Psychotherapy with Children and Adolescents

When I work with children, I always work with parents as well. I am intrigued with the complexity of working with children and adolescents. Everyone comes into the world with a temperament that may or may not fit well with the rest of the family. Children come with parents, siblings, and teachers who all have a perspective on the problem and perhaps a role in it.

Furthermore, children’s brains are developing. My training in child development helps me to understand how children at different ages comprehend and react to life challenges such as divorce, learning disabilities, family illness or moving.

As a parent myself, I understand that parents come to this work with their own histories, doing the best they can. I often think of myself as an interpreter between the land of children and that of their parents. In family meetings or in separate parent meetings I work to facilitate family communication and to teach parents about their child’s cognitive and temperamental strengths and weaknesses. This information informs how parents interact with their children. I can also teach children how best to negotiate with their parents.

I have a particular interest in the ways that learning disabilities and Attention Deficit Disorder can affect all of children’s functioning, especially self esteem and social interactions. Children and adolescents with Asperger Syndrome are also of particular interest to me. Often they have significant anxiety which can be helped with cognitive behavioral therapy. Older elementary school children and adolescents can learn about their learning styles and come to feel more confident in the world as they understand how they function best.

How Do You Start?

During the course of an evaluation I meet with the child and parents, the child alone, and the parents alone. Together we come to an understanding of what will be the best way for me to be helpful.

With a younger child I might meet with a parent at the beginning of each session to get an update and then meet separately with the child. With some children the work is done totally with parent and child together.

With adolescents I meet primarily with the adolescent and have separate meetings with parents as needed. Often we schedule family meetings to clarify misunderstandings or to negotiate agreements. This work often involves teaching the adolescent and parents how to negotiate with each other. For many parents the transition from childhood, where their authority was relatively absolute, to adolescence, where negotiation becomes more important, can be rocky. Of course, adolescents are unskilled at negotiation. I welcome phone or e-mail input from parents between sessions.

With permission I also consult with other involved professionals, such as pediatricians, psychiatrists, teachers, and guidance counselors.

How do you work with Children and Adolescents?

I use a few different approaches depending on what is appropriate. Sometimes children or adolescents present with behavior problems that are actually rooted in anxiety. In those cases I educate parents and child about anxiety and how it affects people. I teach cognitive behavioral strategies to the child to help her manage the anxiety. With the parents I explain the treatment so they can be supportive of their child’s efforts to manage anxiety. Often treatment of childhood depression is quite similar.

Sometimes I work largely with parents to teach them techniques to motivate children to improve their behavior and discourage misbehavior.

At times EMDR (Eye Movement Reprocessing and Desensitization) is useful in treating children’s anxiety disorders. I have found it helpful for phobias, such as needle phobias, or fear of going to parts of the house alone. EMDR is more completely explained elsewhere on this site.

I often use play therapy in conjunction with other approaches. In play children express in metaphor the issues they are dealing with in their lives. It can be a rich source of information about a child’s world view and worries. We can play with dolls, puppets, drawing, board games, or Lego’s, to name a few. I can also use play to introduce new ideas or solutions. With older elementary children board games offer a mode of expression. In addition, when simply talking about events at home, at school, or with friends is too stressful, playing a game helps reduce the stress.

With adolescents I emphasize being authentic. Expressing a sincere, respectful interest in their lives and well-being allows me to enter in to a relationship in which we can address the issues they bring. I meet with parents as needed with or without the teen to help them improve their relationship with their child. In family meetings both teens and parents learn to negotiate to work out problems such as when and how homework gets done, time with friends, time with family, and curfew.