In a previous article, I discussed what to look for in a therapist as an adult client in order to help people determine whether or not you have a good therapist. This article is for parents to help them know what to look for and to identify when they have found a good therapist for their teenager or young child.

While there will be some crossover from good adult therapy, there are some factors unique to working with children and teens. A good therapist for teens, and especially young children, has training and experience understanding family systems, in addition to their training working with children and adolescents. When you work with teens and with children, you essentially have more than one patient. A good therapist knows that they will be treating the child and their family system.

A good therapist understands that a well informed parent, who is willing to adjust parenting strategies, can have an exponentially greater positive impact on a child’s behavioral and emotional well-being than a therapist who is working with their child individually on a weekly basis. A good therapist will also understand that a child operating in a dysfunctional system will not likely benefit from individual therapy as long as that family system remains unchanged.

Adults enter therapy of their own volition, whereas children and teens are usually directed into therapy based upon the observations of a significant adult in their life. Most often it is one of their parents, but may also include teachers and grandparents. Invariably there is an adult in the teen’s or child’s life that has concerns about how they are doing emotionally and psychologically. This is the typical impetus for treatment.

Allowing a professional to emotionally connect with your child and have close personal access to them is a big deal. As parents you have every right to make sure that you feel comfortable with the therapy your child is receiving. I strongly encourage people to seek a referral from a trusted source whenever possible like a family doctor, school counseling office or a family friend. You should be able to speak personally with your child’s therapist prior to your child meeting with them.

A good therapist will include parents in the intake interview process. They will want to get to know the parents as well as get pertinent background information. It is obvious that young children are likely ill equipped to portray an accurate history of challenging behaviors and emotional issues. Teenagers may be better reporters, but they can only tell you what they know and understand about themselves, which can be limited. They are often unaware of family mental health issues or their own developmental history.

A good therapist understands that adolescents have a need for privacy as they are individuating from their parents. They will also understand how young children assume that parents know everything that is happening to them, and will automatically assume their feelings will be shared with their parents unless it is explicitly stated early in treatment. If your child's or teen’s therapist does not talk about the way that privacy is maintained at the beginning of therapy with both you and your child, this is a significant red flag. I would strongly encourage you to ask about it, and if the therapist is ill prepared to answer your question, you should look elsewhere for help with your child. Your son or daughter needs to know what kind of things will be shared with you and what things they can assume will be kept private. Ideally the therapist will include your son or daughter in any decisions to reveal sensitive information to you and will do so with their expressed permission.

A good therapist recognizes that privacy has limits and makes it clear to parents, teens and children that any high risk behavior that could reasonably lead to serious harm will be shared with parents so that they can take protective action.

Ultimately, you want your child or teen to have an emotionally safe and supportive experience in therapy. Unexpected violations of your child's privacy, especially with teenagers, will make it difficult for them to access therapeutic support in the future, should they need it again.

As in adult therapy, children’s and teens therapy should be organized around goals identified within the first few visits in therapy. Parents and children may have different goals and this should be part of the discussion. The goals should ultimately reflect what is in the best interests of the child or adolescent.

The younger your child is the less likely they will benefit from conversation and discussion. Play activities are essential. In my work with small children I would engage them in unstructured play activities. I could look for themes and try to understand the thinking patterns and emotional experiences that organize their play activities. From this play, I would generate hypotheses about what was driving some of their challenges and discuss this with parents and come up with parenting strategies informed by these observations. For older children I would engage them in therapeutic games and activities that promote learning skills consistent with therapy goals.

Because children and adolescents are brought to therapy by others and do not usually self-refer, the therapist will need more time to build a relationship with your son or daughter. This is especially important with teenagers. A teenager will consider what a therapist says to challenge them to the extent that they are invested in the relationship with the therapist. It will take some time and experience to develop that relationship.

Don’t be surprised if the therapist is quicker to challenge you as a parent to make changes in your behavior towards the teen than to challenge your teen on changing their own behaviors. If the parent initiates therapy for their child, it is more likely that they are invested on day 1 and ready to tackle the issues, while the teenager will be more ambivalent until a strong therapeutic alliance is formed with the teen.

Parents, children, and teens are likely to experience some level of challenging emotions around the young person’s therapy. I routinely tell parents that if their teen feels understood by me, they will assume I am aligned with them and may tell the parents I am on their side against the parents. I let parents know at the beginning that I am ultimately aligned with the best interests of their child, which includes developing healthy family relationships.

If your child or teen has a good connection with the therapist they will want to attend appointments. If they are hesitant to attend sessions, the therapist may not be the right fit for them, and/or it might not be the right time for them to tackle their issues. The last thing you want is for your child to feel like therapy is a form of punishment, like serving a detention for not being better able to manage their feelings.

The degree to which a parent requires therapy participation should be in direct proportion to the extent to which the child’s or teens behavior interferes with their functioning. For example, a child who is cutting needs therapy more than a child who is struggling with academic demands. For the former it makes sense for the parents to insist that the child gets some professional help. For the latter, educational planning and academic support may be a better option rather than therapy.

If therapy is working your child should be showing progress towards their treatment goals. If you are not seeing progress after a few months, you should reach out to the therapist. A good therapist will respond with openness to your questions and will want to know about your concerns. While the therapist cannot share what your child or teen is telling them, out of respect for the child’s privacy, they can listen to your concerns and bring them into their work with your child. It is also appropriate for you to ask the therapist about ways that you can support your child in meeting their goals.

Therapy for children and teens can be an extremely helpful and critical part of your child’s healing and emotional and behavioral wellness. With the right therapist your child can overcome mental health challenges and turn their lives in a positive direction. You can become more informed and effective parents. Hopefully the information I have shared will help guide you in the right direction.