Sitting in the quiet waiting room just minutes before her therapist came to retrieve her, my 8-year-old turned to me, and with a clarity that always surprises me she asked, “Mom? Why do I come to therapy?”
It’s a hard question for us parents to answer. We want to protect our kids, make them feel safe, encourage their individuality, yet we don’t want to make them feel like they are different from their peers. My daughter is highly sensitive, and the last thing I wanted to do was add to her anxiety or uncertainty.
The first truth is, we suspect she may have ADD. After visiting with a neurologist, he recommended we start with a behavioral therapist, someone who could really get to know her and make recommendations from there. We found a wonderful woman, and my daughter responds to her really well.
The second truth is, we were experiencing some major Dr. Jekyll/Mr. Hyde types of mood swings that caused disruption within the family, and we were hoping the therapist could help give us all tools to endure these episodes. In fact, when my daughter recognizes she’s having difficulty in her day, she’ll often ask me when her next appointment is.
When she and her twin sister, born at 31 weeks, started occupational therapy at age 7, it was easy to explain. “You need help improving your balance and gross motor skills.” Behavioral therapy and mental health issues in general can carry a stigma. But with the right words and open conversation, we can move on to helping our children succeed.
The following is advice given from Dr. Adiaha Spinks-Franklin, a board certified developmental-behavioral pediatrician at Texas Children’s Hospital in Houston, TX.
How to explain behavioral therapy to children and teens
Behavior therapy refers to a modality of psychotherapy designed to help parents develop effective strategies for managing their child’s behaviors. Behavior therapy also teaches children healthy ways of managing their own emotional reactions and behaviors, and how to adjust to disappointments and tolerate frustrations. It can be challenging to explain behavior therapy to children in order to prepare them for a visit. Parents should take their child’s developmental level into consideration.
Preschoolers (ages 3-5 years)
Children this age have magical thinking and are concrete thinkers. Keep the explanation simple and concrete. Reassure your child there are no shots or “owies” if the child asks.
“We are going to see a talking doctor who can help us learn to listen/use our words/obey Mom and Dad.
School-aged children (ages 6-9 years)
Children in this age range begin to have a broader understanding of the world around them. By this age, children are aware of their own behaviors, but may not be fully aware of how their behaviors affect those around them. If a child this age requires behavior therapy, chances are the child’s behaviors are interfering with school functioning and relationships at home. With this age group, be honest and forthcoming when explaining behavior therapy.
“We are going to see a talking doctor who will help us figure out better ways of dealing with anger, frustration and disappointment.”
Tweens (ages 10-12 years)
This age group of children are developing more abstract reasoning. The peer group becomes increasingly important, and children want to be “normal.” Seeking behavior therapy for children in this age group may be to address anxiety or problems with interpersonal relationships. Parents may consider explaining behavior therapies in a manner that is clear, honest and shows compassion.
“I know you’ve been dealing with a lot of stress lately with school and friends and even at home. We are going to see a type of behavior specialist who can help me figure out ways to help you at home and help you figure out ways to manage your stress.”
Adolescents (ages 13 and older)
Adolescents begin to form their own individual identities. Parents continue to play an important role in their lives, but they seek individuality as well. By this age, teens are well aware of the challenges they have been facing. Since they are egocentric, they possess little insight into how their own behaviors may contribute to the problem. Although teens are older and may even “look like” an adult, they are not “little adults.” In fact, their brains will not be fully developed until they are 25 years old. Behavior therapy at this age may be to address depression, experimentation with substances, cutting or other high-risk behaviors. Try to explain behavior therapy in such a way as to partner with the teen to show that the family is working together to address the challenges.
“This year has been really stressful for us all. The way we have been handling the situation has not been helpful. Our family is going to meet with a professional therapist who can help us figure out better ways of getting along and managing stress and disappointment.” At this age, teens can help decide what characteristics of a therapist they may prefer – male or female; language spoken; religious preferences;
Additional resources
There are several resources parents may explore with an older child to help learn more about behavior therapy, or even learn about the therapist:
- Psychology Today contains a database of psychologists, psychiatrists and psychotherapists all over the country.
- Kids Health contains articles reviewed by physicians and psychologists. The articles review a variety of medical and mental health topics.
- Teens Mental Health provides helpful articles, videos and other tools to help adolescents (and parents) better understand mental health conditions.
About Dr. Spinks-Franklin
Dr. Adiaha Spinks-Franklin is a board certified developmental-behavioral pediatrician at Texas Children’s Hospital in Houston, TX. Dr. Franklin is a renowned expert in childhood development and the behavioral problems that children can face. Her research interests include the cultural aspect of child development.