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This is a very common and appropriate question that parents ask me when scheduling the first session for their child. They might state concerns such as “I don’t want him/her to feel like something is wrong with him/her.” While this is understandable, therapy is usually a lot more anxiety-producing for parents than it is for their child. In fact, most children who come to see me appear relieved to be in my office, and quickly understand my role in helping him/her/their family feel better about whatever it is they are struggling with. Nonetheless, at times children and teens may resist therapy, and these suggestions for how to talk to children about starting therapy can be helpful:

1. Talk to the child about therapy in a calm moment

Parents are often tempted to tell their child during/following an argument or crisis. However, if he/she is angry or upset, it may be hard for the child to process the information. Moreover, if the parent seems angry, the child may perceive therapy as a punishment and be more resistant to attending.

2. Identify the issue

In a simple and compassionate way, parents can tell their child that they notice he/she has been struggling and empathize with how hard it must be for him/her. If either/both parents and/or another respected adult has had a similar struggle in the past, they might share it with the child. For example: “Sweetie, we know that you have been having a lot of worries lately. Sometimes we feel worried too, and know it can be really difficult. Nobody likes to feel worried all the time.”  You can also stress that seeking support is a sign of strength and health.  To the extent that other family members will be involved in the therapy, you can stress that you/they are seeking support as well.

3. Explain psychotherapy

Parents can tell their child in a developmentally-appropriate way that they have spoken with someone that can help. For a younger child, a parent might say something like: “Sometimes when children feel worried a lot of the time, it helps to go to someone whose job it is to help kids better understand their feelings and worries by playing and talking with them. We know someone named Ms. Kathy who helps kids have fewer worries. We think she will help you have fewer worries, and also help us understand how we can help you have fewer worries.” If the therapist has a website, the parent might show the child a photo of the therapist and/or the therapy office. For older children/teens, the parent can say something like: “I notice that you have seemed really sad and are sleeping a lot lately. I think you should talk to a therapist about ways to better understand and manage your sadness. I have found someone named Kathy that I think you will like. I made an appointment to see her on Wednesday afternoon.” If met with resistance, the parent might tell him/her that the expectation is that he/she will attend a few sessions, and then he/she can discuss with the parent their feelings about continuing. If therapy is non-negotiable due to circumstances such as severe depression or suicidal ideation, parents should emphasize that they love the child too much to see them continue in pain without any help. Parents might also validate that he/she knows it wasn’t the child’s idea and make sure that the child/teen understands that therapy is NOT a punishment, even if the teen has been exhibiting poor judgment/behavior. Finally, if it is the family seeking therapy as a unit, the parent might say that they have made an appointment with a family therapist who will help everyone communicate with and understand each other better.

4. Normalize therapy

Parents should not present therapy to their child/teen as a shameful or secretive experience. They should make it clear that they are not going to therapy to be “fixed” because they are not “broken.” Moreover, although parents should respect their child/teens confidentiality re seeing a therapist, it should be made clear that all people have challenges, and talking to a therapist in a safe space is helpful to many people- both children and adults. Parents can clarify that the child’s therapy can also be a place for parents and other grown-ups to understand the child/teen better in order to better meet their needs.

5. When should a parent tell the child that he/she is going to a therapist?

Because some parents have their own anxiety about their child attending therapy or are simply anxious about their child’s reaction to going, they may be tempted tell the child on the way to therapist’s office. This is counter-productive as children often need time to ask questions about therapy and express their feelings about going. While I advise parents to wait to tell younger children about going until 1 -2 days beforehand, especially if he/she is anxious, older children/teens benefit from knowing at least 5-7 days to allow time to process. Of course, if the child is asking for therapy, they should be told as soon as possible as they will likely feel relief to know that help is coming.

Many parents find that, with the above guidelines, conversations with their child about starting therapy go better than they anticipate.  If you stay calm, matter-of-fact, and empathic, your child‘s feelings will likely mirror yours. And, he/she might even feel a sense of relief that you made an appointment without him/her even having to ask you to do so!

-Posted by Kathy Voglmayr