When we see a child in counseling, we always involve the parents. Especially with a younger child, the parent becomes the therapist in the home. We work with parents to explore better ways for their children and family to deal with conflict, undue anxiety, depression, habit problems, and responses to loss, illness, death and divorce. When children experience something that is too much for them, they let you know with symptoms.
When we begin counseling, we discuss confidentiality with the child and parents. Confidentiality issues differ depending on a child’s age, maturity, and the intensity with which a child wants something to be private. Very young children often expect what they discuss in counseling to be shared with a parent.
Young Children (ages 3-8)
Our counselors often combine traditional play therapy with other therapeutic approaches to help meet a child’s needs. These approaches include teaching children behavioral techniques to reduce stress (such as imagining that they are in a safe place), to manage anger, or to get along better with family or friends. They include “cognitive therapy” tools such as helping children to identify negative thought patterns (“Annie hates me and will never be my friend again”) and substitute more positive ones (“maybe Annie ignored me because she was having a bad day and will be friendly when she is feeling better.”). Young children rarely have the emotional, logic, and verbal skills to sit down and talk about problems. They play through them or act them out with symptoms. Play therapy provides an alternative to “acting out” or symptom behavior. Games also are useful in counseling. Some games are specifically designed for therapy.
Sessions for preschool children include a half hour of play. They may also include a half hour of work with parent and child together on specific issues, such as managing impulsive behavior, keeping safe, or responding to limits.
Tweens (ages 9 – 12)
Children in elementary school or middle school often have problems directly related to school or relationships: parents may be referred for Attention-Deficit Hyperactivity Disorder (ADHD) or Attention Deficit Disorder (ADD), or there may be behavior problems at school.
Work with these children depends on the nature of the problem. If parents don’t object, we prefer to meet with parents and children together at times to understand the issues. Sometimes medication is needed, although Family First Counseling is not inclined to make that a first choice. If it is, referrals are made to physicians or psychiatrists. Family First Counseling does not have a psychiatrist on staff and cannot prescribe or monitor medication.
Sessions for school aged children are usually an hour, with a half hour play session for young children combined with a skills training parent-child session for the other part of the session. Older children replace individual play with individual skills training. Skills training focuses on the particular issues. ADHD children work on impulse control and attention skills. Children with intense emotions work on skills to manage feelings. Children with social issues practice friendship, bully prevention, or respect skills.