Ask the Pediatrician: How to work with a child therapist – find a counselor, set goals, know insurance benefits [column] | Health
This is the third in a series of practical approaches to the prevention and treatment of mental illness, designed to provide parents, grandparents and community members with evidence-based ideas for addressing the current behavioral health crisis in children.
It’s time to talk about therapy. When I recommend counseling, there is often a simultaneous groan from parent and child. I think that’s because there are a lot of misconceptions about counseling and how it works. Here are the most common concerns I hear about counseling:
1. It is difficult to get in touch with the right advisor.
2. It’s expensive.
3. It doesn’t work as well as drugs.
4. You have to walk all the time.
5. As a parent, I am disfellowshipped.
Let’s address these misconceptions about counseling.
There’s some truth to #1 that it takes time and commitment to build a relationship with a counselor. This can be sped up by doing some homework ahead of time. Consider calling and interviewing counselors beforehand to find someone who is knowledgeable about your child’s concerns or age group. There are counselors with specializations in LGBTQ issues, art therapy, mutism, trauma, grief, and more.
After you have chosen a counselor, in the first session you should be very clear about what your goals are for your child. For example, with a child with separation anxiety, you could say, “I want them to sleep at a friend’s house.” Ask your counselor what to expect and if there will be “homework.”
About 7% of children in Pennsylvania do not have mental health insurance. Although this number should be zero, it indicates that most children should have coverage for counseling and other behavioral health interventions.
Lancaster also has several organizations that provide free mental health services to people without cover. Start by calling the number on the back of your insurance card and get a good idea of your child’s coverage and places to go. If you don’t have insurance coverage, contact your healthcare provider or school for advice on finding free services.
Counseling, especially cognitive behavioral therapy, works. In fact, it has been shown to work better than drugs for many mental health issues. Additionally, research suggests that medications are much more likely to help when used in conjunction with cognitive behavioral therapy. And there are no side effects to worry about! A child who receives counseling rather than medication is also more likely to acquire the skills needed to prevent other mental health problems in the future.
Research suggests that it takes about 12 to 20 counseling sessions to achieve remission of mental illness symptoms. However, most providers will tell you that a lot can be achieved in six to 10 sessions. After completing therapy, it can also be helpful to do “booster” sessions as a check-in during stressful times.
Counseling is most effective when parents are involved. Talk to your child and your counselor about how much you want to be involved, and listen to what they want in return. Once you’ve taken the time to set goals and outline a treatment plan, you’ll feel more comfortable with counseling following that path.
Present for meetings
Younger children may need their parents to attend therapy sessions, particularly when behavior problems are being addressed at home. This is called parent-child interaction therapy. Older children need more space to declare their own identity and adopt behaviors.
This would not be a fully comprehensive coverage of counseling if I did not highlight the current shortage of mental health professionals in our field. I know many parents who have tried to seek counseling for their children and have encountered long waiting lists, switching providers and a lack of personal opportunities. These obstacles need to be removed, but should not be a reason to abandon counselling. We are making slow progress to address these issues both locally and globally. In the meantime, keep your focus on helping your child in the safest and most effective way.
As Jennifer McSparren Crystle, a licensed professional counselor with expertise in children, puts it, “If you have problems with your vision, see an eye doctor. If you break your leg, see an orthopedist. No one questions or judges this. It should be the same with mental health issues. If you’re struggling with your emotions, see a licensed professional counselor or therapist. There should be no misplaced stigma attached.”
A counselor who can address your child’s needs is worth your perseverance and patience. Contact your doctor if you need help finding a counselor.
dr Lancaster Pediatric Associates’ Pia Fenimore answers questions about children’s health. You can send questions to [email protected]