“My son has been in play therapy for six months. He acts great with his therapist, but his behavior at home is still terrible,” wrote one reader.
Another parent asked if she should switch counselors after three sessions since her daughter doesn’t like attending therapy.
Here are four things you should do if you have any concerns about your child’s therapy:
1. Express your concerns directly to the therapist. Parents seem reluctant to speak up, perhaps for fear of hurting the therapist’s feelings or undermining their relationship with the counselor. Your child’s welfare is more important than a psychologist’s feelings. Do not involve your child in that meeting. Write down your concerns beforehand, and persist in your questioning until you are satisfied. If your therapist is supervised by another, ask that the supervisor attend the session.
2. Review the treatment plan. Therapy is not simply talking or playing with a child. Counselors develop a specific treatment plan that lists the goals of therapy, how they will be accomplished and an estimate of how long it will take. Here’s where you need to be persistent. If your concerns are focused on your child’s school performance or compliance with family expectations, goals should reflect those concerns, not general aspirations such as a child feeling good about himself.
It’s important that both kids and parents have an estimate of how long therapy will last. If a parent of a toddler has concerns about behavior problems, I’ll tell the parent that she can expect to see progress within three to six sessions. Improvement with a depressed teenager is more likely to take five to 10 sessions.
3. Get involved. Except in rare situations, treatment of a child should involve the parents. For younger children, it would not be uncommon for me to spend 75 percent of my time counseling the parents in management techniques and only a few moments with the child. Even in working with teens, parental involvement is key. Kids change their behavior with parental support and enforcement of reasonable rules and consequences, not just by talking with a therapist. I’m frequently asked about play therapy with young children. In most instances, the approach is worthless for dealing with common behavior problems. A therapist’s time is better spent working directly with the parents on discipline techniques.
4. Ask about alternatives. Speak with your therapist about other approaches and techniques. Psychologists have an ethical obligation to do something differently if therapy is ineffective. I’ve referred clients to other programs and therapists if I felt that I just wasn’t connecting with the child or family or making any progress. My colleagues and I are dedicated and caring individuals, but we aren’t always effective. If therapy isn’t working, do something. Your child’s welfare is at stake.