Psychotherapists approach this specialized area in different ways, depending on the child's problem and on their training. Some problems are worked out best when all members of the family (even the children who are seen as problem free) join in therapy sessions. Other children and other problems may respond better in individual therapy, where the child has the time and space, apart from the family, to work on issues that may be getting in the way of development.

When a family meets together in therapy, the therapist listens carefully, without judgment, to each person's point of view. The therapist is objective, and helps family members understand some of the difficult feelings that come up in close family relationships. The therapist insures that no one person is unduly singled out. The goal is to create a safe place in which family members can experience different and improved ways of connecting with one another.

Sometimes children are caught in the middle of a parental conflict, or are highly sensitive to the stresses of family life, or may react strongly to other environments such as school. Contrary to the myth people often hear, children are not more adaptable and less affected by problems than adults. The opposite is true-children have fewer coping skills and less control over the environment. They are less able to verbally describe emotional problems and must therefore 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 is often useful to consult a child or family psychotherapist if your child is behaving in a way that concerns you.

Mental health interventions for children vary with respect to the problem being addressed and to the age and other individual characteristics of the child. Although such interventions share some approaches, treatment methods can be quite different from each other.

As part of the initial assessment, a qualified mental health professional or child and adolescent psychiatrist will determine the need for psychotherapy. This decision will be based on such things as the child's current problems, history, level of development, ability to cooperate with treatment, and what interventions are most likely to help with the presenting concerns. Psychotherapy is often used in combination with other treatments (medication, behavior management, or work with the school). The relationship that develops between the therapist and the patient is very important. The child or adolescent must feel comfortable, safe and understood. This type of trusting environment makes it much easier for the child to express his/her thoughts and feelings and to use the therapy in a helpful way.

Pros for this therapy

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 the psychotherapy session they have the full, respectful attention of an understanding adult.

With young children, the psychotherapist does not usually discuss problems. Problems are 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.

Cons for this therapy

Children entering psychotherapy have most often been exposed to family violence or other traumatic experiences. Treating traumatized children may be unusually challenging for the therapist because of vicarious traumatization. Access to reflective supervision is needed to prevent a sense of helplessness and a "self-protective tendency to view complex clinical cases as intractable."

Psychoanalysis was perhaps the first specific school of psychotherapy, developed by Sigmund Freud and others through the early 20th century. Trained as a neurologist, Freud began focusing on problems that appeared to have no discernible organic basis, and theorized that they had psychological causes originating in childhood experiences and the unconscious mind. Techniques such as dream interpretation, free association, transference and analysis of the id, ego and superego were developed.

Behaviorism developed in the 1920s, and behavior modification as a therapy became popularized in the 1950s and 1960s. Notable contributors were Joseph Wolpe in South Africa, M.B. Shipiro and Hans Eysenck in Britain, and John B. Watson and B.F. Skinner in the United States. Behavioral therapy approaches relied on principles of operant conditioning, classical conditioning and social learning theory to bring about therapeutic change in observable symptoms. The approach became commonly used for phobias, as well as other disorders.

Postmodern psychotherapies such as Narrative Therapy and Coherence Therapy did not impose definitions of mental health and illness, but rather saw the goal of therapy as something constructed by the client and therapist in a social context. Systems Therapy also developed, which focuses on family and group dynamics—and Transpersonal psychology, which focuses on the spiritual facet of human experience. Other important orientations developed in the last three decades include Feminist therapy, Brief therapy, Somatic Psychology, Expressive therapy, applied Positive psychology and the Human Givens approach which is building on the best of what has gone before. 

Child psychotherapy is another form of psychotherapy that comes from the need of counseling and psychotherapy to be adapted to meet the developmental needs of children. Child psychotherapy has its foundation in the work of Freud.  Early pioneers in the field include Hermine Hug-Hellmuth, Anna Freud, and Melanie Klein. These pioneers are widely considered to have shaped child psychotherapy in a significant manner. 

Psychotherapy is a general term referring to therapeutic interaction or treatment contracted between a trained professional and a client or patient; family, couple or group. The problems addressed are psychological in nature and of no specific kind or degree, but rather depend on the specialty of the practitioner.

Psychotherapy aims to increase the individual's sense of his/her own well-being. Psychotherapists employ a range of techniques based on experiential relationship building, dialog, communication and behavior change that are designed to improve the mental health of a client or patient, or to improve group relationships (such as in a family).

Child Psychotherapy helps children and adolescents in a variety of ways. They receive emotional support, resolve conflicts with people, understand feelings and problems, and try out new solutions to old problems. Goals for therapy may be specific (change in behavior, improved relations with friends or family), or more general (less anxiety, better self-esteem). The length of psychotherapy depends on the complexity and severity of problems.

Primary Therapy: 
Review Date: 
February 15, 2012