What Does Therapy Look Like With a Young Child?



Our young child therapist Kelly Jean Tucker, LCMHC developed this blog series to help guide you through the process of engaging your child in therapy. If you haven't yet read through her previous posts, please check them out! Previous posts are designed to support you in determining whether your own child could benefit from therapy (linked here), how to find a therapist who is a great fit for your child and family (linked here), and what to expect in a first therapy session (linked here).


All good therapy is individualized to each child's needs and every therapist has their own approach. In my experience as a child therapist, however, therapy with young children generally includes a few basic components: Age appropriate emotional processing, skill building, and parent support.


1. Age Appropriate Emotional Processing: The foundation of many therapies is for children to learn how to name their emotional experiences. As Dan Siegel says, “You have to name it to tame it.” So many child therapists will start out with engaging ways to teach children emotional expression skills. This can be done through many creative means like games, art, play, using puppets, or role plays. In addition to having words to name their experiences, therapy with young children provides them age appropriate ways to process their day to day stressors and past experiences. For example, a child therapist may ask a child to pick out a toy that best describes how they feel about school or draw a picture of where they feel worry in their body.


2. Skill Building: After your child has a good foundation of emotional literacy, they can begin to learn skills that help them with the concern that brought them in. For example, your child may learn mindfulness based skills that help them with anxiety or tools to help them with impulse control.


3. Caregiver/Parenting Support: Your child’s therapist will keep you in the loop of your child’s progress in therapy and give you tools to help reinforce their newly learned skills at home. For example, in my sessions I will typically reserve the last 15-20 minutes for the child to teach the parent the skill we focused on in session. I believe this gives the child ownership over their therapy and is a self esteem booster. I will then give parents time to discuss their questions about how to encourage children to practice these skills at home and school. Additionally, I will schedule times to meet with parents separately to offer support on parenting skills and ways to support your child’s social-emotional wellbeing.


Frequently Asked Questions about child therapy:


* How Long Are Sessions? My sessions are typically an hour long, with 5-10 minutes to check-in with kids about the week, 30 minutes to work on skill building, and 15-20 for parent involvement. If I am conducting an EMDR or trauma processing session, I may ask for an hour and a half to ensure a child has time to full process and has time to self-regulate before the end of the appointment.

* How Much Will You Share with Me about What My Child Talks about in Therapy? When I discuss confidentiality with kids, I usually tell them that I will not share what they talk about with me unless I have their permission or I am worried about their safety (I am concerned about them harming themselves, harming others, or that they are being harmed). I tell kids that it is important that their grown up knows about the skills we are working on, because it’s just like anything they learn in school or in sports ... they have to practice to get better at them.I also remind them that it’s important to discuss what is bothering us with trusted adults. I usually end sessions asking kids if there is anything they wouldn’t want me to talk about with their parents and, most of the time, they are totally open to share!

* Will My Child Receive a Mental Health Diagnosis? If you would like to use your child's health insurance to pay for therapy, then yes, they will require a formal mental health diagnosis in order to demonstrate that therapy services are "medically necessary." If you are not using insurance, a formal mental health diagnosis is not required to provide treatment to your child. As part of the first appointment, therapists will discuss their initial impression with you and continue to then they will assess your child’s symptoms throughout the therapy process. Some mental health diagnoses, such as Adjustment Disorder and Posttraumatic Stress Disorder, are not always “permanent." If your child has had a major change in their life recently or experienced something really scary, we will work together to treat the symptoms resulting from those events and then they would no longer meet criteria for those diagnoses once their symptoms have been resolved.

* Does My Child's Pediatrician or School Need to Know That They Are Working With a Therapist? While it is not necessarily "required" to share this information with your child's pediatrician or school, I often recommend that parents share everything about their child's medical needs, including mental health symptoms, with their pediatrician so that we can collaborate on your child's care and address any possible underlying medical issues that may be impacting their symptoms. I also typically recommend that parents share the minimum amount of necessary information with their child's school as their teachers and school counselors can offer additional supports in the classroom setting that your child may benefit from.


I hope that you have found the final installment in this blog series helpful and feel more informed about the therapy process. We will continue to publish blogs about various topics related to childhood mental health, so please be on the lookout for upcoming posts! You can also shoot me an email (contact@flourishasheville.com) if you have topics that you'd like to see covered.


Thanks so much for joining me and take care!


Kelly Jean Tucker is a Licensed Clinical Mental Health Counselor providing therapy to children ages 3-11 in Asheville, NC. She additionally provides support to parents through counseling sessions, psychoeducation, and parenting groups. You can read more about Kelly Jean here.