In the last decade or two—and especially since Covid—people in the US have become far more comfortable talking about mental health. This is a very good thing, but it’s also made finding a therapist more difficult, not because there are few therapists but because more people are seeking out therapy.
It tends to be even harder finding a therapist for a child because even fewer therapists are trained to work with children.
For a lot of people, therapy is relatively new territory. This post looks at how to find a therapist (for you or your child), and then how to work with that person. (For more on therapy, what it is and how it works, see the two posts, “What is Play Therapy and How It Works” and “What is Therapy and How It Works.”)
Persistence pays off when searching for a therapist
If you’ve tried finding a therapist, you’ve probably called a whole list of names from your insurance company or the internet. You probably haven’t actually reached anyone because therapists rarely answer the phone when an unknown number (i.e. not a client) is calling. You’ll have to leave a message, and—as is all-too common—you won’t get a call back. (I don’t think this is okay, and it’s a problem that therapists don’t return calls, but it happens not because therapists don’t care but because they get so many calls.)
The truth is, therapists don’t often have openings. When they do, they often don’t get much warning—that is, clients tend to end therapy with just a few weeks’ warning, if that. Because therapists get so many calls, it’s not hard to fill an available time slot when one suddenly opens up. This means there’s quite a bit of luck involved in catching a therapist in that short window when she has an opening.
I recommend you call down your list and leave a short, concise message for each therapist. This is not a time to go into detail about your or your child’s issues. The message can sound something like this: “Hi, my name is Evan Shopper. I’m looking for a therapist for my 8-year-old son. He has XYZ insurance. I’d love to hear back if you have an opening. Thanks.”
Three weeks later, if you’re still searching, call your list and leave another message letting the therapist know you’re still looking and hope to hear back if something opens up. The goal here is to quickly let the therapist know you’re invested in therapy, but that you’re not going to be a nudge. Three weeks later, call again.
In-person vs. remote
As a therapist, I much prefer doing in-person therapy with all my clients. Having done remote therapy with young kids during Covid, I found that it rarely worked with children under 10—it can be done, but it’s often necessary to have a parent present during the sessions, which itself is not always recommended. I generally don’t recommend remote therapy for a child under 12.
It’s a personal choice, obviously. As a therapist, I find it much harder to pick up on the subtleties online versus in person. In-person therapy feels far more “real” to me, and I think for my clients, too. That said, for many people, getting to a therapist’s office may be prohibitive, and so we have to make do. But if you have the choice, and especially if your child is going to do therapy, I recommend it be in-person.
Before bringing your child for the first session
Before meeting with a child, some therapists meet with the parents a few times. Other therapists meet initially with the child and parent together. There isn’t any one way to do it, but before you introduce your child to the therapist—and especially if your child hasn’t done therapy before—you need to do a little work before the initial meeting.
First, tell your child anything you know about the therapist—i.e. your impressions if you’ve already met her or talked on the phone, what your referring doctor or friend has told you, etc. In this way, you’re letting your child know that the therapist isn’t a complete stranger and that they are known—and perhaps approved of—by you or someone you trust.
Next, explain what therapy is. To the child eight and under, you can explain that a therapist is like a Feelings Doctor who helps kids with their big feelings. If your child is over eight, you can explain a bit more: a therapist is someone who knows a lot about feelings and can help your child understand and deal with her own.
The main point here is to help your child feel comfortable walking into a new office with a new person who many children will feel a bit wary of, especially knowing that this person likes talking about feelings. Because many young kids can get intimidated, overwhelmed, and uncomfortable talking about feelings, your child may have some reservations seeing someone who explicitly deals with feelings. It may be helpful to tell your child that she can first get to know the therapist and then decide how to talk about feelings.
Starting out: how to evaluate a therapist
In your initial sessions, it’s perfectly fine to ask questions about your therapist’s experience working with particular subjects, issues, people, etc. The therapist should give you an honest, considered answer.
When looking for a therapist for your child, it’s also perfectly fine to ask how he does therapy with a child who might bring challenges like your own child’s. Essentially, ask any question you’re curious about. Ask if he does play therapy and how he tends to do it. Ask what rules he has for kids when working with them. Ask if there are particular issues or clients he likes (or doesn’t like) working with and why. Ask what your role in the therapy might be.
The point here isn’t to be critical or doubting of the therapist, or to see if he passes some test. You’re only trying to get a better read of who he is and whether you trust he will be able to understand and help your child.
How to get the most out of therapy
To start with, be as vulnerable as you can. I know it’s hard to do, especially when you’re starting therapy and don’t know your therapist very well. It’s also hard because therapy can feel very one-sided: you’re the one exposing yourself while the therapist sits and listens.
But when you can tolerate this discomfort, you will get a lot more out of your therapy. If you risk a lot, you stand to gain a lot; if you risk little—and talk about safe things—you won’t get so far.
Many people feel they will be judged and critiqued by the therapist, but it’s usually their own self-judgment that they’re feeling, not the therapist’s. So put the judgment piece aside and try to talk about the things that really matter and that get in your way. If it feels embarrassing or shameful talking about something, then you’re probably doing it right!
And what do therapists want from their clients?
Therapists only want clients to be their full, authentic selves, to be real in the good, bad, and ugly ways we all are.
If you’re putting on a face or trying to do the polite thing, if you’re wanting your therapist to like and approve of you, this is completely normal; anyone who’s been in therapy has felt this. Just know that it can get in the way of being your true, authentic self.
What to do when you have issues with your therapist
Eventually, something will happen, and an issue will come up. Your therapist will say or do something objectionable. Or she’ll seem disinterested, distracted, judgmental, close-minded, ignorant, etc. You may be disgusted, distrustful, or attracted to your therapist. You may have loving, angry, or collegial fantasies about her. This is all very, very normal, and it’s an important part of the work itself!
To not say something about your feelings is missing an enormous opportunity to learn about yourself—and to build further trust with your therapist. In the end, if you remain silent with these valid feelings—for all of your feelings are valid—it can interfere with your therapy and your trusting relationship with the therapist.
At its roots, therapy is all about relationships, including the one you have with your therapist who is a real person with flaws, limitations, and triggers.
We therapists are not perfect; we’re like everyone else—though we have hopefully done our own therapy and have integrated it so that our own messiness doesn’t interfere with our client’s messiness. But sometimes it does.
Whatever your feelings are, therapists should be able to handle them, even when they directly involve the therapist. Hopefully your therapist will welcome your feelings and together you can unpack them.
Sometimes your feelings may have less to do with your therapist than with the issues you’re grappling with. For example, you’d like your therapist to invite you over for dinner with her family. Obviously, that’s not going to happen, but it’s a valid wish, and it speaks to something going on inside of you. Good! If you can unpack this further, you can better understand yourself.
And sometimes, your feelings are a direct reaction to something your therapist needs to own. For example, when you’re late for your appointment, your therapist clearly takes it personally, is irritated and says something that feels judgmental and shaming. She should hear you out, own her part, and repair things with you.
When your therapist doesn’t seem like a good match for you
Sometimes it might feel like you and your therapist are not well matched. This feeling often arises in the first month or two of therapy. Here, too, it’s helpful to talk about this.
It might feel like you’re being overly critical or rejecting of the therapist, but it’s important to raise the issue. Your therapist shouldn’t take it as criticism but rather as feedback about how he is doing his part, as well as what you are needing from him.
It’s very possible that you two can work through the issue and strengthen your relationship. Or you may both decide that it isn’t the best match, but hopefully you’ll have a better idea of exactly why so that you can use this knowledge when looking for another therapist.
Related Posts
The Most Important Premise of All
An outlook that could change how you see everything–it did for me.
What Actually is Play Therapy and How It Works
If you’ve wondered what exactly happens when therapists “do play therapy,” this post will explain it all as well as how and why it works.
Head vs. Heart: Growing a Neck
Good mental health starts with strong communication between your head (your thinking) and your heart (your feelings). Here’s how.
