Psychotherapy with Children & Adolescents

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When parents bring a child to see a psychotherapist, it is usually because the child is affected in such a way that normal growing up (school work, relationship with parents and/or siblings, socialization, etc.) has become compromised.

In working with children, the goal of psychotherapy is two-fold: addressing symptoms and putting the child back on track developmentally. To do so, one needs to understand what is causing the development to derail. The reasons can be multiple and interacting: temperament, environment, genetic loading, etc. Initial identification of key issues is accomplished by an evaluation of the child and meetings with the parents to get a thorough developmental history and a picture of life at home and school.

Once the whole picture is better understood, the psychotherapeutic work can then focus on the child's specific needs. With younger children, this is accomplished via play therapy which is the medium by which children better express their emotional life.

In parallel, working with parents is essential so as to help them continue to be or become the best parents they can be given the child they have and their life circumstances. This includes understanding the child better, having a better match between the parents' expectations and what the child can accomplish, learning how to better set limits, breaking challenges into more manageable units, developing better problem-solving strategies. The goal is to help the relationship between parents and child become one that is loving and gratifying for all.

Working with adolescents involves the same two processes: in addition to addressing specific symptoms, the therapeutic work also focuses on the typical developmental tasks of that age group. Finding one's identity, defining a new relationship with parents and peers, positioning oneself in a trajectory leading to independence and autonomy — all can be overwhelming. Depression, anxiety and other pathologies interfere with developmental tasks that can be fraught with difficulties in and of themselves. Psychotherapy creates a space and a relationship in which to make sense of what is happening, so that thinking can continue to take place despite all the push for action typical at this age.

The involvement of parents in the work with an adolescent depends on the age of the adolescent, the severity of the symptoms, and/or the importance of certain family dynamics as contributors to the overall picture. The younger the adolescent and/or the more severe the symptoms, the more likely the parents will need to be involved. Some older adolescents can use psychotherapy the way an adult does, without needing parental involvement.