Counseling services for children looks a bit different. Most children are not at the cognitive, emotional, or social development stages necessary to explain what might be upsetting them or triggering their problem behavior. Unlike working with adults, children often are not sure “why” they might be upset, and likely are not sure how to identify the feelings that they are experiencing.

If you take the stance that therapy is more of a fun activity, a child is more likely to perceive it as one. Giving the impression that they are broken and need to be fixed or have done something wrong and require punishment will not be conducive for therapy. I believe that children should not have to do all of the work and find it helpful to incorporate the parents and guardians from the start. Counseling with children can sometimes take longer to yield significant change compared to adults, especially depending on their willingness to participate. Children need to feel safe and accepted in order to develop a sense of trust which is crucial for the therapeutic process.

Services will begin with an intake assessment, which at least one custodial parent or legal guardian will need to be present for. I ask that no other children attend this appointment. During the intake I explain what counseling is, what they can expect, and explain their confidentiality. Most of the hour-long appointment involves me asking the child and the parent(s) questions about their current symptoms, concerning behaviors, their past, health and development, and establishing goals for therapy. Typically, I plan to have a few minutes alone with the child/teen towards the end of the session so they can answer a few questions without a parent present. If clients are able, their next appointment will be scheduled before they leave the office or exit their telehealth session.

Depending on the child’s age and engagement in sessions, most appointments following their intake will begin with a parent/guardian speaking with the child in the main therapy room for a few minutes to discuss progress and concerns. Most of the appointment time will be spent individually with the child discussing problem areas and trying to learn new skills in a fun and relatable way. I like to utilize games, toys, and art supplies to develop a safe environment where they can participate. Typically, at the end of the session, homework given or pertinent information will be shared with the parent and the next appointment will be scheduled before leaving the office.

Although I like to use toys and activities while working with adolescents, I am not a certified play therapist and I do not specialize in working with toddlers and young children. Since my main method is talk based therapy, I work with children at least 8 years old. I have had younger children join sessions when they have had an older sibling or parents involved with therapy and family services were needed and the younger children’s participation was appropriate. For example, a 6-year-old joining their older sibling’s session because they had a pet suddenly pass away.

If your child is younger than eight, I may still be able to help. Depending on the issue, it may be appropriate that I work with the parent(s)/guardian(s) instead. For example, if you have a five-year-old who sleeps in your bed each night and you’d like them to be able to sleep in their own room. One of the adults would participate in the intake, and I could give guidance on how to make that transition as smooth as possible.

Once a teenager is an established client (they’ve had an intake and ideally a few sessions), a parent/guardian does not need to be present at the start and end of the sessions. I do ask that if there was important information for me to have, that the parent(s) inform me prior to the session so I can address it during the appointment. If during that appointment something crucial were to be disclosed that I felt a parent should be apprised of, they would be contacted by phone or email (their preferred method of contact) as soon as I was able. If a teenager does not keep an appointment, I will attempt to contact them directly and then their parent/guardian will be informed as it could be an issue of safety. If there is a co-pay owed, payment arrangements would need to be made. Parents/guardians will still be responsible for a no-show fee if their child misses or forgets their appointments. I can provide reminder calls or emails, but only when requested.

There are two services that I am frequently asked to provide that I do not offer. I do not provide one-time psychological assessments or ADHD testing. By conducting my intake assessment and working with your child, I can determine diagnoses as appropriate. However, if their doctor, school, or probate court is requesting a certain formal assessment, a different provider may be more appropriate. If you are unsure, you are welcome to contact me to discuss. The other service I will not provide are custody evaluations or determinations. I work with families to help them improve and thrive. I am not trained to assess a parent’s fitness to have a child in their care. If you are an established client and request this, it would be unethical for me to participate in legal proceedings. If you, your attorney, or the court subpoenaed me to be at a court hearing or request records, you will be responsible for fees charged.