"You Can't Make Me Go!"
Ten Tips on How to Talk to Children and Adolescents About Coming to Therapy
Children rarely decide to seek therapy independently or request to see a psychologist on their own. Instead, parents are frequently in the difficult position of trying to explain to their child why it is time to see a therapist. Despite the fact that seeing a psychologist has become increasingly common over the years, many children and teenagers continue to believe that psychologists are for "crazy people," or are anxious about the process. Unfortunately, parents often fear their child's discomfort and opposition to treatment and the conflict and negative emotions that introducing this topic may breed. Parents can be unsure how to proceed when their child responds to the idea of psychological treatment with anxiety or worse, such as the dreaded, "You can't make me go!"
To help with this difficult process for parents, the following are some strategies for how to talk to your child about coming to therapy:
- Be honest. Some parents are tempted to tell their children that they are going to a friend's house, to pick up dinner, or to get ice cream in order to avoid the discussion of starting therapy. As you would expect, however, honesty is always the best policy in this situation. When children or adolescents arrive at the therapist's office only to realize that they were misled, they will be much more likely to be angry and distrustful of the process. It will be important to talk to your child not only about coming to therapy, but why you think it is important, and your goals for treatment. Unfortunately, many children and teenagers come to their first session and have no idea why they are there. Setting a tone of openness and honesty right from the start will be an important part of creating a positive therapeutic experience.
- Listen to your child's concerns. Often parents can become so consumed by their child's need to see a therapist that they forget to listen to the child's worries about the process. Instead, adults become intent on just "getting them there." Simply knowing that his/her concerns have been heard can significantly reduce your child's anxiety about the first visit. Also, it will allow you to answer some questions that may make your child feel more comfortable. For example, many children wonder, "What if I do not like my therapist?" "What will I be asked to do?" or "How long will I need to go?"
- "You're miserable, let's do something about it." The decision to see a psychologist frequently comes after experiencing significant frustration, anger, conflict, sadness, or anxiety. Children, just as adults, do not enjoy these negative emotions. Often appealing to their distress and the hope of distress relief, allows them to see a therapist as a way of feeling better. Our therapists will frequently say to children, "I know that you could be happier and that life is not pleasant right now. I think I may be able to help things feel better and go smoother at home/school. We can't continue with life feeling this hard and frustrating."
- Allow your child to feel a sense of control. Children often feel entirely out of control when they are told they must see a psychologist. Can you imagine if someone told you as an adult that you must see a therapist against your will? As such, it is important to give your child control in ways that are appropriate. For example, you may allow your child to decide if he/she likes his therapist or if he/she would like to choose another clinician, or if he/she would like to participate for part of the session and his/her parent participate in the other part. Of course, only give your child control over the issues that may be flexible. Frequently, if children or adolescents come to the office just once they will realize it is not as aversive as they imagined.
- Psychologists are for everyone. One of the most common misconceptions among children and adolescents about psychologists is that we only treat "crazy people." On a first visit many children will say, "I'm not crazy so I have no idea why I am here," or "I don't understand why I am here and my crazy friend, X, is not." Even parents sometimes fear that taking their child to the psychologist will make their child believe that there is "something wrong with them." Our therapists respond to these concerns by letting children and teenagers know that we do not see "crazy," people and that in fact, psychologists are for everyone. Because children do not generally talk about visits to their therapists with their peers, they often feel like they are the only one in their class or among their friends who needs to see a therapist. It is important that adults normalize the experience of going to a psychologist and let their children know that although children and adolescents tend to keep visits to the therapist private, many people see psychologists to help better manage issues that emerge for us all.
- Explain what will happen at the psychologist's office. Going to a therapist's office may feel like going to a foreign country for children and adolescents. They do not know what to expect, what will be asked of them, how long the session will last, if they will be alone with the therapist or have your support during the meeting, among many other unknowns. This uncertainty can create or increase anxiety. It will be important to get a sense of what that first meeting will be like when setting up your appointment so that you can offer as much information to your child or teenager as possible. Once some of the unknowns are known, the process may feel a bit less threatening for children.
- Liken the process to a medical concern. Most children and teens would offer little resistance if you wanted them to see a doctor after breaking an arm, suffering with the flu, or having an allergic reaction. If you liken the process of going to a psychologist to that of having a medical concern or seeking the help of a medical doctor, it may be easier for some children to understand the utility of therapy. In the same way that someone would see a dentist for a cavity or a dermatologist for a rash, it is sometimes necessary to see a psychologist for emotional, behavioral, or family issues.
- Relate to your child or teenager. When appropriate and applicable, explain a time when you saw a psychologist or sought therapy in the past and how it was helpful to you. This kind of disclosure can again help to normalize the experience of seeing a psychologist. Of course, care must be taken to share this information with your child in a way that is not overwhelming to them or inappropriate, but rather comforting and supportive.
- Make therapy time more pleasant. It is sometimes possible to pair therapy with some one-on-one time with a parent or another pleasant activity for a child or adolescent. Following therapy with a dinner out, shopping time with mom, or a movie can be highly rewarding for many children and may make the process of coming to therapy more pleasant.
- Let them know the therapist is on their side. Children will occasionally view a psychologist as working against them or with the goals of their parents or teachers in mind. Sometimes reminding children that the therapist is on their side and working to help make life better for them, helps them to see the psychologist as their advocate and not their enemy.
It is very important to our therapists that you and your child are comfortable as possible throughout the therapy process. Please do not hesitate to let your therapist know if there is anything we can do to put you and your child more at ease.
Copyright © 2010 Hudson Valley Center for Cognitive Therapy. All rights reserved.