Coming to therapy can be stressful when you don’t know what to expect, especially for children and teens who are usually not the ones initiating the demand for support. Parents can dread the conversation and have often asked me how to inform and prepare their children for their first session.
You will approach the conversation differently depending on the age of your child, their circumstances, and the specificities of the therapist you have chosen (art therapist, counsellor…). However, here are some guidelines that can help you out despite these factors:
Find a therapist that you and your child can feel comfortable with. Base your reflection on the knowledge you have of your child, previous experiences with teachers/educators or cultural preferences. Your referring doctor and the administrative team of the practice are able to support you in this decision. Most professionals and practices have now also their own website detailing their expertise and providing pictures of their therapists and office space. Once the session is booked, seeing these pictures will reassure your child or teen and give them a better idea of what to expect.
Pick your timing. Avoid bringing the subject into an argument or during a highly stressful situation. Refrain also from using therapy as a threat, punishment, or leverage to get your child to “behave”. Prefer a calm moment to start the conversation and make sure you have time to answer your child’s questions or help them process what it means. If they are not making a bid deal out of it, it might be better to move on. If you are the one insisting and making sure they are okay with the appointment, they may think that they are not picking up on something they should worry about.
Stay away from the blame game and pressuring comments. We don’t want to guilt or shame the child into going to therapy. Nor do we want them to feel stigmatized and responsible for the wellbeing of the entire family. Pointing fingers could lead to defensiveness and refusal. Other types of pressures may interfere with their engagement in therapy such as giving instructions on what to say and not to say or highlighting the cost of sessions as a lever for payback in a good attitude.
When talking about the difficulties that need to be addressed in session, discussing specific and observable behaviours is more conducive to fostering commitment and cooperation. You could say things like “I am noticing that it’s hard for you to stay calm when /that you don’t seem happy about /that there has been a lot of fighting in the family”.
Therapy is a team effort between the therapist, the child and the family. In any collaborative work, each person involved has their function, their pace, and their process. Parents can model patience and compassion for their children.
Try being honest about the nature of the appointment. Misleading description (e.g., “we will just have a regular chat with a nice lady”), false promising (e.g., “it’s going to be so much fun; you’ll see!”) or disguising the truth on where they are going (e.g., “we are just going for lunch/to visit one of mom’s friend”) may do more harm than good. It will bring your child to the consultation room, but they may feel betrayed, disappointed, and close off as soon as they arrive.
Prefer an encouraging tone by focusing on how therapy is a resource. You can say things such as “we are going to meet with *name of therapist*. Their job is to help people feel better / to help kids make friends more easily / to help deal with all of these strong feelings that show up sometimes / to help kids feel safer and more relaxed at bedtime”. You can also use your child or teen’s words on how they describe their struggles “you have told me that *issue*, *therapist’s name* can help you figure out what to do about that”.
You can add that the therapist may ask questions to know more about them, but remind them that it is not a test, that there is no right or wrong answer and that they are not forced to discuss anything they don’t want to. Depending on the age of your child and the information you gathered from the therapist, you may also mention that they may be offered to draw pictures or play games.
It’s better to not overwhelm them with details and run the risk of misinformation. You can admit that there are certain things you don’t know and encourage their curiosity to find out themselves and tell you more once the first session is over.
If the child is reticent, you may try creating a positive and pleasant ritual around the appointment like spending some time together before or after the session. However, refrain from using it as a bribe e.g., “if you go to therapy, I will take you for ice cream after!”.
Therapists work hard to make the therapeutic work appealing and playful to engage children and teens, but the core of the work is still about addressing struggles and hardships. It may not always be fun or easy but that is okay, as with school, medical appointments, or with life in general, some things are important and necessary to carry out.
If despite all your efforts, your child or teen absolutely refuses to attend, ask the therapist for further guidance. They may offer you to attend some parental sessions to analyse the identified difficulties and learn new strategies to address them and connect with your child.
MSc in Clinical Psychology and Psychopathology (Hons.)