If your child is facing a mental health condition like an eating disorder, suicidality, self-harm, substance abuse, anxiety or depression, it’s easy to feel overwhelmed. And while your child’s pediatrician may help you get an initial diagnosis and point you in the direction of therapists and/or treatment programs, it’s still up to you, the parent, to make the right choice for your child.
First, consider how you will approach finding a therapist for your child. To do this, gather your insurance details and find out how many sessions are included, what is your deductible, what therapists are included in your policy?
Before interviewing a therapist, consider getting the following details up-front:
- Where is the therapist’s office? Is it reasonable for you to get your child there at least once per week?
- How many times per week does the therapist want to see your child, and what time slots do they have available? Will this schedule be feasible for you?
- Will there be a co-pay or are you paying out of pocket? If so, can you afford this therapist?
We recommend identifying at least three different therapists to interview for your child. To find these therapists, you may have to call around from the list your insurance provider gave you, and be prepared for therapists who are not currently taking new clients, who don’t have time slots that work for you, or who do not work with children who have your child’s condition. This can be frustrating work, so be prepared.
Once you begin interviewing therapists, stay organized! Keep detailed notes of the therapist’s name, rate/co-pay, recommended treatment plan, and any thoughts and details you get out of your interview. You will think you’ll be able to remember which therapist you like without notes, but it’s really much better if you document your interaction. Also, if the therapist you choose ends up not being a good fit after a few months’ treatment, you may want to revisit your notes.
Here are seven steps to help you find a great therapist for your child who has a mental health condition:
1. Check their credentials
There are many types of therapists, so it’s important to start by understanding what the different credentials mean. There are two main types of licensed therapists: Licensed Clinical Social Worker (LCSW) and Licensed Marriage and Family Therapist (LMFT). Both have a master’s-level degree and at least to years of supervised clinical practice. Both are qualified to assess, diagnose, and treat the full range of mental and emotional disorders in the Diagnostic and Statistical Manual through the use of psychotherapy. The difference between these two licenses is blurry, so it’s best to ask your prospective therapist why they pursued their particular license.
You may encounter professionals who are in pursuit of their licenses, which means they can charge less. The trade-off is less experience. If you work with a professional who is not yet licensed, you want to be very clear about their level of training and understanding, particularly as it relates to your child’s current status.
There are professional certifications for specific challenges such as eating disorders and substance abuse. If your child has a specific diagnosis, you can ask your prospective therapist whether they have any certifications or specific training in that area.
NOTE: if disordered eating and/or body image is part of your child’s condition, it is important to find a therapist who follows a Health at Every Size (HAES)/weight-neutral approach. Ask specifically whether the therapist is familiar with these approaches. The therapist should be aware of the dangers of a weight-based paradigm. Do not work with a therapist who promotes weight loss as an outcome, regardless of the eating disorder type (e.g. binge eating disorder). This is an outdated approach to eating disorder treatment and can be very harmful.
2. Ask them questions
The single best thing you can do when evaluating a potential therapist for your child is to ask a lot of questions. Choosing a therapist is not like choosing a car to buy – it’s not just about lining up cost and features and selecting based on rational criteria. Therapy is a relationship, not a transaction so it’s important for you to understand your therapist’s motivations, approach, and philosophy.
One of the best ways to evaluate how your child’s therapist will treat your child is to evaluate how they treat you when you ask questions. If they seem disturbed, bothered, or put out by your questions, that may be a sign of impatience. On the other hand, if they treat you with compassion and respect, while still maintaining professional boundaries, you can make an educated guess that they will treat your child in the same way.
3. Talk about expectations
It is perfectly reasonable for parents to ask a prospective therapist about what can be expected from the therapy process. There’s a good chance that the therapist’s answers will be somewhat vague since every therapeutic intervention is unique in its own way. Nonetheless, you should feel reassured that your child’s therapist has expectations for recovery and will follow a path that they believe will achieve certain milestones along the way.
4. Find out how you’ll be involved
The old model of childhood therapy was to keep the parents at a distance. The concept was that if a child was in therapy then their parents had done enough damage and needed to stay away so the child can heal. This approach is generally not recommended anymore since parents can be an essential component of healing from and managing a mental condition.
Your child’s therapist should be able to give you an idea of how often they will communicate with you and whether there will be any family sessions incorporated into the treatment plan. You should also find out how the therapist wants you to communicate with them if you observe any dangerous or concerning behavior at home.
5. Ask for a treatment plan
It doesn’t need to be typed up as a proposal, but your child’s therapist should be able to communicate with you what their treatment plan is based on your child’s condition. The treatment plan is designed to guide your child towards reaching recovery goals. It will also help your child’s therapist measure progress and make treatment adjustments along the way. A therapy treatment plan is not a rigid model, but it is a map to help the therapist, child, and parent all get on the same page about treatment.
6. Listen to your gut
Remember that therapy is a relationship, not a transaction, so one of the most important things, when you select a therapist for your child, is to listen to your gut. If you have an uneasy feeling or are unsure whether the therapist is a good fit for your child and your family, it’s OK to keep asking questions and interview some other professionals to test the waters.
It’s also OK if you engage a therapist and disengage later due to a lack of fit. Remember that the therapist’s work is likely going to disrupt some established patterns for you and your whole family, so when you’re evaluating a therapist, it can help to look closely at whether you really don’t like the therapist or if it’s just that you and your child are uncomfortable with the necessary changes that take place during recovery.
7. Listen to your child
Your child is the one who is working with the therapist the most, so it’s important to listen to your child. Of course, some children are very resistant to therapy in the first place, so you have to listen very carefully to try and tease apart their resistance to recovery vs. their resistance to the therapist.
If your child is complaining about the therapist, that’s not always a sign that there’s a poor fit, but it’s definitely worth letting the therapist know what’s happening at home, and what the child is saying about therapy.
A child may seem engaged during therapy and be making progress, but then they speak poorly of the therapist to others. This is tricky, but don’t shy away from having open-ended conversations with your child about their experience with therapy and the therapist so you can help guide them towards health and healing.