Kids and Therapy: Which Type Is Right for Your Child?
Many children do not naturally have the skills to cope with stress, anxiety and frustration. If you notice your child struggling, be proactive and use therapy to give them the right tools. “The great thing is that there is really no stigma for therapy,” says Dr. Jeff Ashby, director of the Play Therapy Training Institute at Georgia State University. “Parents have to realize that a child needing therapy is not a reflection of their parenting and, in fact, seeking therapy is a sign of good parenting if a child starts to feel anxiety or depression.”
But what type of therapy is right for your child? It can be hard to navigate finding the best fit since there are so many types of therapy available.
Here’s a breakdown of the most effective therapeutic approaches for kids experiencing mental health concerns. Keep in mind the appropriate choice often depends on the child’s age, the specific concern and the child’s individual needs.
Cognitive Behavioral Therapy (CBT)
How it works: CBT helps kids identify and change negative thinking patterns and behaviors. It’s particularly useful for children struggling with anxiety, depression or PTSD. “CBT focuses on identifying symptoms, managing these symptoms, and coping in a very specific, organized and structured format,” says Ashley S. Lingerfelt, founder and clinical director of Playtime Therapy of Georgia.
Why it works: By learning how to recognize and alter unhelpful thoughts, children can reduce emotional distress by using coping strategies learned in therapy. With children, CBT is often paired with another type of therapy, such as play, music or art to be more developmentally appropriate.
Play Therapy
How it works: Play therapy uses toys, games and other playful activities to help children express their emotions and work through psychological issues. “Play therapy works well for kids because it reaches them at their appropriate developmental level,” says Ashby.
It’s especially effective for younger children who may not have the vocabulary to express their feelings. “Even if a child has a large vocabulary, they may not have the words to describe what they are dealing with internally,” says Ashby. “Children also lack abstract reasoning, and a therapist can help them make connections.”
Certain events such as separation, divorce or traumatic events may be a reason to consider play therapy. The goal being to help a child process things in their own time and way. “Play therapy helps to ensure short-term stress, resilience and recovery in that order,” says Ashby. “This is the most common response to all trauma, and therapy acts as a kind of remediation and helps prevent future issues.”
Why it works: Children naturally communicate through play, so it gives them a safe space to explore feelings, develop problem-solving skills, and work through trauma. Play therapy also helps kids learn to regulate their emotions and improve social skills.
Parent-Child Interaction and Family Therapy
How it works: Since mental health issues affect the whole family, therapies that focus on relationships and involve more than just the child work well. Parents are trained to use positive reinforcement and consistent discipline strategies to improve behavior and reduce conflicts. The whole family works on open and clear communication to support one another. “Therapy options with a parental component are ideal, as they provide parents with skills to support their child at home,” says Lingerfelt.
Why it works: The parent-child relationship plays a critical role in a child’s emotional development. “Involving the parents also helps them feel supported,” says Ashby. “Parents don’t want to see their child in distress and want to be able to fix things as soon as possible, so giving them tools to use at home as well as listening to what the parents need helps the whole family.”
Dialectical Behavior Therapy (DBT)
How it works: This form of therapy helps children and adolescents with emotional regulation, particularly those with intense emotions or behavioral issues. “Sudden changes in behavior — outbursts, social problems that are new, withdrawing — can be obvious signs of mental health concerns,” says Ashby. “Even teens who have the vocabulary to say something is wrong may not want to share those feelings with a parent or other adult.” It combines cognitive-behavioral strategies with mindfulness techniques.
Why it works: DBT is particularly useful for kids struggling with self-harm, suicidal ideation or chronic emotional instability. The skills learned in DBT help children manage overwhelming emotions and build healthier coping mechanisms. “Therapy, regardless of type, is not necessarily a short-term intervention,” says Ashby. “Just like therapy with adults.” The DBT strategies learned at a younger age carry kids into adulthood with a better chance of strong mental health.
Creative Therapies: Art & Music
How it works: Art therapy allows children to express their emotions through creative outlets like drawing, painting or sculpting. Music therapy involves making or listening to music. “First and foremost, making art is fun,” says Teresa Woodruff, founder and owner of Art It Out Therapy Center. “Many children feel more comfortable making art in therapy sessions, as opposed to merely talking. Art provides an opportunity for the child to connect with the therapist and share their inner thoughts and feelings in a less-threatening way.”
Why it works: Creative therapies are especially helpful for children who find it difficult to express themselves with words. The creative process helps children process complex feelings and gain insights into their inner worlds in a non-threatening way. Music, in particular, can be soothing and offers children in emotional distress comfort and time to process their feelings.
“Art therapy is helpful in treating anxiety, depression, social or emotional struggles, grief or loss, and adjustment struggles,” says Woodruff. “Art therapy is helpful for all ages, specifically children ages 4 and older. Younger children may use art activities to explore and express their feelings while older children may use it to process difficult friendships or gain coping skills.”
Signs It’s Time for Therapy
Understanding what to look for may help parents intervene when needed. “The very best thing is early intervention,” says Ashby. “Once children can identify and regulate their emotions, they will be in better shape for each new developmental stage and knowing how to deal with these pieces.”
Behaviors that signal your child might need therapy can manifest in a variety of ways. “Some behaviors may indicate a child is struggling internally,” says Woodruff. “Externalizing behaviors, such as being irritable or defiant, are often easier to spot; however, the internalizing behaviors are just as important to pay attention to.”
Some common behaviors to be aware of:
- Withdrawal or isolation from family or peers
- Avoiding after school activities or refusing to go to school
- Sudden changes in mood
- Sudden changes in appetite
- Changes in sleeping patterns, i.e. sleeping more or less than typical for the child
- Irritability or frequent outbursts
Considerations for Choosing Therapy
Age and Developmental Stage: Younger children may benefit more from play or creative therapy, while older children and teenagers may respond better to CBT or DBT.
Type of Mental Health Concern: The spectrum of mental health challenges includes anxiety, depression, trauma, behavioral issues, family dynamics, social issues and more. They all require different therapeutic approaches and coping skills, and therapy should be tailored to address a specific child’s needs.
Comfort and Rapport: A strong relationship between the child and therapist is crucial. Children need to feel comfortable with their therapist to open up, so finding the right fit is key. It’s also important the parents and therapist partner so the child is supported at home as well.
Regardless of the type of therapy you choose, your child will benefit. “Children who receive therapy are usually more resilient, know how to handle difficult situations when they arise, and feel socially confident,” says Woodruff.
Often, a combination of therapy types works best for children. “Typically, anxiety is treated with a combination of cognitive behavioral therapy (CBT) and a relational-based therapy, such as play therapy or a type of parent-child based therapy,” says Lingerfelt. “I personally use a mixture of CBT and play-based therapy to support the children I work with, along with a parental component in all of my work, as this best meets the developmental needs of the children I typically treat.”
-Tali Benjamin
