Child and Adolescent Therapy

• Individual Therapy with Children
• Individual Therapy with Adolescents

Individual Therapy with Children

Meeting with children individually gives them an opportunity to present their difficulties—as well as the family’s challenges—from their perspective. Children, though, usually do not choose to begin therapy; most often, it is parents, relatives, teachers, clergy, etc., that have identified a need for therapy. The child’s motivation and interest is created through the development of the therapeutic relationship: rapport, trust, and safety are crucial, necessary elements for progress, growth, and healing. The challenge is engaging children so that therapy is not a boring, uncomfortable chore, but rather, can become a place of comfort and acceptance; or, a place where exciting and vital adventures in self-discovery can happen.

Working with children differs greatly from the traditional adult “talk therapy” session. It is important to have an understanding of child development and to work with each child at his or her own level. Children (even very bright, verbally sophisticated children) often do not know how to identify or explain the causes for their sadness, fears, or behaviors. Sometimes, it is embarrassment, shame, or traumatic experiences that are an obstacle to direct verbal expression. Part of the work with a child is to help them find images, symbols, gestures, and words instead of symptomatic behaviors, to express themselves, and to start again on their path of healthy development.

I engage children in the therapeutic process by using:

• Play therapy as a way to reduce anxiety and guardedness. Play provides a structure and context that is comfortable for children, while allowing indirect yet experiential expression of feelings, needs, traumas, and hidden strengths
• Art therapy to help encourage free expression of familial, social, behavioral, and emotional themes, and to creatively search for solutions
• Sand Tray therapy using small toy figures and objects, enabling children to symbolically enact healing story themes

In many situations, I have found Cognitive-Behavioral Therapy (or, CBT) to be an extremely effective model for working with children struggling with a variety of commonly-seen emotional and behavioral problems. CBT explores, challenges and replaces skewed thoughts and perceptions, helping clients achieve a more realistic and positive self appraisal, and to attain measurable goals by using new coping skills.  Although it might seem that CBT is not compatible with children’s capabilities, children actually respond very well to this approach when it is woven into a format or presentation that is attuned to their developmental level. Using child-friendly materials; I help parents and children to work together to develop a plan to measure specific behaviors at home and at school; to use new ideas and approaches for making desired changes; and to feel a sense of reward in achieving those goals. This approach allows the child to actively participate in their own success as we identify and track their progress. The parent too, often feels once again a sense of joy and hope as they see their child naturally develop ways to think, feel, and behave better.

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Individual Therapy with Adolescents

I have a great deal of empathy for teens as they experience so much change all at once. Hormones trigger physical growth; academic and social pressures increase; expectations change at home and at school; dating and sexuality emerge; and a more cognitively, emotionally mature sense of self begins to develop. Adolescents are discovering their personal power for the first time, and often struggle with how to effectively use assertiveness to communicate their needs, resolve conflict amicably, and make beneficial choices. At the same time, parents have new demands placed on long-established roles, and often struggle to adjust their parenting approach. The entire family shifts as the adolescent develops and strives for autonomy, making for one of the most challenging stages in the life of any family.

Any one (or more) of these growth-areas can exceed coping capacities, becoming stressors that are more than enough to create functional and relational difficulties for teens, parents, or for the family as a whole.  The therapeutic issues that arise with adolescence can significantly improve with intervention, however, as with younger children, engaging the adolescent in a therapeutic alliance is a vital first step. I have found that teens often respond to and benefit from variations of the same rapport-building and therapeutic approaches as those used in child therapy. In addition, the developing adolescent is also more readily able to benefit from direct communication and insight-oriented therapy, as well cognitive-behavioral approaches.

Common issues focused on in individual therapy with Adolescents are:

• Managing anxiety, depression, and mood swings
• Enhancing educational performance and motivation
• Improving anger management and frustration tolerance
• Dealing with social pressures and joining healthy peer groups
• Improving judgment and making positive choices
• Developing positive coping skills
• Effective ways of handling peer pressure
• Improving positive and clear communication
• Improving compliance at home, school and in the community
• Developing a healthy and positive sense of self

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