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Family therapy

Getting the right kind of professional help when your children or you need it is an essential part of personal safety.

Therapy can be tremendously healing and important for people of any age who have been abused, bullied, or faced any traumatic experience – or who are stuck in destructive behavior towards themselves or others. Although not every upsetting situation requires therapy, getting the right kind of professional help when your children or you need it is an essential part of personal safety.

Unfortunately, the wrong therapist can do more harm than good. Most people who do this work are deeply caring and very professional – a few are emotionally coercive or incompetent. Even with an excellent therapist, the right choice for one person might not be a good fit for someone else.

Here are seven recommendations from experts in our Kidpower International community about how to go about finding the right kind of therapist for your children or yourself – and how to manage the treatment process.

1. Overcome resistance. One big challenge is to realize when a problem is too big to handle on our own or with the support of caring, respectful, and empathic friends, family, and mentors. For adults and kids, an array of feelings can get in the way of being open to therapy:

  • “It’s silly. I should just be able to work this out myself.”
  • “It’s embarrassing. I don’t want anyone else to know.”
  • “I don’t want to think about it anymore. Talking just makes me feel worse.”
  • “It costs too much.”
  • “I am too busy.”
  • “I went to a therapist, and it didn’t help.”

Although times have changed, many people still feel that there is a stigma attached to needing therapy – and parents are often far more likely to seek professional therapy for their children after a traumatic experience than for themselves, even though their own mental health is also essential to the well-being of their children.

Suppose you had a leaky pipe in your house. You could start by taking steps to fix it yourself or with the help of a handy person. If this didn’t work and the pipe kept leaking, you would seek the help of a professional plumber. You would know that the longer you waited, the more water damage your house would have. You would know that allowing someone who was well-meaning but lacked the proper skills to tinker with your pipes would be likely to cause even more trouble. The same is true of making the decision to seek a therapist.

Most difficult times do not require therapy. Children and adults can often handle adversity with the help of their community of family and friends, especially if these individuals have good interpersonal skills such as active listening and empathy. However, as important as these relationships can be to resilience and recovery, good interpersonal skills are not enough when someone is struggling with mental health issues and having trouble coping.

Professional counselors can offer additional expertise through:

  • conducting a mental health assessment to help determine what the underlying issues are;
  • offering an informed perspective and advice on your and/or your child’s emotional well-being; and
  • making recommendations on possible solutions.

They should be qualified to identify the presence of mental illness, such as clinical depression, over and above the distress that people normally experience when having had an upsetting experience, such as being bullied, etc. If they are not qualified to treat mental illness, then they should be able to guide you in how to access appropriate help.

2. Learn about your choices. Even if highly recommended and with lots of credentials, counselors have different approaches, skills, and personal qualities. Finding the right person for your child or yourself is an important decision and worth taking the time to research.

Start by asking knowledgeable people for suggestions – a healthcare provider, school psychologist, or a religious or spiritual leader you know and respect. There are many different kinds of therapeutic approaches and what will work best will depend on the nature of the problem and of the individual.

Also, the level of professional help needed is going to depend on the severity of the problem. Often, a few sessions can make a very positive difference very quickly. Sometimes a person is struggling with ongoing challenges that require longer-term support. For more deep-seated mental health issues, more specialized care from several professionals might be required – but getting the most specialized care available can be counter-productive unless this is truly needed.

Cast a wide net rather than limiting yourself. Many people are surprised to find that the best fit for them might be a therapist they never would have imagined seeing when they first started looking for help.  Many of us have preconceived ideas that the best fit is someone like ourselves (in terms of race, gender, age, sexual orientation, etc.).  But sometimes the best connections and opportunities for self-exploration happen with people completely “opposite” of who we are.

3. Check credentials and references. Look up a potential therapist’s qualifications, licensing, and ratings online. Where relevant, credentials can be checked through a professional society or legal agency that licenses psychotherapists, psychologists, marriage and family counselors, social workers, or any other trained professional who is licensed to perform individual counseling.

The term “therapist” is not protected and encompasses a huge range of individuals ranging from people with no professional background or training to highly experienced professionals, e.g. clinical psychologists with training in a broad range of therapeutic approaches. Take the time to ask questions, insist on answers that make sense to you, and be sure to pay attention to your intuition.

4. Look for the right “fit.” Interview different people so that you can choose someone who is the right “fit” for your child and/or for yourself. Use the following checklist to find a therapist who:

  • listens carefully and empathically without judgment
  • remembers who you are and demonstrates understanding about what your issues are
  • acts respectfully at all times towards everyone and, when relevant, works with all affected parties in a family or other group as a team
  • focuses on helping empower clients to find solutions rather than just processing feelings
  • upholds excellent personal and professional boundaries
  • accepts feedback well and is open to your making changes or different choices than recommended
  • does not support destructive choices
  • adapts any method to fit your needs rather than trying to make your situation fit the method
  • helps you find other resources when needed
  • acts with high integrity at all times
  • can demonstrate experience in treating people with the type of problem, age, and needs of the individual needing help
  • can provide evidence of her or his professional registration and the code of conduct required to keep this registration
  • can demonstrate how he or she keeps skills up to date through continuous professional development
  • treats your time with respect by staying focused on your concerns
  • for children, will keep parents informed of progress and answer questions.

5. Make a Plan and Keep Checking In. Together with the person you select, make a plan for treatment. Decide how you are going to know that you are making progress and that this person is helping you and/or your child in a way that furthers your goals and fits your values.

If your child is the one going to therapy, make an agreement at the outset about confidentiality.  Not keeping secrets is important in a healthy family, but especially for older children, they may need to feel that what they say will be kept private so that they can talk frankly.  A therapist should make it clear that, while privacy will be respected as much as possible, certain matters, such as those to do with child protection, cannot be kept secret.

Keep evaluating how things are going using the checklist in the above section. Even though you may develop a deep emotional bond with a therapist, remember that you are paying for a professional service. Be sure this person helps you feel comfortable about expressing any concerns about how the therapy is going. Set boundaries about your use of time if a therapist wanders off-topic by telling lots of stories that are only vaguely related or giving unasked-for advice outside your purpose in being there.

While it is not your job to take care of the feelings of your therapist, be sure to also express appreciation about what is working well for you and about the care that this person is offering.

Sometimes a therapist is an excellent fit for an individual or family and can be a valuable source of guidance and support as needed for many years as different problems develop. Sometimes a therapist is very helpful for a while and then the issues are resolved – or you and your child have developed better skills for handling them – or a different kind of counselor is needed.

Most therapists are great at helping their clients recognize when it is time to stop or change – and to honor the importance of their own strengths and relationships in their healing, rather than giving the therapist all of the credit. Unfortunately, a few will hang onto their clients even when this is not the best choice. Remember to stay in charge of your and/or your child’s therapy – and that the purpose of therapy is to empower people to make positive choices, manage their feelings, and be in charge of their own lives.

6. Understand The Differences Between Therapy for Children and for Adults. The process of therapy for children and teens is often different than for adults for the reasons below. One of the frustrations for many child therapists is that parents don’t understand this difference and give up before the child is ready.

Length of time. While some kinds of the problems children struggle with require long-term support, most do not. However, the length of therapy is not an indication of how “good” it is – the important thing is to ensure that the type of therapy suits the individual and their situation.

Sometimes children face life challenges that require ongoing support. Also, as children mature, problems that seem to be past are re-visited with a more mature understanding. For example, suppose six-year-old boy has just lost a loved one and seems to grieve and move on. Then a few years later, as he has a greater understanding of death, he re-visits the loss in a new way, and grieves again. This can be confusing for his adults as they thought the grief process was over years before.

Decision-Making. Adults CHOOSE to go to therapy – even if they choose to do it simply to comply with a court order. Children do not usually choose to go to therapy, and while “bad therapy” can be uncomfortable, the truth is that good, effective therapy is also likely to be uncomfortable. A child may not “want” to go to therapy. By itself, this is not an indicator of the value of the therapy or the therapist. As the parent, it remains your responsibility to assess the entire situation constantly, not just react to the expressed opinions of your child.

Complaining about going to therapy is normal. You can empathize with these feelings and respect your child’s right to choose what happens in therapy while still insisting on continuing. For example, you might say, “This is about health. You don’t have to like it, but you do have to go. And, what you do with your therapist is YOUR business. It’s my job to create this space in your life, so we are going. What you DO with that space is your decision.”

Slow Progress. Patience and persevering through discomfort is important – as long as you can see that the therapist is supporting the growth of trust and positive choices. As one parent shared with us, in many situations, developing better mental health can be “more like orthodontics than like getting stitches.” The process of moving teeth can only go so fast. Even at its fastest, it’s quite slow. From week to week, it looks like no progress is being made. However, a year or two into the process, looking back, you can see quite a bit of progress, and you understand that each day in the process was needed in order to reach your current position.

Discomfort for everyone. Getting and wearing braces causes pain that comes and goes at times. So does therapy.

When children get their braces tightened, we can empathize and provide care and relief. However, we don’t actually feel pain ourselves.

The process of parenting a child in therapy might occasionally be joyful – but, unlike orthodontics, is likely much of the time to be acutely painful for the parent, not just for the person getting treatment. When our children deal with their emotional issues, we adults are forced to face our own issues and our deep regrets about any ways in which our limitations might have caused them harm.

Therapy for the parents is the best path for helping the child. Sometimes it makes more sense to help a child through work with one or both parents rather than or in addition to therapy with the child.  If this is suggested by a therapist, feelings of blame and inadequacy are normal, especially because most parents are doing the very best they know how. Speak up if you feel blamed or in any way uncomfortable with the therapist’s approach. Having a frank discussion allows the therapist to explain so that you can make an informed decision about whether the therapist’s approach is right for your child.

7. Remember That Mental Health is Priceless. In some parts of the world, children and adults get help with more serious mental health problems free of charge from state-funded health care systems.  While this is great for making sure money is not an obstacle to getting help, it may mean that choice of therapist is more limited.  However, many of the recommendations below will still apply.

Sometimes people limit their options because they feel that they don’t have enough money or because they want to stay within the limits of their insurance company. Often, deciding to pay for therapy is a matter of choice.

Here is how one father that we’ll call Ben made his decision:

“I was a single parent of two children living on the equivalent of an elementary teacher’s salary. I could have made the argument that ‘I can’t afford to pay for this,’ and no one would have argued with me. Many would have agreed with me.  I paid about $90 a week for 7 years, out of pocket, to send my child to therapy. I did not get reimbursed or get any tax credit.

“This was the price I paid. It’s money that didn’t go into retirement or college savings or living expenses. It was difficult – and it was worth every penny. What good is a college savings account if your child is suicidal, addicted, or unable to function independently due to deep-seated mental health issues? But, if an 18-year-old is physically and emotionally healthy, they are in a stronger position to pursue higher education even if all the money is not saved.”

Many, many people don’t have enough money for food or shelter – and might need to advocate for access to free or lower-cost professional services for their families. However, I have heard many parents who make more money than “Ben” say that they cannot afford therapy for themselves or for their child. How we spend our money reflects our personal values. “Food and shelter” need to be higher on this list than “therapy”. Cable TV or eating out can probably be lower on this list.

What is more important – more disposable income, more entertainment – or better mental health?

Cultural Stigmas. One factor to consider in making decisions about whether or not to use insurance is that, unfortunately, we still have cultural stigmas around therapy. In order to get insurance to pay for therapy, a ‘diagnosis’ is required. Even if some ‘mild’ term such as ‘adaptive disorder’ could be applied to a child so that you can get this financial benefit, you have to consider potential consequences.

There is no one right answer to this issue. Here is how my friend Darla made her decision:

There is no diagnosis checkbox for ‘parent made messed-up choices that caused disruption in the child’s life.’ Once I decided to pay the money myself and not involve an insurance company, the ‘diagnosis’ was no longer a primary issue – the therapist could simply focus on the process and on my child. In addition, my child would not have a medical record history of a diagnosis in her files.

“We can’t predict the future, and perhaps my children will get a future where privacy violations involving medical records are impossible. Perhaps they will get a future where a history of therapy is celebrated, not stigmatized. But, since I can’t see the future, I don’t want a diagnosis in my child’s file that was put there primarily for the purpose of getting my money reimbursed.

“If my child’s process had been more involved, or had her issues been more severe, I might have changed this decision. In that case, though, I would be accepting a record of diagnoses that were a true reflection, not a convenient reflection, of her situation. I might have done that to access resources that were truly beyond what I could afford. Within the context of my own values and our specific situation, I could not justify having a therapist submit a diagnosis just so that I could get a reimbursement.

One Mother’s Story About Her Child’s Journey Towards Mental Wellness

The following story from one of our Kidpower parents shows the struggle that many parents face when their children need long-term therapy – and the enduring benefits that are possible:

When I first sought out a therapist, my child was hurting, and in my heart, I really WISHED that therapy could be like getting stitches. I wanted his pain to be an identifiable wound that could be neatly and skillfully closed. I wanted his pain to stop within a timeframe that a professional could predict and guarantee. Then, I wanted the injury to become part of the past.

“I was in a better position to support my child’s mental health when I accepted that what I wished with my heart was not possible and switched to the ‘orthodontic view’ that I was pursuing long-term change and growth. I accepted that the process would likely not give me satisfaction or resolution in the short term.

“I learned that being a supportive parent of a child in therapy meant managing my own personal triggers about many issues. Staying in communication with the therapist, building a relationship of trust and boundaries, helped significantly. However, the most uncomfortable part was the vulnerability of letting someone into my family’s life in this way. This is a person who hears stories about you, siblings, another parent, and your family dynamics and behaviors. For me, it felt as intimate as letting someone go through my house, including all my personal spaces, while I am away.

“This sense of intrusion was compounded by the fact that therapy brings pain for the parent as well. As trust grew, this all became easier. But, this combination of pain and vulnerability was a major hurdle for me personally, and I can imagine many parents might be repelled by this feeling and pull away. That is too bad, because therapy has brought my child and all of my family great gifts. The benefits have significantly outweighed the discomfort.

“About 10 months into my child’s therapy, I had doubts about whether this was going anywhere – doubts such as, ‘Is this the right therapist for us?’ And, ‘Is it a good use of money when my boy seems to spend the whole hour not talking, or just shooting darts at toy soldiers?’ 

“At the time, my son was about 7 years old. My goal was to support his current mental health and also to support the development of structures for his long-term well-being. The stressors in my child’s life that were at the heart of many of his challenges would not go away – he needed to develop lasting tools to take care of himself with the reality of these stressors in his life for years. I realized that my decision about continuing my son’s therapy was NOT about sticking with this therapist or quitting. It was about sticking with this therapist or starting with a new one.

“Now, thirteen years later, I cringe to think how easily I might have quit at that ten-month point. It would have been so easy to say that the process was a waste of time, that nothing was happening, that it wasn’t worth it. We worked through the discomfort, and I decided that this therapist was worth more investment. As a result, she and my son grew the roots of a strong therapeutic relationship that has provided outstanding support for him for many years.

“Interestingly, as an adult, my son has chosen on his own to return to his therapist to get support with the challenges of early adulthood. This process does not involve me at all; the child who complained incessantly about going to therapy now schedules his own appointments and gets himself to them without talking with me at all.

“At the same time, I suppose in a deeper way, his current process DOES involve me: his current action reflects an understanding that seeking help is not shameful, is worthwhile, and is a sign of strength and courage. It reflects an understanding that emotional well-being and safe, healthy relationships are worth time, money, and some discomfort. It reflects an understanding that acknowledging your own vulnerability can lead you to wonderful places. I believe that my leadership, and my commitment to doing the therapy process well, played a big part in instilling those lessons. I feel proud about this, and proud of him.”

When people are already going through a hard time, the time and energy required to find the right kind of professional help can feel overwhelming – and the therapy itself can be painful and frustrating – but the payoff of better mental health for your child, your family, and yourself is worth it.

Poor mental health is stressful – and chronic stress at any age is bad for our bodies and can make it harder to take charge of our well-being. For example, the Adverse Childhood Experiences (ACE) studies of adults found a strong correlation between harmful experiences as a child and greatly increased risks of severe health and emotional problems even decades later.

Getting professional help as soon as possible can help young people as well as adults to heal from trauma; improve communication; better manage emotional, physical, intellectual, and situational challenges; reduce stress; and develop positive relationships that will enrich our lives.

Additional Resources

Protecting Kids From Suicidal Thoughts
Helping Children Regain Their Emotional Safety After a Tragedy

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Kidpower Founder and Executive Irene van der Zande is a master at teaching safety through stories and practices and at inspiring others to do the same. Her child protection and personal safety expertise has been featured by USA Today, CNN, Today Moms, the LA Times, and The Wall Street Journal. Publications include: cartoon-illustrated Kidpower Safety Comics and Kidpower Teaching Books curriculum; Bullying: What Adults Need to Know and Do to Keep Kids Safe; the Relationship Safety Skills Handbook for Teens and Adults; Earliest Teachable Moment: Personal Safety for Babies, Toddlers, and Preschoolers; and The Kidpower Book for Caring Adults: Personal Safety, Self-Protection, Confidence, and Advocacy for Young People.

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