Oftentimes, young children (under age 8 or 9) who seem to need therapy, are more efficiently and meaningfully helped by working with the parents to help them become more effective and, in fact, more therapeutic with their own children.
Most trained child/family psychotherapists are very familiar with a scenario that goes something like this: One or both parents show up for an initial appointment with their young child about whom they have concerns. The expectation, sometimes overtly spoken and sometimes not, is that the therapist will spend some regular time with the child and make them OK.
As ridiculous as the following simile sounds, this expectation is like dropping a dented and dirty car off at the body shop with instructions to detail it and take the dings out. Repaint and tune it up if it is necessary. That is not how therapy for anyone works and especially when dealing with young children, that type of expectation is neither healthful, helpful nor achievable.
That being said, there are two basic roads that can be followed by a therapist trying to assist the child with their adjustment or mood. One would be to engage the entire family in treatment. The rationale is clear. Following a concept we call ‘homeostasis,’ it is difficult (if not impossible) for any one member of a family system to change if everything and everyone else remains unchanged.
So, the treatment intervention, if it is to stand a reasonable chance of bringing about the desired change in the child, must involve the parents as well.
The second fundamental option and the one I personally prefer – especially if the child is under 8/9 years old, is to avoid making a patient out of the child at all! This may sound odd to some, but the motive is to spend the available time, instead of working directly with the child once every week or two for 50 minutes (max) at a time, to work directly with the parents to help them develop new methods of dealing with the child that will help them become more effective as parents.
After all, these are the people who live with the child every day. They are usually the real experts about the child and the most important people in the child’s life. If they can learn to do some things differently, that is much more apt to produce a favorable outcome with the kid than an hour every week or two with the world’s most brilliant child therapist.
It is not uncommon to encounter therapists who disagree. Some people like seeing young children in their practice – Heck, I like spending time with young children, too! But the goal is not my enjoyment, but some improvement in the overall (or specific) functioning of the child. I do not see the role of the therapist as being that of becoming a ‘better’ parent to a child who is having some problems. Rather, I see the therapist as a professionally trained adult who can work to help the really important adults achieve a more satisfying relationship with their own child.
None of this precludes the possibility that individual treatment may be, in specific situations, indicated or that a referral for evaluation for medication may sometimes be in order as a part of the overall treatment plan. As a matter of preference born of nearly 40 years of practice experience – all else given as equal- I find the best ‘bang for the buck’ is to spend the time with the parents.
The desirable outcome is generally not to have the child do well in a therapy session (many do but it does not generalize readily to other situations – home or school.) Rather, a good outcome is a happier, more successful family life for child(ren) and parents alike.