As a child and teen therapist, I can see that it is difficult for parents/care-givers to leave their child for a 45-minute therapy session and not really know what's going on in the office. You may have questions about how therapy with your child works, how it's going and how progress is being measured.
As confidentiality laws apply to minors, parents are not given all information from sessions. It is important to the therapeutic relationship that a child/teen feels like they can talk to their therapist honestly and not every word gets repeated back to their parent. Where I try to balance confidentiality and letting parents/care-givers know how sessions are going is by giving a little tidbit or homework assignment to work on throughout the week, after their session, to continue progress in between sessions.
Getting only a nugget of information can be difficult so this post is to help parents feel they know a bit more about how their child is doing in therapy.
1. Goal Setting
Therapy, as a whole journey, is goal-oriented. Therapists are typically asking clients in their first few sessions what their goals for therapy are. With children and adolescents, the goal setting is typically deferred to the parent. We ask what they've been noticing in their child and why they are bringing them to therapy now, in order to understand what their goals might be. For example, increasing communication skills, decreasing social anxiety, decreasing test anxiety, etc.
As the therapeutic relationship between child and therapist grows stronger, goals can be changed to the perspective of what the client wants to work on, especially depending on the age of the client. Adolescents may have different goals than their parents have for them because they have a different perspective of what's going on, more of a main view than a side view.
It's important to set goals in the beginning of therapy in order to know what we are striving for and how we can help.
2. Progress Markers
Progress markers are like stepping stones, not everything will happen fully and all at once, but rather in stages and slowly. Progress is individualized to how your child processes information, how much effort is being put in sessions and outside of sessions and how much consistency the child has in using the skills they are learning (which comes from parents help).
One thing to keep in mind is that progress may not look how you want it to look for your child. Increasing communication between parent and child, for example, may look like your child leaving you a note or sending you a text, rather than a face-to-face conversation. It's important to remember to be patient and take the wins even if they feel "small". Progress takes time and there is no exact amount of time because every child is different.
Progress can look like your child's reaction to something being different, less intense or needing less time to move forward from a particular situation. Progress can also be your child going back to some of their favorite activities, using more self-care and coping tools or something even more noticeable, like going up to someone new at school. We won't know in the beginning what progress looks like for your child, however, the signs will be there.
You can encourage your child to notice their progress as well! Asking if they notice any changes in how they are thinking about themselves, certain people or certain situations can help them (and you) see if their thought process is changing. It will also help your child to see how the effort and time they are putting in is helping them; it can give your child a sense of pride by showing them how far they have come.
3. Practicing Self-Care and Skills to Sustain Progress
No matter the age, we all need self-care to make sure we are staying at our best. Your child is in school, most likely doing lots of activities after school and on the weekends, juggling chores at home and if they are struggling with anxiety, emotion regulation, etc., they have a lot on their plates. Self-care is a must so that we can feel rejuvenated and recharged.
Practicing the tools your child is learning or if age-appropriate, encouraging them to practice their tools is all a part of the therapy journey. I always tell clients to practice coping tools when they are in a calm state so they (and their brain) can recall them in a heightened state. Communication skills also need to be practiced at home or in school in order for your child to get better at them and for them to turn into their primary way of communication.
Consistency in using and practicing the skills being taught to your child and encouraging self-care at home is a great way to encourage and sustain progress outside of sessions.
4. Keeping In Touch with the Treatment Team
At the end of the day, your child's therapist won't keep you in the dark. We are happy to have family sessions, parenting sessions, scheduling check-in phone calls or having email threads, in order to be up-to-date on your child's care. We need to know information from home, school, extracurricular activities in order to best treat your child and we know that having some information from us, is a way you know your child is being taken care of.
Boundaries around communication are something that you should talk to your child and their therapist about. You want to make sure your child feels that you respect their therapeutic relationship and that everyone on their team is on the same page to help them.
If you have any further questions on child therapy, let us know! If you are noticing some behaviors or changes in your child that you are concerned about, please reach out for a
free 15-minute phone consultation with one of our therapists. Your child deserves the best care and to live their life being their best self!
Stephanie Polizzi is a licensed psychotherapist (LMHC) in Scarsdale, NY at Peaceful Living Mental Health Counseling, serving clients living in NY, NJ and FL.