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Explaining Mental Health Treatment to Children
By Riikka Melartin, Psy.D.
Someone asked me recently about how to explain what therapy is to preschoolers, and I realized that explaining treatment may be something parents run across when a child or their family member gets counseling. As a psychologist, I think it’s important to de-stigmatize mental health treatment, so if you or a family member is going to a therapist, it is helpful to be open and matter of fact about it.
For young children (preschool to early elementary,) a “feelings doctor” is a good term to use, since they all have some concept of a doctor and going to the doctor. My explanation would be something like, “Just like if your arm is hurting, you might go to the doctor. If your feelings are hurting, you go to a feelings doctor. Maybe you’re really scared or sad or mad, and the feelings doctor can help you feel better.“
A child may assume that a therapist will do things a PCP does, like take their temperature, give them shots or listen to their lungs; they might even resist going, based on a misunderstanding that they might undergo medical procedures. It is important to explain that a lot what happens in therapy or counseling is that the child shares how they feel. It could be using words, or it could be by drawing or playing. You can explain that sometimes our feelings make us do things that hurt us or hurt someone else. You might ask your child, “Remember when you were little you got so mad you bit a friend? If something like that happens a lot, a feelings doctor can help you know when you’re mad, and not bite someone. They can help you understand why you’re mad, and how to get that mad feeling out without hurting yourself or someone else.” It will also be important to convey that this won’t be a one-time visit, but that they’ll be seeing the therapist regularly for some time.
Older children can get a more sophisticated version of this explanation. They usually will have an idea themselves of why they are going to start therapy (I have nightmares, I get into fights a lot, I’m scared of spiders, I’m really sad since dad died.) However, ask them why they think they’re going, and what they think will happen. Sometimes children have very odd ideas that they have gleaned from their incomplete knowledge of the world, and this is your chance to avoid misunderstandings.
Teenagers usually are familiar with the idea of therapy through the media and through friends. The main concern for many adolescents is that they be able to speak in confidence, and you should reassure them that their sessions will be private. However, you and the therapist should make it clear that in cases where your child might harm themselves or another, safety comes before confidentiality.
The overarching message I’d like children to get is that taking care of our mental health is just as important getting physical checkups and going to the dentist. If they ask questions about their own or someone else’s treatment, you can strive to answer matter-of-factly, the way you would about any other medical care. If you’re not sure how to best talk about mental health issues with your child, ask your doctor or mental health professional for pointers on how to individualize the message for your child’s age and temperament.
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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