As a parent or caregiver, even bringing up the topic of therapy with your child can be challenging. Especially if the child is resistant to the idea, or has negative feelings about therapy, how can you have the conversation in a positive way that will help them feel included in the decision? And what can you do to set them up for success, so they will open up to a therapist?

Straight from our expert therapists, let’s explore how you can prepare a child for therapy — and what you can do to be their ally throughout this new experience. 

Signs a Child Might Benefit From Therapy

Mental health therapy can be beneficial for many children and many adults. Could it be valuable for your child too? Here are some signs that therapy could be helpful:

• A normally positive, happy-go-lucky child becomes withdrawn
• Isolating from friends and family
• Behavior issues (irritability, acting out)
• Not eating or emotionally overeating
• Gravitating toward peers who are an unhealthy influence
• Struggling in the classroom or at home to the point of it impacting their grades or ability to relate to others

As a parent or caregiver, it’s important to be aware of the difference between a child who’s really struggling and a child going through a developmental stage. Keep in mind that some behaviors may be normal during certain developmental stages. If the behaviors persist for more than a few weeks with no obvious cause, or if the child is acting significantly differently than what is normal for them, then it may be wise to discuss therapy.

How to Talk to a Child About Starting Therapy

Talking to children about therapy is your chance to set the right stage. You can help them understand that going to therapy is positive! The goal should be first and foremost to listen, ask questions and help the child feel empowered about the therapy journey.

KVC West Virginia therapist Rachel Criss suggests talking to your child about some signs you’ve noticed, like struggling in school or reacting with anger, and then asking them if they think it would help to talk to someone about it.

Rachel Criss, LPC

“Many kids will react in anger when they’re anxious or emotionally distraught and they don’t know how to verbalize their emotions,” she explains.

To help you start the conversation, here are some ideas for approaching it with children of different ages:

Starting the Conversation with Younger Children (Ages 3-8)

Therapy can be intimidating to young children. Being alone with a stranger and talking to them about difficult things may feel overwhelming, after all! So your role as the parent or caregiver is to help the child feel safe and know what to expect.

Staggs recommends that parents and caregivers talk directly with their child’s therapist about what to expect so they can more accurately explain to their child what will happen in therapy.

As a parent, you can ensure your child has a great therapeutic experience by helping them feel safe and comfortable. “Getting the child to open up is usually a little bit harder than getting the child to go to the first session,” says Criss. A little nervousness is normal! But talking to your child about the session in advance helps.

“It’s important to do away with that negative stereotype of therapy,” says KVC West Virginia therapist Emma Staggs, MSW, LGSW.

You can also base the conversation on the child’s age and comfort level. For the youngest children, you can be truthful and straightforward, mentioning that you’re going to visit with someone who helps with emotions and they’re going to ask some questions. Younger children might like to bring a comfort item along, like a toy or stuffed animal.

Starting the Conversation with Older Children (Ages 9-14)

Talking about therapy with pre-teens and middle schoolers is much easier in this generation than it has been historically because of how commonplace and accepted therapy has become. “Some kids actually think it’s kind of cool to have a therapist, believe it or not!” shares Criss.

Adolescents and young teens may also worry about the confidentiality aspect of therapy. It’s important to emphasize this to your child. They don’t need to worry about their friends knowing that they go to therapy, or their therapist telling their parents what they said in a session.

“We want to be helpful to you, not annoying you,” says Staggs. Unless a child is in danger or a danger to themselves or others, everything will always remain 100% confidential in a therapy setting.

Starting the Conversation with Teenagers (Ages 15-19)

Talking to teenagers about therapy is similar to discussing it with older children — they will also appreciate the confidentiality and may be more open to it because of the acceptance in their generation. However, it’s especially important for these young adults to feel that they have autonomy over the decision.

Staggs even works this independence into therapy sessions with teenagers by allowing them to “feel like they’re in the driver’s seat.” If her client doesn’t want to talk about something, they’ll chat about something else until the client is ready. Even if the teenager has been court-mandated or otherwise directed to go to therapy, they still have some control over what goes on in those therapy sessions.

Explaining What Therapy Looks Like Practically

Regardless of the child’s age, it’s helpful for them to understand what therapy will look like before they get into it. This will assist with feelings of anxiety or being overwhelmed and empower the child to see therapy as a helpful and safe experience.

Criss has heard clients describe therapy as “having a best friend that doesn’t come and hang out with you except for one hour a week and doesn’t tell your secrets.” A therapist is there to help you solve problems, understand your emotions, and express yourself in healthy ways to others. As Staggs puts it, “It’s for anybody who feels like they might need someone to talk to.” It’s that simple!

Therapy has some structure, like a set time frame that may include some planned activities, but it’s meant to be flexible based on what the client needs in a given session. The goal is to build on the child’s strengths and help them learn new things at a pace that works for them.

Balancing Autonomy and Safety

There may be some cases where therapy cannot be optional, like when a child’s safety is in question or if Child Protective Services is involved. Even in these situations, the child should never be forced into an environment where they have no choice. Ultimately, this is a balance your child’s therapist will work with them on, helping them get the help they need in a way that is comfortable for them. However, a parent or caregiver can help by being attentive to how the child is receiving the therapy experience.

Ask your child if they like therapy and find it helpful. Without digging into private matters, check in after a few sessions to see if your child feels like they mesh well with the therapist they are seeing. “Not every client fits with every therapist,” says Criss. And it’s okay if the child wants to see someone else! This can offer a level of autonomy.

What to Do When a Child Refuses Therapy

If a child refuses to go to therapy or refuses to engage with their therapist, the most important thing to do is be patient. And therapists like Staggs and Criss are well-versed in patience! It can take time for a child to open up to the idea of therapy, and they may lash out and be unkind to their caregiver or therapist at first in rebellion.

The key? Don’t take it personally and trust the process. Your child’s therapist can help by engaging in your child’s interests and starting conversations to get to know one another before launching into the heavier stuff.

If a child pushes back a little against therapy, it’s okay to let them at times. Giving them the option to leave early or miss a therapy session can sometimes help them feel better about going the next time.

KVC West Virginia is Here to Help!

At KVC West Virginia, we understand that every child is different and needs to feel valued and understood. Our goal is to help children learn to express themselves in healthier ways, no matter the reason for them seeking therapy. KVC West Virginia provides mental health therapy services for children, families, and adults across West Virginia who are covered by Medicaid. We can provide these services in your home, in the community, at your child’s school or at your closest KVC office – whatever you’re most comfortable with.

Contact your local KVC office for more information and to begin mental health therapy!