What Kind of Therapy Does My Child Need?
This is the fun part. Countless clinicians and researchers have dedicated their life’s work to developing and testing evidence-based assessments, treatments, and interventions designed specifically to improve mental health in children.
Each therapist will have their own approach to treatment and a variety of therapeutic tools to use based on a child’s specific needs. Factors they consider include your child’s age, family environment, personal experiences, diagnoses, developmental level, symptoms, and goals.
When selecting a therapist, ask them to describe their approach to treatment. “Which evidence-based treatments do you use? Describe your experience with children like mine.”
Scientific research supports evidence-based treatments.
There has been a rapid transition to telehealth by mental health professionals since the COVID-19 pandemic (Pierce, Perrin & Tyler, 2021). Telehealth is the remote delivery of health care, usually online using videoconferencing through a smartphone or tablet. It is not unusual to find therapists who offer only telehealth appointments.
In adults, video-conferencing psychotherapy is shown to be effective in reducing symptoms of depression (Berryhill, Culmer et al., 2019) and anxiety (Berryhill, Halli-Tierney et al., 2019), with no statistical differences between in-person and videoconferencing groups.
In children post-COVID, there is evidence that telehealth is feasible and effective for delivering interventions to treat Autism Spectrum Disorder (de Nocker & Toolan, 2023).
There are pros and cons to telehealth. If transportation and childcare make in-person therapy difficult, telehealth can be a lifesaver (Berryhill et al., 2019). However, telehealth may not be possible if access to reliable internet and technology is a barrier for your family (Ramsetty & Adams, 2020).
When selecting a therapist, ask, “Are your appointments and treatment offered in person or through telehealth? How should I prepare for a telehealth appointment? What if we find telehealth is not a good fit for my child?”
Talk therapy is appropriate for adolescents and adults who have the ability to think abstractly. To use language to reason about feelings, complex problems, and motivations in what Piaget would describe as operational thinking (Piaget, 1952).
However, young children do not think in abstract concepts required for talk therapy and do not have the verbal skills to support this type of thinking until age 10 or older (Kool & Lawver, 2010).
Young children think by using symbols beginning around age two. They use mental images, objects, and actions to represent that which is not present or able to be seen (Piaget, 1952). A banana is a phone, a shark is a bad guy, a drawing can represent their family.
Children communicate through their play, and toys are their words (Landreth & Bratton, 1999). Play therapy uses children’s play in a therapeutic context.
During play, children hold the power and control they lack in their day-to-day interactions. This power allows children to work through their fears, beliefs about themselves, anger, and shame without negative consequences that would occur in real life (Kool & Lawver, 2010).
One role of the play therapist is to create a play environment where the child feels safe to play out their big emotions without fear or frustration and with complete acceptance by the therapist (Kool & Lawver, 2010).
Play therapy is an evidence-based treatment widely used with children aged 3–10 years who are experiencing behavioral, emotional, social, or relational issues. Many mental health treatments for children include some form of play therapy (Bratton et al., 2005). It is suitable for children with autism spectrum disorder (Francis et al., 2022) and attention deficit hyperactivity disorder (ADHD) (Abdollahain et al., 2013).
In this video, play therapist Dr. Brenna Hicks explains why child-centered play therapy is so effective for children and how it differs from talk therapy used with adults.
Familiarize yourself with different approaches to Play Therapy: What Is It and How Does It Work?
Interested in using play therapy at home with your child? Visit the Play Therapy Parenting Podcast to scroll through episodes about topics ranging from TikTok to divorce.
Parent–child interaction therapy
Parent–child interaction therapy (PCIT) is an evidence-based treatment to improve disruptive behaviors in children aged 2 to 7 years by improving parent–child interactions (Lieneman et al., 2017).
During a PCIT session, a therapist behind a one-way mirror communicates secretly with the parent through an earpiece while they play with their child. Parents are coached in the moment on how to talk and interact with their child to increase child compliance and positive behaviors and decrease their own frustration (Herschell et al., 2002).
Telehealth-delivered PCIT (iPCIT) uses videoconferencing technology with a mobile device as the therapist coaches parents in real time by video rather than in person. iPCIT is an evidence-based treatment for effectively treating behavioral issues in children with disruptive behavior disorder and developmental delays (Ros-DeMarize et al., 2021, Bagner et al., 2023).
Find a PCIT therapist in your area.
Behavior therapy uses behavior modification to increase the behaviors you want to see in your child and reduce unwanted behaviors. Behavior therapies are used to treat a wide variety of problem behaviors in children and adolescents. Many mental health treatments for children include some form of behavior therapy.
Behavioral parent training (BPT)
BPT programs are designed specifically to teach parents skills to manage their child’s behavior, such as structure, consistent consequences, and to have realistic expectations. BPT programs differ in content depending on the age of the child and their symptom severity.
Applied behavior analysis (ABA)
ABA is individualized therapy to teach communication, social, self-regulatory, and pre-academic skills. When used with younger children, it is called early intensive behavioral intervention. ABA is an evidence-based treatment for autism spectrum disorder.
Cognitive-Behavioral Therapy (CBT)
CBT is a short-term treatment to teach children and adolescents to change unhealthy patterns of thinking. A therapist helps a child identify harmful thought patterns and replace them with thinking that is healthy and adaptive. CBT is effective in treating disruptive behavior disorders, depression, anxiety, and post-traumatic stress disorder (Donnelly & Amaya-Jackson, 2002; McCart & Sheidow, 2016; Oud et al., 2019; Sigurvinsdóttir et al., 2020).
Trauma-focused CBT (TF-CBT) is an evidence-based treatment option for children and adolescents who have experienced trauma (Pollio & Deblinger, 2017). Watch this video describing TF-CBT for children aged 3 to 18.