Talk to Kids About Therapy

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It is beneficial to talk to your child about the process of therapy before their first session with a provider. However, at times parents, guardians, and/or caretakers may be unsure of how to start this conversation with their child. The purpose of this article is to share helpful factors to consider when starting the conversation(s) with your child about therapy. Please keep in mind this article is not all inclusive and may not cover aspects of your particular situation. It is recommended that you consult with your INTERFACE Lead Referral Counselor, Mental Health Provider, PCP, or child’s school guidance office if you have additional questions not addressed in this article.

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Before the conversation...

Self-reflect on how you feel about therapy.

Setting up mental health treatment for your child can bring up many different emotions, thoughts, and even concerns. It is important to reflect on how you are feeling about your child starting therapy as well as your own understanding of the process of therapy prior to talking to your child about beginning treatment. Seeking additional information about the process of therapy can soothe/resolve things that may be coming up for you as you set up mental health services for your child. Listed below are some different guides that can shed more light on the process of therapy.

• Glossary of Mental Health Services and Approaches to Treatment
• How to Choose a Mental Health Provider
• Types of Mental Health Care Providers
• What to Expect When You Schedule and Attend Your First Session

Consider the timing.

The timing of this conversation with your child can impact their feelings and perception of therapy. Ideally it is best to have this conversation when both you and your child are comfortable and calm. Starting this conversation in a heightened state, such as following an argument or your child’s misbehavior, may have your child view therapy negatively (e.g., as a punishment) and they may be less receptive to therapy.

Think about the time you would like to have this conversation as it relates to their first session. It is not recommended to have this conversation with limited time between their first session (e.g., in the car before the appointment). Additional time allows potential opportunity to help resolve/soothe your child’s concerns, questions, and/or resistance about starting therapy; this may take multiple conversations.

Consider their developmental age.

Developmental age is the measurement of emotional, social, cognitive, language, regulation, and moral functioning based on the standards set within a specific culture. Whereas Chronological age is based on a person’s age (i.e., from birth – current day). Developmental and chronological age can be the same, and they can also be different. It is best to describe therapy in ways that fits your child’s developmental age so they will be able to build a good understanding of therapy. As a parent, guardian and/or caretaker, you likely have a good sense of your child’s communication style. Below are key points to consider when speaking to your child about therapy while keeping in mind their developmental age.

Preschool Aged (approx. ages 4-5)

At this stage, children need less details and more big picture concepts. Keep things simple and explain the most important part.  

Example: We’re going to a new place where you get to talk to a person about your feelings and you get to play with toys.

Child (approx. ages 6-10)

At this stage, children need more details than previously during preschool age. However, it’s a good idea to focus on the big picture ideas and only provide helpful details to grow their understanding rather than confuse them.

Example: Therapy is a place where you get to talk to someone about your feelings. It’s like when we went to see Dr. Roberts when your tummy was hurting, but Ms. Smith (therapist) is going to do a check-up on your feelings not your tummy. She’s going to talk to us and ask us questions to see how we can help you feel better.

Adolescence  (ages 11- 17)

At this stage, children are able to handle more detailed and specific information. Adolescence can be a time where peer relationships are a large part of children’s lives. It is typical for adolescents to gain knowledge from their peers; this could include information about mental health services. In addition, social media can provide a large source of information to children as well. It can be helpful to see the information they already have about therapy and provide more or different information as needed.

Example: I’ve noticed that you are more stressed, and I’m worried about you. How would you feel about seeing a therapist? It could be good to talk to someone with a different perspective about how you are feeling, and they can help you figure out ways to help manage stress.

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During the conversation...

Consider who will be a part of the conversation.  

Would it be helpful to have others involved such as family members, school counselors, and/or other community supporters (e.g., coaches, club/group leaders)? Or will that not be helpful to your particular child.

Ask the child what they already know about therapy.

It Is important to get your child’s baseline understanding of therapy prior to providing them with information. In recent years, mental health awareness has grown, and it is likely that your child may have some information about therapy. However, misinformation and stigma continue to surround mental health concerns and treatments. It is good to see what your child already knows so you can understand what information you will need to give them, so they have the best understanding of therapy and what to expect when meeting with a provider.

Have a conversation that includes give and take.

Throughout the conversation, listen to their concerns, thoughts, and opinions. Generally, children are more receptive to ideas when they feel like they are heard, and their opinions are valued. Remember concerns that may sound unimportant or silly to you may be very important to them. If you don’t have the answers to any of their questions, don’t be afraid to tell them you don’t know. You may be able to find information to help soothe their concerns prior to the scheduled session. Alternatively, you may be able to reach out to the provider with these questions or have your child join for a consultation so you can ask the provider together. Your child may open up and share their feelings or emotions, this can be a great opportunity to provide support and affirmation. For example, you may say “I know that was hard to share with me, but I’m proud of you for telling me.” or “I’m glad you felt comfortable talking to me about how you are feeling. We can find ways to help you with this.” Again, you may not have all the answers but sharing that you care and you want to help can go a long way.

Be patient.

You may need to have multiple conversations with your child about therapy. In the initial conversation, they may be resistant to therapy, unwilling to talk/ join in the conversation, or express a negative emotional reaction to the conversation. Try to shift the conversation to their feelings, your concern for them, and desire to help them. For example, you could say “I see that you are uncomfortable, and I did not mean to upset you. We care about you, and it seems like you have been more sad than usual. We just want to help.” If at any time the conversation appears to be unproductive or counterproductive, it is a good idea to pause the conversation and revisit it at a later time.

It is important to mention, if you have any concerns for your child’s safety including risk of possible harm to themselves or others you should seek mental health support regardless of their willingness to meet with a provider. Your child’s safety is the most important so seeking help to evaluate and support concerns for safety must take priority over other factors. If you have any concerns for your child’s safety, it is recommended to call the Massachusetts Behavioral Health Helpline (833-773-2445), reach out to their PCP, head to the local emergency room, or call 911.