- Many parents feel helpless and shut out when their child is in psychotherapy.
- Parental participation in a child's psychotherapy is necessary for optimal results.
- Parents sometimes need to initiate cooperation with the child's psychotherapist.
Many parents feel helpless and shut out when their child begins psychotherapy. You take the child to the therapist’s office. The therapist comes out and greets you and your child and then the two disappear behind a closed office door. Forty-five minutes later, you pick up the child and nothing is said about the session. T
his post describes what a parent can do to help their child get the most out of psychotherapy and reduce the feelings of being shut out.
Confidentiality. An Obstacle?
The right to speak to one’s psychotherapist in private is protected by law for competent individuals 18 and older. The guardian of individuals under 18 years of age and those who are incompetent have access to the medical record and hence the right to know anything that is going on in the child’s therapy.
Teenagers often feel that they need some level of privacy in their psychotherapy, so therapists and parents may negotiate with the child to keep the work private as long as there is no risky behavior occurring.
In order to be most helpful to your child, you need to be involved in the treatment. That doesn’t mean that you need to know every single word that is said. It means that you need to make sure that the psychotherapist knows information that your child might not share and to support changes that are being encouraged. Without this knowledge, you might be inadvertently undermining the work that the psychotherapist is doing with your child.
The governing theme for your participation in your child’s mental health treatment is that you be respectful of the process. You do not joke about the child’s therapy or therapy in general (no “How many therapists does it take to screw in a lightbulb?” jokes). Do not share the fact that your child is in therapy with others unless it is necessary and the child knows in advance. Do not express that you are burdened by therapy, either because of the need to transport the child or the expense.
You should meet with the child’s therapist before the child does. You should use this as an opportunity to assess whether the person meets your standards. You should also use this opportunity to give the therapist a history of the problem and to share your current concerns and expectations.
Supporting Therapeutic Interventions
After the diagnostic phase of therapy, treatment often focuses on coping mechanisms. This will typically involve either new approaches to problems or changes in the existing methods. Your awareness of these changes will help you maximize the effectiveness of the intervention. In the example below, Sara inadvertently sabotages the intervention because she was not aware of what was being done and how it helped her child.
Gina, Sara’s daughter, is 13 years old. She is seeing a therapist because her mother found her cutting herself with a razor. Gina told her therapist that she gets very strong urges to cut herself when she is upset. The therapist told Gina that until she learns to better process her feelings, she should resist cutting herself by pinching her arm, instead of cutting. Sara did not know about this instruction and saw Gina pinching her arm after arguing with her friend over Facetime.
Sara: Gina, what are you doing?
Gina: It’s OK mom, I’m pinching myself.
Sara: I thought we were working on you not hurting yourself.
Gina: The therapist told me to do this.
Sara: Am I supposed to believe that?
Sara: Maybe you need to be in a hospital. The therapy clearly isn't working.
Gina: I don’t care. I’m done!
Gina then ran off and cut herself on the wrist with a scissor. This could have been avoided with a simple phone call or email contact where Sara is told about the intervention. Had this happened, Sara would have recognized what Gina was doing and not interfered.
Knowing what your child is working on in therapy allows you to model healthy forms of these behaviors in the household. In the example below, Barry got an email from his son Chris’ therapist telling him that they are working on using time-outs to decrease impulsivity.
When Chris came home from school, he found his father trying to clean the gutters on their roof. Barry was frustrated because his ladder was too short and he was stretching and straining and still having trouble reaching. When he saw Chris he got off the ladder and had the following conversation.
Barry: Hey Chris, how was school?
Barry: Would you like to have a snack with me?
Chris: Aren’t you going to finish the gutters?
Barry: Yes, but I was feeling frustrated because my ladder is too short so I decided to take a time-out. I will get back to it in a few minutes.
Chris: You take time-outs?
Barry: Yes. I take them when I am frustrated or angry. That way I don’t do anything I might later regret.
Chris: I see.
In this example, because Barry understood that Chris was working on using time-outs, he was able to naturally demonstrate how the tool is used. This increases the chance that Chris will be able to use the time-out tool effectively when he needs it.
Many therapists that work with children take the initiative to reach out to the parents of the children they treat. If your child’s therapist does not reach out to you, then you should take the initiative to reach out to the therapist and form an ongoing partnership to foster your child’s healing and growth.