What is it like to be a child in therapy?

September 30, 2011 7:37 AM

What is child therapy like?

Hello! I'm writing a fictional story where an event takes place during a depressed child's therapy session. I realized I have absolutely no idea what happens in therapy for children who are anxious and depressed. Does the therapist do a lot of the talking? Or just ask questions? Do they play or color? Can anyone enlighten me? Thanks!

posted by EtTuHealy to Grab Bag (10 answers total)

In my experience, it was mostly talking. There was a focus on sort-of CBT: learning to recognize the feeling of being depressed and/or anxious, recognize things that might trigger those feelings, and how to deal with them in a positive way. I don't know if it was actual CBT proper, but there were elements of that therapy present for sure. So, there were some questions, and also just some discussions. And there was a bit of "play" -- drawing and playing board games, because those are things that put kids at ease. There was also a definite sense of "this is something with a goal or endpoint"; the point was to teach ways to accept and deal with these feelings, and once those tools and techniques were in place the sessions would probably not be necessary.
posted by Janta at 7:49 AM on September 30, 2011

Depends on the child, and depends on the therapist. There's a huge range here, so you could believably write about almost anything. Some child therapy is play-oriented, and some is talk-oriented. Some is child-led ("what do you want to do today?"), some is therapist-led ("let's draw a picture of a house"). Some involves talking directly about coping tools or thoughts or feelings, and some involves making up stories, or playing structured card/board games, or drawing/painting, or playing dress-up, or playing in a sand tray (which is basically an indoor sandbox where the kid can play with different types of objects and figurines, etc.).

I am a child therapist. (I am not your child therapist.) Feel free to MeMail if you have specific questions. :)
posted by so_gracefully at 7:54 AM on September 30, 2011 [1 favorite]

My daughter played with Legos. The therapist gave her a bunch of choices of things she could do, things that occupied her hands but didn't take a ton of brain power. She chose the Legos. (One of my therapists had a dollhouse in her office for little kids. There have always been lots of teddy bears and stuffed 'lovies' in every therapist's office I've been in.)

The therapist asked my daughter some questions and let her talk. She would redirect her if she started getting off topic. If the therapist didn't understand something and my daughter couldn't explain the therapist would ask me for clarification.

It was very much like a grown-up therapy session, the therapist let my daughter do most of the talking. If she got quiet the therapist would ask leading questions. The therapist also did more hand holding.

We only had one session, she's going to see a psychologist next month. If you'd like more information you can MeMail me.
posted by TooFewShoes at 7:56 AM on September 30, 2011

The sandtray therapy that so_gracefully mentioned is awesome--it's great with kids who don't want to talk about or can't articulate their feelings well, especially younger ones. I could see this making for a really fascinating short story. You could check out Sandplay Therapists of America or the Sandtray Therapy Institute for further info (including videos) of the process.

(I am not a child therapist, but I worked in a child-focused social service agency for nearly 10 years, knew many child therapists well and learned to write in their language for grant applications.)
posted by dlugoczaj at 8:04 AM on September 30, 2011

Mostly talking. In the first session the therapist asked that next week I bring in an object that was important to me. We talked about it and that spun off into other conversations. Every week I brought in a possession that was important to me and it kind of went from there. It never felt like anything other than sitting down and talking and having a little playtime with an adult who seemed cool and never seemed to get mad.
posted by FAMOUS MONSTER at 8:17 AM on September 30, 2011 [1 favorite]

Back in the day, a class I was in read the book Dibs In Search of Self, which is a true (if anonymized) story of a boy progressing and improving through play therapy. Granted, this play therapy would have taken place in I think the 1950s, so, you know. Take it with a grain of contextual salt.
posted by theatro at 8:20 AM on September 30, 2011

It kind of depends on the age of the child. IME, in early childhood it's more like the play IS the therapy--acting out scenarios and telling stories with figurines in the sand tray, or drawing pictures, or playing with puppets, etc. As kids get a little older (8-12 or so) are shift in real life from playing with toys to playing games, I've seen a lot of therapists use games or other activities (simple craft projects, for example) as a way to casually engage with the child and take some of the pressure off the "talk therapy" Q-and-A that occurs while therapist and child are mutually participating in the activity. There are also therapy-specific games (question cards, board games, etc.) that some therapists may use.

My daughter can kick my ass at Connect Four after spending many years in therapy.
posted by SomeTrickPony at 8:35 AM on September 30, 2011

Response by poster: Wow, thanks so much everyone! This is incredibly helpful :).
posted by EtTuHealy at 10:46 AM on September 30, 2011

As far as I can remember, little to no discernable difference from therapy as an adult.
posted by hoyland at 1:01 PM on September 30, 2011

I got the impression I was supposed to talk about any bad things that had happened with my therapist (it was talk therapy), so went along each week and dutifully told her about every bad thing that had ever happened in my life. It made me very miserable, and she wanted to put me on drugs. I'm very glad I told her I didn't want to, because I was miserable in sessions, but if she'd checked with my teacher, friends, etc, I was actually doing ok. I didn't like going, but thought I was what I was supposed to do.
Finally I asked to stop going, and while worried she was doing the wrong thing, my mother let me stop as I'd been going for ages with no apparent improvement. I felt much better when I stopped going.

CBT or something might have been more useful. The school coming straight out and telling my mother they thought I had ADHD, rather than telling her they thought I should see a Psychiatrist/Psychologist because I wasn't doing well at school, and her misinterpreting that and sending me to a Psychologist for counseling, would have also helped.
Therapy can be good for a child, but a child is obviously less likely to shop around if it's not the right therapist than an adult, and I think that's the number one reason for the bad child-therapy stories. If I was doing it, I'd take a kid to 3 different therapist, and let them pick the one they got on with best. And ask them if they thought it was helping!
posted by Elysum at 9:37 PM on September 30, 2011