“Fine, I guess.”
“What did you do?”
“I don’t know, talked I guess.”
Is your child or teenager attending therapy? Can you tell if it’s helpful? Frequently, parents feel uncertain of what occurs within the therapy office. They are likely equally concerned as they are curious. The concern can potentially be a source of frustration particularly when it can feel as though they are paying for someone to “chat” with their child. When progress isn’t obvious and the child continues to suffer, concern may graduate to worry.
The process of therapy is dynamic, individualized, and unique. Therapists become trained in techniques to elicit emotion, identify ambivalence, challenge distorted thinking, and most importantly, provide empathy to one’s experience. Therapy is not advice-giving, but can be problem-solving. It’s not a panacea to your child’s problems and can take significant time. Progress at times can be quantified, but not always. Similar to life, therapy is uncertain and this can be incredibly challenging for parents.
The aforementioned concern and curiosity can lead parents to inquire about their child’s therapy session. Naturally, this occurs within two minutes into their car ride home. Parents ask, “How was it? What did you learn?” Unfortunately, these questions are often met with, “It was good. We chatted.” Neither answer provides more insight, or helps the parent identify whether therapy is helpful.
There may be a huge desire for a child to state,“Mom, Dad, in therapy we discussed problems I’m having with expressing myself. It seems my therapist believes these are related to areas of vulnerability likely caused by episodes of shame and guilt during my childhood and adolescence. Furthermore, we explored my support network and patterns I make when making friends. We identified the difficulties I have with attention and how I often isolate when I feel stupid.”
Although as parents, we would so appreciate a response such as this, we know it is unlikely and unrealistic. In fact, the expectation that a child is able to express himself/herself in a cohesive and articulate manner what they discussed in therapy is unattainable.
Of course, some of this depends on the reason your child is in therapy. With many of the clients I work with it’s pretty clear what we did, or discussed during the therapy hour. When working with teenage clients to overcome OCD, panic, or social phobia we engage in specific exposure activities to challenge their fears. This is concrete, objective, and parents often seen rather quick results. Sprinkled amongst these session, however, is “chatting” to build our relationship and develop insight.
Maybe the best response to your child climbing in the car after therapy is, “I’m glad you did that today. Good job.” And if you’re curious whether therapy is helpful, ask, “Do you want to come back next week?” If the answer is yes, they likely find value in it.
Talking with the Therapist
Therapists are not off the hook, however, in providing rationale for what they do.
I would ask the therapist either following the intake appointment or a few sessions in, what the treatment plan is?
I would inquire into what diagnosis the therapist believes best describes your child’s symptoms. “Depression and anxiety” are not clinical diagnoses and provide little understanding into how your child is suffering. Ask the therapist to be more specific.
Inquire how the therapist intends to track progress? For some symptoms, it is helpful to use specific, validated questionnaires that help with rating symptoms and allow one to track progress. This helps your child and you see weekly change (in one direction or another). Other ways can be specific behavioral changes such as improve sleep, school attendance, decrease isolation, etc. Sometimes, it is rather difficult to measure insight, the development of self-esteem, and ability to communicate. This is fine, but your therapist should be able to explain the rationale behind this.
What are the goals for therapy? Again, these can be very specific, but often the goal is to establish a strong relationship, provide support, and offer a safe-place for your child to express herself/himself. There aren’t “incorrect” goals for therapy, but there should be thoughtfulness on what your child is working on.
Lastly, request that the therapist provide a parent-session to educate you on your child’s symptoms, get recommendations on how to be helpful, or at minimum provide yourself with reassurance that someone understands what is going on.