The vast majority of children do not refer themselves for psychological help. Their parents make the decision to bring them. Sometimes this is because someone at school has suggested that the child get help.
Common reasons for seeking treatment:
- not getting along with a family member (parent or sibling)
- trouble in making or keeping friends
- not living up to their potential academically
- adjusting to parental separation or divorce
- dealing with having a sibling who has a severe developmental delay or medical problem
- to have a better adjustment to a diagnosed or undiagnosed learning disability
How do we start?
If the child is younger than a teenager, the first step is that I meet with the parents. In this first meeting, we discuss what is going on with the child. After the parents meet me, they decide if they feel comfortable that I should be the person to help their child. If so, we decide whether I can give this help through parent guidance alone, not meeting with the child directly, or whether it would make sense for the child to come in to meet with me.
If we decide that it would make sense for the child to meet with me directly, we would start a consultation process. This process usually lasts 4-6 weeks. It involves meetings with the parents alone, the child alone, and sometimes the whole family together or parts of it. During this time I would also determine if there were any other evaluations that were needed (i.e., medical, learning, psychological testing). When appropriate, i visit the school or the home. At the end of this process, I would come up with an understanding of the child’s strengths and difficulties and I would offer a treatment plan to the parents. The parents would then decide if they want to proceed.
What is play therapy?
Play is the language of children. It is through play that children come to understand their world and their place in it. In play children can try on different identities and imagine different creative solutions to problems. In a child’s world many things are happening over which he or she has little or no control. Play can allow a child to experience mastery. A simple example is a baby playing peek-a-boo. Baby’s love to play peek-a-boo. The reason this simple game is so compelling is that a baby is trying to figure out what happens to things/people when they disappear, are they gone forever. In peek-a-boo a baby is in control of making something disappear and, most importantly, reappear. This reassures a baby struggling with separation anxiety. I use play to help children sort out the psychological/emotional difficulties they may be having. Most often children come to me when their natural developmental path is being obstructed. I’m there to help clear these obstructions so their natural forces for growth and development can again take over.
How does it work with adolescents?
The process is similar to that with children, but I find that it is important for the adolescent him/herself to make the first contact with me. So before meeting with the parents, I generally meet with the adolescent. Many adolescents use a combination of talk and play. It can be helpful for adolescents to have an activity like throwing a ball, or playing cards to put them at ease for talking. Also, having art supplies allows them to express themselves through a different modality when they are learning to express their emotional states with language. Some adolescents use talk only. With an adolescent I also have a consultation process. At the end of this process I would similarly make treatment recommendations. As always, I can help refer to another clinician if the adolescent and family think they would be more comfortable with someone else.
Parent Involvement
I believe strongly in the importance of parental involvement in the treatment. Sometimes a child’s problems can be addressed solely through parent consultation. When I do see the child or adolescent in treatment I almost always meet with the parent regularly as well.
School
When a child is in treatment with me I am also a liaison for the school. I can help with IEP meetings and in general help the school to understand the child.