Starting therapy can be confusing and scary, especially when it comes to your child. A caregiver might wonder what will happen, if will it help, and what exactly the therapist will do during the session. Each child is unique and each family functions differently, so it is first the job of the therapist to assess each child and family and design a plan of treatment best suited to address the needs of the situation.
Want a more in-depth look at some of the tools we have? Here are several techniques our staff are trained in and might recommend for your child.
Every relationship in the family is important, and how they work together depends on each person’s emotional environment. Family Therapy is an important part of CGC mental health treatment and the saying, “No child is an island,” is specifically pertinent when addressing a client’s needs using the techniques of this type of therapy.
Including family members in therapy sessions allows for a broader view of what may be causing and supporting the problem. It creates a much broader and stronger way of tackling the issue and finding the solution. All members of a family are involved and affected by any one member’s struggles and getting everyone’s perspectives, opinions, and support in the therapeutic process increases the rate of success tremendously.
In these sessions, the therapist typically acts as a facilitator to move the conversation ahead, provide ways to think about issues, and make sure the whole family’s voices are heard.
The structure of the family system is explored during treatment, as well as how it influences the overall strategies of the family members in their behaviors and interactions with one another and their community. Exploration of the family story is another manner of learning what family history affects current behaviors and relationships.
Typically, treatment of families with children and young teens requires the participation of, at minimum, those family members living within the physical household and should also include any other significant persons involved with the family’s functioning.
Client-centered therapy, or person-centered therapy, is a non-directive therapeutic approach. The client actively leads each therapy session through discussion of his or her experiences, while the therapist provides support for the client.
In this type of therapy, the therapist and client are considered equals. The therapist’s role is to reflectively listen and provide a safe place for the client to share and make decisions.
Client-centered therapy grew out of American psychologist Carl Rogers’s theories. He believed that the client’s experiences are more valid than another person’s ideas. He also felt that these experiences should be explored in a supportive, non-judgmental environment.
There are three main qualities of a client-centered therapist:
- The therapist demonstrates genuineness by showing they are comfortable sharing their feelings with the client.
- The therapist does not judge the client, but instead fully accepts them; this concept is referred to as unconditional positive regard. This approach enables the client to share freely.
- The therapist exhibits empathetic understanding. By reflecting the client’s thoughts and emotions, the therapist helps the client gain insight into their experiences and learn more about themself.
Client-centered therapy increases self-esteem and self-awareness. It can help clients with a wide range of clinical issues, such as anxiety, depression, and trauma recovery.
Dialectical Behavioral Therapy (DBT)
Dialectical Behavioral Therapy (DBT) is a type of therapy where you work together with your therapist on acceptance and strategies for change. It’s focused on being present in the moment.
Originally DBT was used for people who are chronically suicidal or living with Borderline Personality Disorder, however, it can also be helpful for those experiencing depression and other mood disorders, eating disorders, and PTSD.
Many of the techniques of DBT work well for children and teens who struggle to cope with intense feelings or mood swings. DBT can be broken down into four skill sets:
- Mindfulness: Paying attention to the here and now, using the five senses to calm down and accept the situation or circumstances without judgment.
- Interpersonal effectiveness: Being assertive to get your needs met, while also respecting others and yourself.
- Emotional regulation: Understanding your feelings and using strategies to cope with them instead of being controlled by them.
- Distress tolerance: Making appropriate and safe decisions in a crisis or uncomfortable moments.
Mastering these four skill sets can help you feel better and improve your relationships.
Cognitive Behavioral Therapy
Cognitive Behavior Therapy (CBT) is based on the belief that psychological distress is largely due to disturbance in cognitive processes. This type of therapy focuses on changing negative thoughts into positive ones.
Much like statements made by other people, self-statements have a major effect on thoughts and behavior. If someone tells you they think you’re too skinny, this can have a profound effect on you. At the same time, telling yourself that you’re too skinny can have just as much of a profound impact on you. Either way, these thoughts can affect how we think, feel, and behave.
By working on challenging those negative cognitions instead of accepting them as being true—and by learning how to do cognitive restructuring to replace those negative thoughts with positive thoughts—can lead to higher self-esteem and self-confidence, as well as an improvement in symptoms of depression and anxiety.
Play therapy is a therapeutic technique widely used with children, particularly those that have been through a traumatic experience. It is an indirect intervention that is helpful for anxious children or those that are not old enough to benefit from more talk-based models of therapy.
The idea behind play therapy is play = language and toys = words. Any parent who has small children will notice they sometimes will use toys to “play” events that happen in their everyday lives, such as the “teacher is being mean” or a “sibling is being too rough”. Trained play therapists are skilled at translating the child’s play into therapeutic meaning and helping the child work through the trauma or emotional upheaval they have experienced.
One of the primary reasons families seek mental health services is because their child often misbehaves. It can happen solely in one atmosphere, such as mainly in school or only at home, but it can also be a consistent pattern across environments.
Behavior modification is a type of therapy that focuses on why misbehavior occurs and looks for strategies and techniques to encourage the behavior to be more positive.
For example, a child is crying at a grocery checkout because they would like a treat. When their caregiver gives in to the misbehavior of crying by giving in and buying a treat, it can be a powerful reinforcer of negative behavior. Working with a therapist to dig into the family environment, habits, and structure can help the caregiver learn powerful ways to reinforce positive behavior while decreasing negative behavior.
This technique relies heavily on the adults in the home to focus on what behavior is reinforced, when, and how. It’s a simple but successful intervention for many families.
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
As the name suggests, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an intervention that is quite effective with clients that have a history of trauma. It is evidence-based, which means there is rigorous research behind the intervention that shows it is effective with a wide variety of populations.
TF-CBT is an intervention that needs to be offered by a specially trained therapist and has several stages of treatment. The beginning of therapy involves setting a foundation of stability, which will help the child later when confronting anxiety-producing topics. The therapist and caregiver work on understanding the problem, improving behavior, and increasing the child’s ability to cope with stress.
The main part of TF-CBT, called the trauma narrative, has the child work through the trauma they have experienced so it can be processed with storytelling in an age-appropriate way. Following the trauma narrative, the therapist works with the family to reinforce coping skills and improve self-esteem. TF-CBT has also been very successful in treating adults.
Trust-Based Relational Intervention (TBRI)
Trust-Based Relational Intervention (TBRI) is a therapeutic model that trains caregivers to provide effective support and treatment for children. TBRI has been applied in courts, residential treatment facilities, group homes, foster and adoptive homes, churches, schools, homes, and community mental health services.
Often, children experience trauma early in their lives. Whether this is a car accident, a death in the family, a crime, being bullied, or being abused, the trauma impacts the way a child interacts with their environment, the people around them, and their social behavior.
Interventions that include caregivers may be more effective because treatment occurs in the child’s environment where challenges occur. While children may spend an hour a week in a professional’s office, they spend most of their hours in the care of their parents or caregivers. It has been noted that relationship-based trauma can only be resolved through loving, stable relationships, such as can be offered by nurturing caregivers.
This type of intervention teaches parents about how our brains develop, how we form our personalities, and how our responses to children can nurture their well-being and decrease their negative symptoms.
TBRI focuses on three concepts:
- Empowerment: attention to physical needs
- Connection: attention to attachment needs
- Correction: attention to behavioral needs.
Through the course of treatment, parents learn responses that foster their children in these areas of growth.
Your child’s, or family’s, therapist may choose any of these types of treatments, or a combination of several, depending on the needs of the situation. Caregivers and children can help by participating, remaining engaged in the process, and making their best attempt to try out the skills learned in the therapist’s office in their daily lives.