3 Questions to Ask About Child Counseling

Grayson is a lively 7-year-old in the first grade, whose parents are concerned about whether he is “normal.” They love his excitable spirit. Yet, when they try to do even simple things as a family, they have grown increasingly frustrated with what other parents, even friends, have labeled “over-the-top” behavior.

A simple trip to the grocery store seems to send Grayson spinning. His mom never knows if he’s going to be singing at the top of his lungs or flailing around on the cold tile during one of his tantrums, as strangers look on with judgmental glances. His teacher has told them that Grayson struggles to complete his work and requires multiple reminders to “stay focused.”

He’s even begun alienating his classmates at school and in Sunday School class. He loves being with other kids, yet he doesn’t seem to understand or be able to maintain personal space.

Grayson’s parents just want him to be a happy, thriving boy. And now, after multiple complaints from his school, church community, and even strangers, they’ve come to realize that he may need professional help from a therapist. On a recent visit to the family pediatrician, medication for “ADHD” was recommended, but his parents are hesitant to give Grayson medication and prefer to meet with a therapist first.

They also weren’t sure if child counseling was the right answer. Grayson’s parents were afraid of him being labeled as “abnormal.” Their biggest worry is that Grayson will think something is “wrong” with him if he goes to counseling. They have accepted that they need professional expertise and the support of a therapist who specializes in working with children, but they wonder if it will be worth it.

Can you relate to Grayson’s parents? Does their predicament strike a chord with you as you think of your beloved child?

Many parents like Grayson’s find themselves between a rock and a hard place. They want what’s best but may not know what that is. There is so much access to information—and misinformation—which can lead to parents feeling overwhelmed and confused. If parents don’t have the proper knowledge of the role of a child therapist, they may decide to skip seeking help from one altogether.

3 Questions to Ask About Child Counseling

Here are three questions, along with helpful answers, that many parents want answered before they will seriously consider child counseling for their son or daughter:

1. Will my son or daughter have to be put on medication?

A child behavior therapist focuses on helping the entire family (the child, parents, involved siblings, and even other caregivers) learn new ways of interacting or behaving to address the parents’ concerns and the child’s presenting problem. The key here is a focus on behavior: the behaviors we see, like acting out, crying, tantrums, etc. and the behaviors we don’t see, like feelings of sadness or anxiety.

Medication evaluations are typically carried out by primary care physicians, nurse practitioners, and child psychiatrists and are used to determine the necessity or effectiveness of a psychopharmacologic intervention.

Child therapists may offer a referral for a medication evaluation to parents if their review of relevant background and familial history, coupled with current presenting concerns, indicates medication may be one useful tool in the therapy process, and if, after exploring the needs and values of the family, parents opt to consider medication.

Parents are the ultimate authority for directing their child’s treatment. An effective child therapist will honor the traditions and desires of the family while offering best-practice recommendations for intervention. It is critical for parents to bear in mind that they are the chief advocate for their child and to advocate effectively they must openly offer their concerns to the child’s therapist.

This not only promotes a safe and honest atmosphere between the child therapist, the child, and the entire family, it also paves the way for treatment time to be focused on interventions that will work within the dynamics of the family. Interventions are most likely to be carried out (and therefore more likely to produce positive results) when the family agrees with and embraces them.

2. Will I be able to sit in on my child’s counseling sessions?

Yes and no. Child counseling operates under the same basic premise of counseling for adults: establishing trust. For child therapy to be effective, the child therapist must have the opportunity to establish trust with your son or daughter. To do so, they must spend time alone with them, one on one.

Often, parents will join their child in the first session so the therapist can gather background information pertinent to the child’s case. Subsequent sessions are spent building rapport, or trust, with your child without the parent present. Your child and the child therapist may play games together as they talk. It is important that the therapist gets to know your child if there is to be positive progress made in treatment. The length of time it takes to build that trust varies with every child.

Expecting this uncertain timetable and anticipating the necessity of trust-building between the child and child’s therapist without parents present allows parents to facilitate an effective therapy experience and the likelihood of positive outcomes.

Children also need a space in which they can exercise their voice autonomously. Children often look to their parents to determine how they feel, or what they should say. When a parent is present, the child therapist may be unable to effectively elicit candid, honest feedback from the child.

The one-to-one component of the child therapy process also promotes self-discovery in the child. Children, like adults, have their own “aha” moments when offered a safe, nonjudgmental space (such as that provided in child therapy).

An effective tool used in child counseling is for the parents to be called into the session during the last several minutes for updates and a time to debrief. The child therapist may prompt the child to share with parents the highlights of the session and what they learned that could help them. The child therapist may also suggest practical tools the parents can use between sessions in addition to sending homework for the child to work on to implement and emphasize what was taught in session.

Parents must understand they may not know everything talked about during the session, but they will be apprised of critical information (such as safety concerns) either from the child directly as prompted by the therapist, or by the child therapist if the child is unable to articulate the information.

3. How long will it take?

The most direct answer is, as long as it takes. Every person is born with a unique temperament, personality, and set of gifts. Therefore, no therapy process will, or should, ever look the same or take the same amount of time. Some children are slow to warm up to strangers and the trust-building stage with the behavioral therapist may take considerably longer than that with a child who is naturally quick to trust and engage.

Similarly, parents play a critical role in the length of treatment. Their readiness to disclose all pertinent information to the child therapist also informs the trust-building stage of treatment. Your child’s therapist is trained to ask the right questions and no question is irrelevant to the successful treatment of your child.

Furthermore, parents must make a commitment to the process of implementing suggested interventions and strategies between each session. Unfortunately, many parents underestimate the power of living out the work done in an hour session over the next week to practice new behavioral strategies and to observe their effectiveness in the real day-to-day life of the family.

It would be a mistake to leave the work of therapy to only one hour per week when there remains an additional 167 hours outside of therapy per week. Therefore, parents must be prepared to be an integral part of the therapy process. Their child’s success depends upon their commitment.

Finding the right child therapist for your child may not happen on your first try. Don’t give up. Because you desire what is best for your child, expect to be a joint partner with your child’s therapist, and expect to make changes in your parenting style. Through this experience, you and your family will grow, learn, and gain new insight.

Don’t be afraid to ask questions or bring up concerns. Please be open and share information with your child’s therapist. Ultimately, it is important that you advocate for your child to help them have a successful, meaningful child counseling experience with long-lasting and far-reaching results.