What Is Child And Family Psychotherapy?

Adapted with Permission From Creating A New Future, a booklet published by AMHA Massachusetts and The Consortium For Psychotherapy

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Revised: May 21, 2014

Parenting can be complicated and is frequently a difficult job. Children differ tremendously yet are alike in many ways.  The differ emotionally and in their temperament based on their place in the family, their biology, as well as the culture and the experiences in  which they are raised.  Children adapt and grow in response to their environment regardless of their biological or genetic attributes.  Environment strongly influences a child’s personality, moods, behaviors, and relationship patterns. Some children may seem especially difficult for a particular parent to handle.  Problems are rarely the result of a child's biology.   Problems are more often the result of experience and learning. 

Keep in mind that any particular behavior or type of problem can be the result of different causes.  In addition, a similar life experience or environment can lead to many different outcomes.  Children are more different than similar in terms of how many ways they will adapt to a given experience.  Parents are often unable to see themselves or the impact of their behavior because they are unknowingly reminded of their own childhood.  The result can be stress in the parent-child relationship.

The relationship between parents is crucial.  Sometimes children are caught in the middle of a parental conflict.  Children are very aware and sensitive to the stress in family life.  Children will usually react strongly to other environments.   Children are not more adaptable and less affected by problems than adults. Children have less experience, fewer coping skills and less control over the environment. They also have difficulty describing emotional problems. Children will usually show their distress in indirect ways such as irritability, sleeping or eating problems, personality changes, physical complaints, disregard for personal safety, school problems, problems getting along with others, acting younger or older than their ages, and so on.

It can be very helpful to consult a child or family psychotherapist if your child is behaving in a way that concerns you. A consultation can help you understand the source and purpose of the behavior and to assess whether your concerns are within a normal range.

What Is Special About Family, Adolescent and Child Psychotherapy?

Family, adolescent and child psychotherapy is a specialization.  Psychotherapists approach a child’s or adolescent's potential problems depending on their training. Some problems and approaches work best when all members of the family (even the children who are seen as problem-free) join in therapy sessions. Other problems and children may respond better in individual therapy  where the child has the time apart from the family.

When a family meets together in therapy, the therapist listens carefully and may take an educative or facilitative approach.   This will depend on each person’s point of view and an understanding of the family.   A psychotherapist will attempt to be fair, objective, further create insight and understanding, and help family members understand difficult feelings.  A psychotherapist will generally avoid singling one person out especially if doing so is not helpful.  The goal is to create a safe place in which family members can communicate, gain insight, develop new skills, create new experiences and forge realistic expectations and assumptions.

While at first it may feel frightening or embarrassing to "air one’s family linen" in front of a stranger, most families find that the opportunity to create greater trust and harmony among family members far outweighs the initial fears.  Psychotherapy is not supposed to be an emotional dumping ground.  A good psychotherapist will moderate emotional unloading to a manageable level.

Individual psychotherapy with adolescents is similar to the therapy that adults engage in. Although they may be somewhat self-conscious at first, teens often come to enjoy therapy. It is a place where they can focus on themselves, on their experiences and relationships, on their problems with family or peers. and on their hopes, dreams and fears. In psychotherapy sessions a teen should have the benefit of a psychotherapist's full and respectful attention.

With very young children, a psychotherapist does not usually discuss problems. Problems are usually explored and worked on in the context of play. Play, often called the work of the child, is far from conflict-free. To a trained eye, it is a powerful form of communication about the child’s ways of experiencing his or her world and a way of expressing difficulties the child may be experiencing. Play is also a form of healing. When a child "plays out" fears and difficult experiences in a context in which they can be understood, the child is able to move on. If parents are puzzled by a child’s description of fun in the therapist’s office, they should be aware that much more than play is taking place.

Will A Therapist Keep Secrets From Me About My Child?

With both adolescents and younger children, parents should expect feedback from the psychotherapist about his or her evaluation of the child. The therapist should share concerns about the child and suggest ways to improve difficult parent-child relationships. With adolescents, the question of what information is shared with the parents and what information will be considered private is carefully worked out with all concerned.