The Ellie Blog

Mental health tips and insights

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What To Expect When Your Kid Starts Therapy

I have worked with children as a therapist for years and I am consistently impressed by the parents I have worked with. The amount of love, adoration, and respect they have for their children makes me grateful to have the opportunity to provide support to such wonderful families. As a therapist, I have received many of the same questions from parents over the years, so consider this post your go-to-guide for what parents can expect from therapy.

Finding the Right Therapist for your Child

There are lots of therapists out there, and not everyone is a good fit (and the fit is crucial to making therapy successful!). Every therapist has different specializations, approaches, and techniques. You and your child need find someone that best suits your needs—but how? In an initial therapy intake, you might ask the therapist questions like:

  • How long have you been in this field?
  • What does a typical therapy session look like?
  • What modalities are you trained in?
  • How does mental health treatment work?
  • What kinds of therapy do you think will help my child based on their diagnosis?
  • How often do we assess goals?
  • What does parent involvement in therapy look like?

I encourage families to try meeting with the therapist for several sessions before determining if they aren’t a good fit, as it often takes a while for a child to feel comfortable. If after several sessions your child doesn’t seem comfortable or you’re not noticing any changes, you can ask your therapist for referrals. Do not feel bad if this happens—you want what is best for your child, and part of your job as a parent is to advocate for your child’s needs. We are trained professionals, and we want what is best for them too, even if we are not the right fit.

Ready to take the next step? Click the link below and get matched with the perfect therapist for your child’s needs.

How Long Does My Kid Need to be in Therapy?

Therapy can be expensive and time-consuming, and so while I’d love to tell you the exact amount of time you can expect your child to be in therapy… unfortunately, the answer to this question varies. The length of time your child is in counseling depends on your child’s needs, parent’s involvement in therapy, therapy goals, and how much effort you and your family are willing to put in. Therapy can last just a few months, or it can last a year or more.

Keep in mind that if your child has been struggling for a year or more, then the odds are it will take longer than that for them to recover. It takes a while to rewire your brain. Please try your best to be patient and set realistic expectations.

Role of Parents in their Children’s Therapy

Parents’ involvement in therapy varies depending on the age of the child and the point of therapy. The first two sessions typically require parent participation so the therapist can complete the diagnostic assessment (insurance word for the child mental health assessment) and treatment plan (where we set therapy goals). Parents help fill out assessments during the therapy intake, describe symptoms, and give the therapist another perspective of the presenting problem. Then during the treatment planning session, parents will help the therapist come up with therapy goals.

Other Times that Parents’ Involvement in Therapy is Expected

The therapy space needs to feel safe for your child, so I often encourage parents to only be present for certain sessions, unless this is specifically family therapy. Here are some other tips for when a parent might be a part of their child’s therapy:

  • Kids need time to build trust and rapport with their therapist in the beginning, so it’s not unusual for them to request that their parents to be present as they warm up to their therapist.
  • Kids and teens should also know that parent participation is required whenever a therapist might have a concern about their safety and wellbeing.
  • Kids can also request for their parents to be present if there is an issue they would like to discuss with their parents that they would like me to help facilitate.
  • Parents can request to be present if there is something they would like me to help discuss with their child as well.

Many parents are surprised to find out that kids have a right to confidentiality. That means that parents need to know that their child’s therapist will not tell them everything that is discussed in the session. It’s important that a kid can discuss things with their therapist freely without worrying that they might turn around and tell everything to their parents. Of course, there are limits to thus, which I detail below.

How Does Therapy With Kids Differ from Therapy With Adults?

Good question! It can vary quite a bit, especially the younger your child is. With children, we often do more activities. We will play board games, create art, and even imaginative play. We usually do less talk therapy than we would with adults. This is developmentally appropriate because children actually make sense of the world, process and speak through their play. It’s also helpful because oftentimes children do not have the attention span to talk about mental health the entire hour or so of session.

I’ve had parents ask me why a few months in to therapy with their child I am still playing games and not pushing to discuss the “real issues”. Remember that children need to feel safe within the therapy environment. We will often spend months just building rapport so they can feel safe within the therapy space. In order for therapy to be successful, we need that sense of safety and security to be built.

Using Therapy Techniques at Home

Parents often ask me about how they can create a supportive environment and use therapy techniques at home. I love this question because I know that their support and help is crucial to making therapy work.

Tips for Reinforcing Therapy Skills at Home:

  • Ask your child’s therapist what they are working on! For example, if your child is working on self-esteem, perhaps their therapist will have some book recommendations you could be reading together at night.
  • Ask the therapist directly for feedback. I often provide parents with parent coaching sessions and resources to help learn new parenting strategies. Sometimes the strategies you are using are great, but do not meet your child’s needs. In that case, we as therapists may suggest something different to better meet your child’s needs.
  • Try to implement recommended strategies as best you can. Even though change is hard and it requires more time and effort on your part, therapy is often faster and more effective if everyone is on board.

Some parents send their child to therapy in hopes that the therapist will just be able to work their magic and fix the child. However, most therapists take a systemic approach to therapy, especially family therapy. We do not believe in one “bad guy”. Not the parents, or the child. This can be frustrating for some parents when we give them suggestions or ask for their help. In order to improve your child’s mental health, it may require change in their home environment and others around them. This is not to place blame, but to help improve everyone’s quality of life and overall wellbeing. You as a parent might be exhausted, but hopefully at the end of therapy, you will feel much better.

Will My Child Complain About Me in Therapy?

If your child feels comfortable with their therapist, at some point your child will likely complain about you. This is VERY common for children and especially for teenagers. It’s developmentally appropriate for children, and their therapist knows that there is more than one side to every story. I generally take complaints with a grain of salt since parents are disciplinarians, so of course children will be upset from time to time. If you are doing your job as a parent, at some point your child will be mad at you. That is normal.

It is important to note that this does not apply in cases of abuse or neglect. If your child reports that they are unsafe and being harmed by a parent, we are legally obligated to report that. If a child is at risk of being harmed, harming themselves, or harming others, we have to report that to ensure the child is safe. We are not investigators, just reporters. The child may be lying, and in that case, CPS will determine if that is what is happening. In the scenario that CPS becomes involved, we can work with your family alongside of CPS to help support your child and the needs of your family.

What Happens if Therapy Doesn’t Work Right Away?

As cliché as it sounds, kids’ behaviors can often get worse before they get better. This is tough for parents to hear since they are often already at their wit’s end. I encourage you to be patient and trust the process. People in general do not like change, so your child may push against the recommendations we are making in therapy. That is normal and to be expected. Please do not give up on therapy immediately or on implementing these strategies right away. Give it a month or so before you decide it is not working because your child will likely fight against that change before they see that it can be helpful.

If things have escalated and your child’s safety is in question, please contact a crisis line or call 988. You may want to go over a safety plan with your child’s therapist to discuss what to do in the case of an emergency. It can be helpful for parents and their children to know at what point they should go to the hospital.

If it is determined that your child needs a higher level of care due to their current risk, your therapist will likely put things on pause so your child can focus on that therapy. They can always come back to their outpatient therapist when their treatment is complete.

Beginning the Therapy Journey

Therapy can be a wonderful experience for your child, and it can provide support and healing for them and for you as well! By bringing your child to therapy and working on these things earlier rather than later, you are providing them the opportunity to be more successful as adults. This can also allow you to feel more relaxed at home as things start to improve.

You are vital to your child’s recovery. Parents’ participation and buy-in is crucial to determining how successful therapy can be. I encourage you to continue to advocate on behalf of your child and to learn alongside them. I am excited for you and your child as you begin this journey.

Ready to take the next step? Click the link below and get matched with the perfect therapist for your child’s needs.

About the author

Anna Trout headshot

Anna Trout, MA, LMFT, Board Approved LPCC Supervisor


Anna is an #actuallyautistic Licensed Marriage and Family Therapist. She is a quirky, honest and direct therapist who is passionate about working with a variety of families, couples, groups, and individuals. Prior to joining Ellie, she worked extensively with autistic children and adults or who have other learning disabilities, and… Read more