goal here is to get to know one another better and to see if you are a good fit. One of the most important factors in therapy is that you and your child feel comfortable with your therapist and that you feel like you are a good match.  Not every person clicks well with every therapist, and your therapist understands this.

 

Feel free to bring up questions or concerns if there is something that you don’t feel so comfortable with or think that the therapist’s approach isn’t what you need.  We appreciate your feedback and your therapist wants to make sure that you get the best service possible.  Many times, with your input, the therapist is able to adapt his or her approach so that it may be more helpful for you, your personality style and your unique needs.

 

If for any reason, your therapist really doesn’t feel like a good fit, this is completely okay. Your therapist is able to help facilitate a transfer to another professional who would better suit your needs.

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Assure them that they are safe                                                                                                                         

Preparing your child for their first therapy session goes beyond telling them what they should expect when they get there. Spend some additional time going over with them the specific needs that the counsellor can help them address. Assure your child that whatever they discuss with the counsellor is between them, and they should feel comfortable talking about whatever they think they need help with to feel better. Here’s a way to explain to your child who the counsellor is and what their role is.

 

We’re going to meet with the counsellor, Cierra. I’ve already met them, and they’re very friendly. Much like your doctor you see when you’re sick, they also help kids feel better whenever (having a hard time at school), (having fights with friends), (they are having trouble coping with the death of a pet) (their parents have gotten a divorce). You can talk to them about anything you want to, and they’ll help you feel better. They’ll mostly want to talk with you or play some games together with you. You will be safe with them, but at any time, if you’re not comfortable, please let me know right away.

 

How to Explain Counselling or Therapy to a Child Who’s Not Entering Counselling

Whether your child is resistant to therapy or it’s simply something you’ve considered together, explaining what therapy is and how it can help can be a challenge. You can prepare your child for therapy years ahead of when they might need it by carefully explaining what therapy is and what it isn’t. Some children learn to associate counselling or therapy with punishment for having done something wrong. You’ll need to work on changing their mindset into thinking that therapy is a safe place to talk openly about their feelings and find ways to heal from their past pain and trauma. Here are some ideas for talking to your child about therapy.

 

Introduce them to mental health care                                                                                                                    

Sometimes a child is unaware that mental health treatment is available to them and under what circumstances. Children of all ages may have heard of counselling from the kids at school or on television but have no real idea what it is. You can teach a child early on what it means to get mental health treatment and who might benefit from it. 

 

Most young children won't have the mental capacity or maturity to understand the concept of counselling. Still, you can begin by telling them what a counsellor does and what types of situations they're available to help with. The younger you acquaint children with therapy, the more receptive they'll be to receiving mental health care as they need it. 

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It can prepare them for a loved one’s death                                                                                                          

Families experiencing the heartache of seeing a loved one suffer through a long-term illness or sudden terminal illness or accident will become familiar with end-of-life counselling offered at or near death. A hospital or hospice chaplaincy staff usually provides this type of counselling free of charge. Its main goal is to help those transitioning to death find peace and hope in their last days. End-of-life counselling also helps the dying patient’s loved ones struggling with the pain of losing their family member. Children can benefit from this type of counselling when someone close to them is nearing the end of life.

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Assure them that therapy is private                                                                                                            

Often, older children refuse to go to therapy because they don’t trust that what they say to the therapist will remain private. There’s a misconception around older children that their parents have a right to know what they discuss in therapy. Many times, this alone creates an aversion to seeking therapy or professional counselling. 

 

Reassure your child that what they discuss during their counselling sessions is entirely private and confidential, except in cases of physical or sexual abuse (the therapist may be required to report it). Once the child has built trust with how therapy sessions go, they may be more inclined to go.

 

Give them options for traditional therapy                                                                                                              

Traditional therapy has long involved making an appointment and waiting to see the therapist or counsellor in person in an office setting. These sessions are slowly becoming a thing of the past, with more and more people seeking online counselling and therapy. Because counselling mainly involves talk therapy, meeting with a counsellor over the internet is more convenient and comfortable for a child because they can go online while still at home and in the privacy of their bedroom. 

 

Therapists have also adapted to meeting their patients online and assigning work or activities they can do together over a video chat session. Overall, online sessions provide an excellent alternative for older children whenever they consider entering into therapy. 

 

Destigmatize getting help                                                                                                                                        

All in all, one of the most incredible things you can do for your child who may need mental health therapy is to destigmatize getting the help they need. Children need all the love and support they can get at home and in a professional setting where appropriate. The more therapy is normalized, starting at home, the easier and more comfortable it’ll be for your child to ask for the help they need.