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Clinician's Corner

Therapy with Children
Julie Rupena-Reynolds, MS, LPC

Parents seek out therapy for their children for a number of reasons. Significant life events such as divorce, separation from caregiver, trauma, abuse (physical, sexual, emotional), and death of family member or pet may be more obvious reasons to seek therapy. Other reasons may not be able to be pinpointed to a specific event. You may be able to identify stress in your child that may have led to problems with behavior, mood, sleep, appetite, and academic or social functioning. In some cases, itís not clear whatís caused a child to suddenly seem withdrawn, worried, stressed, sulky, or tearful. If you feel your child might have an emotional or behavioral problem or needs help coping with a difficult life event, trust your instincts and seek help from a psychotherapist or doctor. Signs to look for to know if your child will benefit from seeing a psychotherapist include:

      • Learning or attention problems (ADHD/ADD)
      • Behavioral problems (excessive anger, acting out, bedwetting or eating disorders)
      • A significant drop in grades, particularly if you child normally maintains high grades
      • Episodes of sadness, tearfulness, or depression
      • Social withdrawal or isolation
      • Being the victim of bullying or bullying other children
      • Decreased interest in previously enjoyed activities
      • Overly aggressive behavior (biting, kicking, or hitting)
      • Sudden changes in appetite (particularly in adolescents)
      • Insomnia or increased sleepiness
      • Excessive school absenteeism or tardiness
      • Mood swings (happy one minute, upset the next)
      • Signs of alcohol or drug use
      • Bereavement issues

Ask your childís teachers, relatives, and others who spend time with your child, if they have seen any of the above signs. Try to determine if the signs are dependent upon the environment or if the child displays the signs in different environments. Gather this information prior to calling for an appointment and bring it to the first session.

How to prepare your child for the first therapy visit
It is best to be honest with your child regarding the reasons you sought out therapy for them. The psychotherapist is going to ask what brought them to therapy so help them prepare for this question. Explain to young children that this type of visit doesnít involve a physical exam or shots. Explain to them that the therapist is there to help families solve problems and feel better. The therapist will play and talk to them. If your child is older, reassure him/her that you will agree that anything he/she says to the psychotherapist is confidential and canít be shared with anyone else without their permission. The exception is if he/she indicates they are having thoughts of suicide or otherwise hurting themselves or others. Give your teen the choice of a few different psychotherapists. Let your older child/teen read biographies of the psychotherapist, meet the psychotherapist and have him/her decide which they feel is the best fit for them. Your teen will be more open to the idea of therapy if they have a sense of control regarding who is the best fit for themselves.

How can you support your child during therapy?
Most likely, the whole family will be involved in therapy at some point or another during the therapy process. Family plays a very critical role in helping children be successful in therapy. While your child copes with his/her emotional issues, be there to listen and show that you care. Offer support without judgment. Patience is critical! Many young children are unable to verbalize their fears and emotions. Encourage your young child to identify sad, mad, scared and happy feelings. Understand that rapport building with a psychotherapist may be slow during this time. Teens are often unsure what to expect from therapy and it will take time for the teen to feel comfortable and unguarded in sharing their feelings and concerns. Help your child/teen learn that it is okay to get mad but acting out violently is not. Give your child/teen guidelines on what they can and canít do to express their anger. Explore healthy coping strategies with your child/teen. Model those healthy coping strategies for your child and ask them to try new strategies such as exercise, listening to music, crying, taking a shower/bath etc. Encourage your child/teen to journal (word or picture) about their feelings during the process of therapy. Some children may prefer to write lyrics, poems and utilize music as a way to express themselves.

What is play therapy?
Play therapy is allowing the child to explore toys while the therapist looks for common themes in play. There are many key toys that are needed for a therapeutic experience for the child. Uses of play in a therapy setting allow the therapist to develop a diagnostic understanding of the child. It helps to establish a working relationship and to break through a childís defenses against anxiety. The use of play helps a child verbalize certain conscious material and associated feelings. Play is often used as a way for a child to solve inner conflict and relieve the accompanying tension. I also work with the parents to help facilitate pretend, non-directive play at home. The non-directive play at home helps reconnect your family. All members of the family can learn how to use play as a therapeutic outlet.

Committing to therapy can be a difficult decision. If you would like to know if therapy is right for you and your family, call Julie Rupena-Reynolds, MS, LPC at the Glendale office (262 542-3255 X234) or visit to learn more about her services.
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