Guidelines for Talking with your Child About Going to Therapy

Prepare your child about going to therapy by explaining what will happen and why. Knowing what to expect will help alleviate anxiety. Let your child know that they can talk to you about how they feel about their therapist and the process. Discuss with your child’s therapy during the initial intake session about how to introduce your child to the therapy process. Take a look at these age by age guides.

Lubbock Adolescent Counseling: Play Therapy for Teens and Tweens

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Play therapy is an evidence based practice for children and adolescents and has many techniques for counselors to perform. (Bratton & Ray, 2000; Bratton, Ray, Rhine, & Jones, 2005; Gallo-Lopez & Shaefer, 2005; Roaten, 2011).

Working with a teen is very different than working with an adult client due to biological, developmental, and psychosocial tasks. Developmental tasks of teens include: physical maturation, sexual relationships, peer groups, emotional development, formal operations cognitive development, and identity development.

Because of the development of formal operational thought, preteens often vacillate between play that is more common to younger children and activities that appeal more to teenagers.

Play therapy can benefit preteens and teens struggling with depression, abuse, grief, addiction, adoption, ADHD, trauma, family stress, anxiety, relationships, problems with peers, identity, self-esteem, sensory processing issues, body image, anger issues, parent’s divorce, autism, etc.

Rather than teens doing therapy, they EXPERIENCE therapy. It is an opportunity to safely distance the self from problems through activity, creativity and imagination. Using a teen’s interests through play, sandtray figures, and expressive techniques will stimulate the teenager's desire and need to be expressive and create identity--which is central to this developmental stage. The positive therapeutic relationship that develops between a teenager and a counselor brings healing, forward movement, and relief of emotional stress. 

Expressive arts are a great tool to address new thoughts and feelings or communicate and rework perspective. It can include art, music, or movement such as yoga or dance.

Games and activities can be used to deal with anxiety, power and control issues, self-esteem, relationships and difficult behaviors. 

Sandtray invites adolescents to explore the uncertain world between childhood and adulthood and to explore the internal world and subconscious in a creative way by choosing miniature figures to place in a tray of sand. Sandtray allows clients to become mindful and allows clients the opportunity to blend memories, fantasies, wishes, and emotions without verbal constraints. (Rae, 2013)

“Appropriately structured creative art activities provide preteens with opportunities to change perceptions about self, others, and the world as they try out new roles and solutions...Furthermore, [they] facilitate a process of self-development, providing the preadolescent with the inner resources to cope with future difficulties.”
— — Bratton & Ferebee

Group therapy is quite effective for making friends, improving communication skills and learning coping skills from peers who experience similar challenges. When the opportunity is available to pair 2 or 3 preteens or teens, group activity therapy can be beneficial.

Trained play therapists can use play therapy with tweens and teens to

  • Informally assess a client’s psychosocial and psychological functioning

  • Build rapport

  • Explore and facilitate expression a client’s inner world and emotions

  • Build skills through psychoeducation

  • Develop mastery, identity, and empowerment

  • Relieve a client of stress

Play Therapy Poster Gallery

Kelly Martin, child counselor and play therapist of the Playroom Lubbock, along with Deborah Faith Photography created a sense of what a child experiences in a play therapy or activity play therapy session. You are invited to click and browse through our play therapy posters and learn why and how play therapy matters and is effective. (Children used in photos are not actual clients. The playroom is our actual play therapy playroom).

How Do We Start the Play Therapy/Counseling Process? What parents can expect

When parents begin to notice a child's functioning or well being is being affected by a life circumstance or behavior, speaking to a mental health professional is an appropriate first step. At the Playroom Lubbock we do not require a pediatrician referral. You can simply call our office to ask questions, tell us a little bit about your concerns, and book your first appointment. In fact, when you call inquiring about play therapy/teen activity therapy you will speak directly to Kelly Martin, LPC. Once you book your appointment, Kelly will send via email the necessary consent forms and intake paperwork through a secure client portal. Unless you have custody papers or prior assessment evaluation reports, you do not need to bring any other paperwork to the first session. 

  The first session 

The first session is a parent only session with our children's counselor and play therapist, Kelly Martin. There are several topics that will be discussed during this 45 minute session: 

  1. Kelly's practice policies and privacy policies
  2. Stages of play therapy
  3. Background history of the child
  4. Goals the parents have for both the child and for themselves  
  5. A treatment plan for therapy

  

Warm and inviting office for parent sessions. 

Warm and inviting office for parent sessions. 

The fourth session 

Prior to the 4th session, Kelly will send a parent report form for the parent to complete. This gives them the opportunity to record changes, rate progress, and jot down questions or concerns. Every 4th session Kelly and the parents/guardians come back together for a session to discuss progress, changes, review goals, and to provide support to keep the therapy process moving forward. We continue this cycle of 3 child therapy sessions followed by a parent session. 

 Value of the parent

Parents and guardians are also an agent of change in the therapy process. Parents know their children best and their insight, perspective, and observations are valued and helpful to the counselor in her work with their child.  

  

How does the counselor involve parents?

Parents are a vital piece to the child's process in play therapy. Here at the Playroom Lubbock, the parents and and counselor work alongside each other during the course of treatment. I usually tell parents when I first meet with them that when they sign their child up for play therapy, to buckle up and be a part of the ride. Vulnerability and personal growth for the parents is just as important to the child's therapy process as is the child's play "work" in the therapy playroom.

One of my favorite authors and speakers, Bob Goff, provided this anecdote. One of his favorite things about visiting England was the red double decker buses. When he first saw one he was so excited that he took a picture of it. (See picture). He was so close to it he lost sight of what it really was. Sometimes we need to back up our perspective so that we can see the whole picture. This is what the process is like for parents. I walk along side them in this process, backing up to see the whole picture, gaining insight, adjusting perspectives.

To help ease your concerns or perhaps fears of your role in the process, I will outline below how we involve parents.

1. Initial parent consultation session. This is the very first session with the counselor, but without the child. It lasts 45 minutes. We will discuss history, concerns, and what progress you would like to see made with your child. The counselor will also explain the therapy process as well as practice policies and your privacy.

2. Follow up parent consultation session. These typically occur after every 3 child sessions. During the parent consultation meetings you, the parent, will have the opportunity to discuss changes, progress, and concerns. The counselor will cover these 4 topics: Positives, Themes, Goals, and Strategies

Positives: Positive feedback regarding your child's behavior, emotions, or progress of therapy.

Themes: The counselor will loosely discuss play themes that have been observed over the last few sessions. Play themes are dominant or recurring themes within a child's play. The counselor takes in a child's feelings during play, intensity of play, the child's level of including the counselor, a child's level of connectedness, self control, problem solving capabilities, etc. As discussed in the initial Parent Consultation and in your Informed Consent forms, parents are reminded of the value of the therapeutic relationship and the trust that develops between the child and counselor. The counselor will only talk about a child's play to parents in vague terms, not giving many details or specifics. The counselors ask that parents trust that the counselor will communicate to them any "red flags" or concerns that she has regarding the child.

Goals: Based upon parent/school feedback, parents concerns, counselor’s insight, observations, and experiences in the playroom, and the play therapy process, the counselor and parent co create goals and areas that may need additional support in their child’s growth. Goals will be based upon the child’s individual developmental capacities and needs underlying their behaviors. Behaviors are symptoms and clues inside a child’s body, brain, and nervous system.

Strategies: We will discuss strategies for you to use at home to facilitate and support the goals. These strategies may be in the form of suggesting a book to read or may be more direct suggestions of ways of responding or interacting with your child.

3. At times the counselor may send a Parent Feedback form through our client portal. The Parent Report Form gives the parent the opportunity to rate the stress level, rate the overall progress level, state what changes have occurred in the child's life, and voice concerns or questions the parent still has.

4. Sometimes the intervention that is needed to support a child is family therapy or child parent relationship therapy which is a play based approach. These options can be discussed and explained and prepped for during the parent consultation sessions.

We value the parent child relationship and fully acknowledge that the parent is more of an expert regarding his child than the counselor. First and foremost the counselor wants to communicate to both the parent and the child: I am here. I hear you. I understand. I care. Relationship is the vehicle for change. By partnering with parents in considering the whole child and the whole picture, we are hopeful for progress, relief (for both parent and child), and healing that is supported by connection.

 

A Different Kind of Playroom

Here at the Playroom Lubbock we have 2 Play Therapy rooms for using in child counseling or child play therapy. These playrooms, at first glance, may seem like a kid friendly room with toys, however, the play therapist's selection and placement of toys is deliberate and based upon sound rationale.

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Children are more likely to feel comfortable in places where a sense of openness exists that says to the child, ‘You are free to use what is here. Be yourself. Explore.’
— Play Therapy: The Art of the Relationship by Garry Landreth

We have thoughtfully selected the toys of our playrooms so that children will feel a sense of openness and interest rather than caution or hesitancy. The toys and play materials facilitate a wide range of creative, exploratory, and emotional expressions without the expectation of children talking or verbalizing. Mechanical and electronic toys do not allow for children's expressions and therefore are not included in our playrooms.

We want toys to support these essentials of play therapy as cited in Play Therapy: The Art of the Relationship by Garry Landreth.

Establishing a positive relationship between child and counselor

Expressing a wide range of feelings

Exploring real-life experiences

Reality testing of limits and boundaries

Developing a positive self-image

Developing positive self-understanding

Developing self-control

The three main categories of toys in our playrooms include real life toys, aggressive-release toys, and toys for creative expression and emotional release. Below are pictures of our play therapy playroom for children ages 3-10. Soon we will give you a peak into our playroom for older kids and teenagers.


Expressive Arts in Counseling

At the Playroom Lubbock we offer individual and group counseling to kids and teens. You've probably heard us talk about play therapy (using toys as a safe medium for expression) and sandtray (using toys/figures in the sand), but what is "expressive arts" that we talk about?  Quite simply, expressive arts is an opportunity to use the arts to safely express oneself and through the process, learn by doing. It uses the arts as a basis for discovery and change. The arts can include art materials, dramatic play, acting, music, dancing, or other artful movements. The emphasis is on the process rather than the product. No previous art background is needed.

 

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When will expressive arts be used at The Playroom Lubbock?

Kids in individual counseling have the opportunity to spontaneously engage in expressive arts because of the assortment of expressive arts materials and toys available to them in the therapy playrooms. The counselor may also incorporate expressive art activities into group counseling or kids groups.

How does the creative process produce change?

Carl Rogers explains that under certain conditions, a person (child) is free to be creative, to be himself, and be open to a new experience of self awareness and change. 

If offered in a safe, empathic, non-judgmental environment, it is a transformative process for constructive change.
— Natalie Rogers in "Giving Life to Carl Rogers Theory of Creativity"

The counselor 1. accepts the child as having unconditional worth 2. listens with empathy and shows understanding of the child through nonverbals and reflective statements 3. provides a non judgmental climate by not making evaluative or critical statements regarding the child or what the child is doing.

The counselor trusts the process that the child (with the help of a safe therapeutic relationship) will take his/her experiences, perceptions, and potential where and when the child needs. *However, there are boundaries and limit setting which can be explained in an entirely other blog post.

A child's expressive art is an image or metaphor representing a child's perspectives, experiences, desires, fears, and goals. Once a child feels emotionally safe and psychologically free, he is able to blossom.  It is through the process of creativity that a child gains awareness, resolve, and ideas to move forward. It is not through a counselor's interpretation or analysis of a child's creative product that brings change.

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What is the ultimate goal for counseling?

You may have very specific goals for your child. For example, control his temper, obey the rules, not be so impulsive, not be anxious, play better with others, learn social skills, etc...Play therapy, expressive arts, and sandtray therapy will address all of those. However, the ultimate life goals for kids (and adults) is to 1. adjust, change, and seek new experiences 2. be yourself in the present moment 3. trust yourself to make the right choices and take responsibility for your choices and 4. treat others with positive regard, respect, and love.

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Let Children Color Their Perception of Therapy

You've made the first step and made an appointment with a child/adolescent counselor. You may have showed up a little apprehensively to the initial intake appointment with the counselor/therapist. After you realize the counselor wants to support your efforts as a parent (you are, after all, the primary influence over your child's life) and the counselor "hears you out," it occurs to you that you have to think of a way to tell your child he/she is going to therapy. In fact, let's just cut out the word "therapy." Add "fix your problems," "bad feelings," "disobeying" to the list of What Not to Say. "Ideally, it is best if the child is allowed to develop their own impressions of the therapist and what therapy is all about from actual experiences in the playroom" (Killough McGuire, D. and McGuire, D, 2001. Linking Parents to Play Therapy. NC: Taylor and Francis). We hope our name, The Playroom, provides a sense of comfort and familiarity for your child so that he feels safe and free to form his own impressions.

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So How do You say It?

McGuire and McGuire in their book Linking Parents to Play Therapy suggest parents tell their child (depending on developmental level) something like this: "This is a time for you to play in a room full of toys and things you like to do with someone who really cares about you" (p. 16). As necessary, the therapist can also provide further information to the child. Another way to phrase this for an older child would be:

It’s a safe place to find support and an unbiased adult to listen.
— Kate Leyva, LMFT Contributing to Tartakovsky, M. (2015). Common Things Parents Say to Their Kids About Therapy That Aren't Helpful. Psych Central.com

Communicate with Feeling Words

When your child comes out of a session reflect his/her emotion. "You're really excited coming out of there." "You seem to feel quiet." "You're feeling ready to go!" You can also respond with a feeling to any questions they may have: "You're curious that_____." "You're wondering if ______."

Communicating about their Art/Creations

At times your child may bring home something he/she created. It is important to view their creation from their therapy session as a page out of a journal. It can be very private and emotional. Be mindful that your child may choose not to talk about it. If your child is eager to show you (and quite honestly you may have no idea what you are looking at), you can say "Tell me more about that." You can focus on details of what he or she did: "You put those colors right there." "Looks like you spent a lot of time on that." "You drew this here and that over there." Or if a child asks you if you like it, you can respond with, "What's important is if you like it. What do you think about it?"

Communicate with Nonverbals

Dr. Kay Sudekum Trotter, PhD, LPC-S, suggests that when you stay in the waiting room instead of running errands during a session, you nonverbally communicate that "you're so important to me that I will be here the whole time supporting you." (Tartakovsky, M. (2015) Common Things Parents Say to Their Kids about Therapy that Aren't Helpful. Retrieved from PsychCentral.com)

Communicate Privately with the Therapist

It is important to be mindful of little listening ears. Talking about your child's progress or lack there of, or more specifically the problems you want to see addressed, in front of the child, may lead to feelings of inadequacy, embarrassment, and shame.

What NOT to Communicate:

The following list of common comments that parents make may isolate your child or negatively color their perception of therapy or the therapist.

The therapist is going to help you with your problems. You need help”
”We can’t help you anymore because your problems are too big.”
”We have to go to therapy because your dad or mom left us.”
”You need to go to therapy because since the divorce you have been really emotional and difficult to deal with.”
”Your therapist is going to be so disappointed in you for doing___”
Speaking to therapist: “Maybe you can help _____with learning how to better control his emotions when he doesn’t get his way.
— Tartakovsky, M. (2015). Common Things Parents Say to Their Kids about Therapy that Aren't Helpful. Retrieved from PsychCentral.com

 

In Conclusion

Parents are very well meaning in their communication with kids. Hopefully these suggestions provide another perspective about how your words can and should encourage your child and therapeutic play.

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Collaboration with Parents in Play Therapy

At The Playroom Lubbock we provide optimal and collaborative therapy solutions. Collaboration begins and continues with parents/caregivers. Parents or primary caregivers know their child best. 

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How does collaboration with parents/caregivers work in Play Therapy or Child Counseling?

Before play therapy sessions with a child begin, the counselor will set up an initial parent consultation appointment (without the child present). During this consultation the parent will have the opportunity to share concerns and background information about the child.  The counselor will explain the therapy process/procedures and will provide a few forms to sign.

Parent consultations (again, without the child) will continue after each 3rd session with the child. These consultations allow the counselor to address the parent's concerns, allow parents to have a better understanding of the child, allow the therapist to share information regarding the child without breaking confidentiality, and allow both the counselor and parent to communicate progress.

At The Playroom Lubbock, we seek to also strengthen the parent/caregiver role. We believe parents and caregivers are a vital resource to understanding a child and for a child's progress.