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As CPA begins to expand our child & adolescent services, we’re pleased to announce we’ll be periodically sharing short articles by CPA clinicians on issues addressing children, adolescents, and parents.
Parental Involvement in Children’s Treatment
When children go to therapy, parents often wonder how involved they will be or should be. In general, when looking for treatment for your pre-adolescent child, expect to your provider work directly with you as well. The reason is two-fold: to provide guidance to you on how to help your child at home, and for the clinician to obtain useful information from you (since children are often not the best reporters!)
The parent guidance portion of treatment can also offer you much needed support and validation as you’re dealing with sometimes difficult or confusing challenges in your family. This parent-clinician communication can take different forms: some therapists check in briefly during every appointment, some make sure to periodically have a session with only parents, and some may communicate mostly by phone. You also may be asked to fill out questionnaires or keep logs as a part of the treatment.
Why is parent-clinician communication so important? I like to tell parents that you can be your child’s best therapist. No, you may not have specialized training but you are the one who spends the most time with your child and will implement the suggestions of the clinician on an every day basis.
You can support and guide your child every day through numerous exchanges and events. This is most obvious in behavioral therapies. For example, a child being treated for encopresis or enuresis (toileting accidents) may have a behavioral plan whereby he/she is asked to sit at the toilet several times a day for fifteen minutes. It’s the parent’s job to make sure this happens, to provide a fun timer that the child can turn on himself, to read together during the bathroom time, give reward stickers, and so on.
The therapist can formulate the treatment plan, but the caregiver has to carry it out. Even with treatments that are less behaviorally focused, the parent has the role of helping the child practice new ways of coping and thinking. Adults in therapy have the cognitive wherewithal to do this on their own (if motivated) but younger children may not. For example, with anxious children, I might ask a parent to always preview a new event such as a birthday party: “How many children will be there? What might you feel like? What can you do if you feel nervous? Is it easier for you to be the first one at the party or to come later?”
As parents make this type of mental preparation explicit for their child, it can become internalized over time. I also do what’s called psycho-education with parents and children, giving them reading and homework to do together. The children’s book series What to Do When You (Worry Too Much/Grumble Too Much etc.) is wonderful for explaining common psychological issues in a simple format and provides child-friendly exercises to practice at home. The books educate you, the parent, and provides a common language for you and your child to talk about issues. Children are familiar with the idea of homework and will often gladly do something that the therapist has assigned, when otherwise getting them to talk can be like pulling teeth!
Finally, check-ins between parent and therapist can help gather information about how the treatment is going. Check ins are also helpful for making changes when necessary. A colleague of mine uses two questions that I have found useful as well: “Tell me about one time things could have gone wrong but didn’t,” and “Tell me about one time things didn’t go well.” These questions can facilitate a weekly forum for discussing what elements contributed to or prevented behavioral or emotional successes, and can shape both treatment and the home environment over time.
Riikka Melartin, Psy.D. is a licensed psychologist who provides individual therapy, counseling, and consultation for clients who are diverse in age, ethnicity, and sexual orientation. Until recently, she also worked as a school psychologist.
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