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Key points
- The patient-confidentiality cloak can make assessing your child's therapist tricky.
- A good child therapist is a frequent and open communicator with the parent without crossing the line of trust with the patient.
- Small shifts in your child’s behavior and confidence at home and school can signal that therapy benefits them.
So you’ve done the work–identified that your child could benefit from therapy, found a therapist, collaborated with your child to get them interested in going, and now your job is done–right?
Except, it’s normal to start wondering, “Is therapy working for my child, and how will I even know?” Once your kids step behind the patient-mental health professional confidentiality cloak, it can seem like a mystery whether your child’s therapist is helping and whether they are the right therapist for them.
It doesn’t have to be a secret, and there are concrete signs, both from the therapist and your child, that can help you answer that question. Here’s how:
Your child talks about their therapist.
In the same way, your child might mention something a friend or teacher said in passing, demonstrating that they feel comfortable enough to share something their therapist did or said is a great sign that things are going well. Referencing their therapist while outside of sessions means that they are continuing to internalize and consider the discussions they had with their therapist in their daily life.
However, it’s also okay for your child not to want to talk in detail about what’s happening in therapy, as it can be difficult to reopen a discussion they’ve already dealt with during therapy. If your child isn’t chatting with you about therapy or after therapy, that’s okay. Just consider other routes for checking in, such as talking to the therapist directly.
The therapist is an excellent communicator and provides updates.
With kids, patient-caregiver confidentiality is essential. Kids have to trust they can talk openly with their therapists without a parent knowing every detail, aside from emergency threats or situations. But that doesn’t mean the therapist should never include you in the process.
A top-notch therapist will initiate check-ins and meetings with you, especially if you have young children, to gather more information about what’s been going on in your child’s life outside of therapy, the progress they seem to be making, and whether the process is working well for everyone involved. If they aren’t, you can ask for and reasonably expect this from your child’s therapist.
In addition, the therapist should be accessible by phone and/or email to provide updates that might relate to your child’s sessions, with a clear process for mental health emergencies. Even a voicemail or email line where you can leave the information you want your child’s therapist to be aware of can be helpful.
The relationship between child and therapist should remain protected, but as a parent, it’s important to talk to both parties about how much involvement you should have. If appropriate, ask your child and therapist to include you for a few minutes at the occasional session for family-oriented discussions or to help support your child’s mental health journey.
As a psychiatrist and parent, I understand that both roles play a distinct part in supporting a child’s mental and emotional well-being.
You are confident your therapist knows your child.
The ideal therapist really “gets” your child, including their personality, needs, and struggles. Parents want to rest assured that their child is working with someone who has taken the time and made an effort to get to know them deeply in order to help them as completely as possible. If you are conversing with your child’s therapist and feel you are talking about two different people, that is a red flag that they might be taking too generic of an approach or aren’t truly invested in your child’s needs. You can gather such information through virtual or in-person meetings with them, and it’s imperative to trust your gut instincts on this one.
Your child is excited to go–or refuses to go.
Just like you knew when it was time to quit t-ball or piano, your child will let you know whether they enjoy or benefit from therapy in many situations. Pay attention to their attitude and demeanor on the days they are supposed to go to therapy. Kids who are avoiding it, or older children who are skipping sessions, are telling you something, and it’s possible it’s not a match.
However, don’t make such an assumption too soon, as the first month or so of sessions can actually lead to some increased anxiety as they get used to the therapy process. After that acclimation process, most kids who like their therapist and feel understood will either be excited about going or at least won’t protest about it and will go willingly.
Your child’s mental health symptoms are improving.
If your previously anxious child is singing in the morning, you might have their therapist to thank. Observing small, positive changes in your child can give you signs that therapy is benefiting your child and that their therapist is helping.
Watch for your kid attempting things that would have previously been out of their comfort zone, like initiating a playdate with friends or trying out a new activity they previously weren’t sure about. They might feel a bit more at ease going to school, or you might notice them gaining more confidence in expressing emotions than before. Older children might be able to express whether they think therapy is helping if you simply ask them about it, while you might need to watch for signs of mood changes or improvements with more reserved or younger children.
If your child has been in therapy for an extended period and you’ve monitored behaviors and still haven’t seen progress, it could be time to bring up the lack of progress with the therapist and pediatrician. They might be able to advise you whether additional interventions are necessary or whether it’s time to pursue a different type of therapy—or a different therapist. Therapy is solely to help your child, and you address their specific health concerns, so you don’t need to feel awkward or guilty about talking to the therapist about wanting to make a change if you or your child feel like you want to seek other options for care.
Each indicator can give clues to whether you have a helpful therapist for your child, but you also might have to simply ask the therapist and your kid how things are going directly, when appropriate. Combined with a strong awareness of your intuition about the needs of your child, who you know the best, these steps can ensure a strong long-term relationship and fit with the best therapist for them.
To find a therapist near you, visit the Psychology Today Therapy Directory.
