Myths, Facts, and What to Expect in Child Therapy

As children grow up, they change rapidly, but we do not just mention how tall they get or how much they grow physically. They also grow up emotionally and socially. Most of these changes are a natural part of development.  But during their development, it is inevitable for children to face stress, loss, trauma, school pressures, family changes, or relational challenges. And depending on their developmental level, these experiences can be “too big” for them and much harder to make sense of compared to how an adult might cope.

One of the most important things children need at this point is for the adults (mostly caregivers) around them to be able to carry them safely. Because children often cannot put into words what they are going through, instead, they show their feelings through their behavior. And eventhough caregivers are the first adults who understand their language, sometimes this can be both exhausting and confusing for caregivers. At times, especially when stress intensifies, caregivers can also feel like “I don’t know what to do”. Because what children go through can affect not only the child but the whole family system. And this effect is often bidirectional. When the child is stressed, the family system is affected; when the family system is under stress, the child also feels it. When tensions, uncertainty, busy schedules, or emotional burdens increase at home, children may show it not in words, but rather in behavior, changes in sleep and appetite, more outbursts of anger, or withdrawal.

In either case, child therapy can become an important area of support when both the child and the family system begin to struggle. Therapy helps the child make sense of their experiences in a developmentally appropriate way, develop emotion regulation and coping skills, and feel more secure. At the same time, for caregivers, it provides a process in which they do not feel alone, gain a clearer road map, and concrete tools to use in supporting their children.

However, even if child therapy becomes an area of support, this process can raise new questions for many caregivers. In particular, the many myths circulating about child therapy, the existence of different approaches and therapy models, and the lack of a clear answer to the question “Which one is right for my child?” can make the process confusing. Moreover, the increasing number of resources available on the internet and social media makes it easier to access information, but this can sometimes add to the confusion. In this therapy sketch, we are aiming to provide a general framework for child therapy, address some of the most common misconceptions, and provide a clearer overview of child therapy.

Questions before start

Before starting child therapy, you might have many questions in mind. Maybe one of the first ones is how do I know whether my child needs therapy. There is no single, definitive answer to this question that applies to everyone. This is because each child’s temperament, developmental level, experiences, and environmental conditions are different. Some children may recover more quickly from a challenging period, while others may experience it more intensely or show it through their behavior (like adults!).

Nevertheless, as a general framework, we can say that if a child’s emotional or behavioral changes have been going on for a long time, are causing the child significant distress, or are beginning to affect home, school, and friendship relationships, child therapy may be an area of support worth considering. In particular, therapy can provide the child with an “additional safe space” if these difficulties persist despite support from caregivers, family, friends, and loved ones. Since the definition might be a bit abstract, let’s give examples for behavioral changes:

• Persistent emotional difficulties: An important sign can be when a child experiences
  • Intense sadness, 
  • Anxiety
  • Fear
  • Restlessness, 
  • Easy anger that persists for weeks or even months.

Some children may express this directly by saying, “I’m sad”, while others may show it in more indirect ways and through behaviors.

• Behaviors that disrupt their daily life: In children, emotional distress is often more visible through behavior because children may not always have the language or words to explain what they are feeling, so their struggles can show up in the way they act
  • Intense outbursts of anger or tantrums
  • Persistent stubbornness
  • Behavior that overly enforces rules or is impulsive
  • Withdrawal
  • Frequent crying
  • Physical complaints such as abdominal pain and headache with unclear causes
• Significant changes in functionality and development: These behavioral changes can be reflected in daily functioning. For example:
  • Not wanting to go to school or avoiding school
  • Significant decline in classes
  • Distancing from friends
  • Giving up activities you used to enjoy

Especially in young children, the following changes may also be noticeable after stress or trauma:

• Sleep problems
• Changes in appetite
• Decline in toilet habits
• Regression in previously acquired skills

When you read these symptoms, you may look at them one by one, as if they were a checklist, to see if you observe them in your child or another child you want to support. But when it comes to children, this approach is not always the most accurate. Because what really matters is more than the appearance of a behavior. It is also important to consider how intense the behavior is, how long it has been going on, and whether it significantly exceeds the expected limits for the child’s age and developmental level.

And for many caregivers, this is where the hardest part begins. The question “What should I do now?” follows after the observation. Once you start noticing these patterns, it’s natural to start looking for answers. Child therapy often comes up in that search, but many caregivers still feel uncertain about what it really means. This is where some common beliefs and myths about child therapy can come into play.  Here are the most common ones.

Child therapy myths

• Going to therapy would mean that something is wrong with my child 
  • Children and adolescents experience mental health challenges just like adults do. This, however, doesn’t mean the child is doing something wrong or that there is something wrong with their character. On the contrary, most of the time, mental health challenges emerge as a combination of genetic, psychological, and social factors and affect individuals in a unique way. Children and adolescents have a right to the treatment and care they need for their mental health struggles, just like they do when they experience a physical illness. And just like a physical illness is not a child’s fault, neither are their mental health struggles.
• Therapy will change my child’s personality
  • Therapy, when delivered adequately, can help your child manage their symptoms, navigate difficult experiences, and overcome challenges. It provides them with the tools they need to cultivate positive experiences in their lives. Although therapy has the power to provide necessary psychological change to support us, such as helping manage anxiety and depression symptoms that often take over our lives, it doesn’t mean that it changes who we essentially are or who we hope to be. On the contrary, often mental health challenges can make it difficult for us to live like who we actually are or who we wish to be, and can limit our expression. Therapy can equip us with the inner and external resources we need to become our authentic selves. Your child can learn healthy ways to express their unique needs, wishes, and preferences through therapy and relate to the world and others in their unique ways.

• Therapy is only for severe mental health problems
  • Children and adolescents, eventhough they experience mental health challenges just like adults can do, their inner and external resources to manage their distress may be limited, as many of them are still developing. Children start developing many of their cognitive, emotional, and social skills as early as 6 months; however, development is an ongoing process, and they may sometimes need additional resources to overcome difficulties that an adult might not need in a similar situation. Children and adolescents do not have to suffer to the point of maxing out their capacity to receive the help they need. If you believe that you and your child can benefit from even a little bit of support, then that’s an enough reason to receive the help you and your child need and rightly deserve.
• The therapist will judge me as a caregiver for my child’s mental health problems
  • Caregivers have immense capacity to affect their children, and unfortunately, abuse and neglect experienced in childhood are some of the significant contributors to mental health struggles, and some people may experience adversity really early in their lives. This, however, doesn’t automatically mean that all caregivers are the sole cause of the children’s mental health struggles. Mental health struggles often emerge as a combination of genetic, psychological, social, and environmental factors, and each individual’s story is unique. Still, when you see your child in distress, this may stir up negative emotions in you, too. You may be experiencing feelings of shame, guilt, and a sense of worry that you are doing something wrong as a caregiver, or that you will be judged for that. If you can relate to these feelings, it may be helpful to note that just as your relationship with your child has the capacity to affect your child negatively, it also offers a great medium through which your child can learn how to regulate themselves, relate to others, understand and express their emotions, and repair when there is a rupture in the relationship. That is, relationships with caregivers are not only a source of distress but also a source of love, compassion, and a healthy, supportive attachment. Therefore, instead of being a space where you will be judged, child therapy, family therapy, or individual therapy for you as a caregiver can all be a space where you and your child are supported in developing both your child’s and your capacity to interact with each other in a supportive and compassionate way.

The Process and Modalities

When you start looking into therapy for children and young people, you may realize there are a variety of options, which can make it confusing and overwhelming to decide which is the “right choice” for your child’s unique needs. 

Research shows that many of the therapeutic modalities available for children and teens, such as Cognitive Behavioral Therapy (CBT), play therapy, and Attachment, Regulation, and Competency Framework (ARC), can be effective for helping them navigate distress, symptoms of anxiety and depression, self-esteem issues, and more (Bailey et al., 2023; Parker et al., 2020; Oud et al., 2019). What matters just as much, if not more, than the specific approach appears to be the therapeutic relationship that is formed with your child and whether therapy is delivered in a way that is developmentally sensitive to children’s and young people’s cognitive, emotional, linguistic, and social needs. Similarly, delivering therapy in a trauma-informed and culturally sensitive way can help your child to experience a trusting connection during therapy and feel safe, understood, and open to growth. Below, we introduce some of the modalities we use at Roamers Therapy so you can become more familiar with how each one can support you and your child.

• Cognitive Behavioral Therapy (CBT): CBT is an evidence-based approach that can help children and young people understand how their thoughts, feelings, and behaviors affect each other. It helps them recognize unhelpful thinking patterns and build coping strategies, so that they feel more empowered in their choices. CBT can be particularly helpful for navigating anxiety, depression, or self-esteem issues. For young people, tools that allow direct reflection, such as journaling and skills training, are also used to support their CBT sessions.
• Play Therapy: Children not only play for fun, but also use play to understand, explore, and communicate their experiences, including their thoughts and feelings. Especially for younger children whose verbal capacities are still developing, play is rich and complex with details that reflect their inner worlds. Play therapy is an evidence-based approach that utilizes this aspect of play to create a safe, effective space for children’s healing and self-expression.
• Attachment, Regulation, and Competency Framework (ARC): Children’s and young people’s capacity to form healthy relationships and manage and express their emotions can be affected by overwhelming or unsafe early experiences, including chronic stress and developmental trauma. ARC is an evidence-based framework with three key elements: building secure and harmonious relationships (Attachment), strengthening a child’s ability to manage and understand their emotions (Regulation), and supporting skill and identity development (Competency). 
• Family Therapy: We understand that we exist in different systems, including our families, and that our problems and challenges are often contextualized within these systems and don’t exist in isolation. Children and young people’s inner worlds are shaped by their families, and, in turn, their family members’ inner worlds are shaped by them, continuously interacting to shift their communication and interaction. Since family dynamics, communication patterns, stressors, and intergenerational and other shared experiences all play significant roles in children’s and young people’s emotional well-being, it is valuable to involve the family in the process of supporting the child.

Takeaways

• Children and young people face stress, loss, trauma, school pressures, family changes, or relational challenges that can lead to mental health struggles, while developmentally not being as equipped as an adult to manage inner worlds and external struggles. 
• Often, your child’s need for additional support and care becomes evident through signs such as persistent emotional difficulties (e.g., intense sadness and fear), behaviors that disrupt your child’s daily life (e.g., intense outbursts or withdrawal from school and activities), or sleep issues.
• Therapy can be a great source for supporting children and young people’s well-being. Yet, myths surrounding seeking help, such as misconceptions that a child’s mental health struggless is their or their parents’ fault, as well as the variety of therapy options, can make it particularly difficult for caregivers to seek and receive the care they need.
• Therapy, including evidence-based approaches such as CBT, play therapy, ARC, and family therapy, especially when delivered in a developmentally sensitive and trauma-informed way, creates a space for your child’s unique needs to be understood and met with care. It can help them express their authenticity, make empowered choices, and thrive in life. Therapy also supports you as a caregiver in improving your relationship with your children and helping them navigate their challenges.

References

• Bailey, B., Tabone, J., Smith, B., Monnin, J., Hixon, B., Williams, K., & Rishel, C. (2023). State of the Evidence of Attachment Regulation and Competency Framework and Adaptions: A Rapid Scoping Review. Journal of Child & Adolescent Trauma, 17(2), 571–583. https://doi.org/10.1007/s40653-023-00575-5
• Nibras, S., Kentor, R., Masood, Y., Price, K., Schneider, N., Tenenbaum, R., & Calarge, C. (2022). Psychological and Psychiatric Comorbidities in Youth with Serious Physical Illness. Children, 9. https://doi.org/10.3390/children9071051.
• Hudson, J., Minihan, S., Chen, W., Carl, T., Fu, M., Tully, L., Kangas, M., Rosewell, L., McDermott, E., Wang, Y., Stubbs, T., & Martiniuk, A. (2023). Interventions for Young Children’s Mental Health: A Review of Reviews. Clinical Child and Family Psychology Review, 26, 593 – 641. https://doi.org/10.1007/s10567-023-00443-6.
• Hudson, J., Minihan, S., Chen, W., Carl, T., Fu, M., Tully, L., Kangas, M., Rosewell, L., McDermott, E., Wang, Y., Stubbs, T., & Martiniuk, A. (2023). Interventions for Young Children’s Mental Health: A Review of Reviews. Clinical Child and Family Psychology Review, 26, 593 – 641. https://doi.org/10.1007/s10567-023-00443-6.
• Hansen, A., Telléus, G., Mohr-Jensen, C., & Lauritsen, M. (2020). Parent-perceived barriers to accessing services for their child’s mental health problems. Child and Adolescent Psychiatry and Mental Health, 15. https://doi.org/10.1186/s13034-021-00357-7.
• Parker, M. M., Hergenrather, K., Smelser, Q., & Kelly, C. T. (2020). Exploring child-centered play therapy and trauma: A systematic review of literature. International Journal of Play Therapy, 30(1), 2–13. https://doi.org/10.1037/pla0000136
• Oud, M., De Winter, L., Vermeulen-Smit, E., Bodden, D., Nauta, M., Stone, L., Van Den Heuvel, M., Taher, R. A., De Graaf, I., Kendall, T., Engels, R., & Stikkelbroek, Y. (2019). Effectiveness of CBT for children and adolescents with depression: A systematic review and meta-regression analysis. European Psychiatry, 57, 33–45. https://doi.org/10.1016/j.eurpsy.2018.12.008
• Reardon, T., Harvey, K., Baranowska, M., O’Brien, D., Smith, L., & Creswell, C. (2017). What do parents perceive are the barriers and facilitators to accessing psychological treatment for mental health problems in children and adolescents? A systematic review of qualitative and quantitative studies. European Child & Adolescent Psychiatry, 26, 623 – 647. https://doi.org/10.1007/s00787-016-0930-6.
• Radez, J., Reardon, T., Creswell, C., Lawrence, P., Evdoka-Burton, G., & Waite, P. (2020). Why do children and adolescents (not) seek and access professional help for their mental health problems? A systematic review of quantitative and qualitative studies. European Child & Adolescent Psychiatry, 30, 183 – 211. https://doi.org/10.1007/s00787-019-01469-4.
• Hardwick, P. (1998). Health Beliefs and Myths in Child and Adolescent Practice. Clinical Child Psychology and Psychiatry, 3, 101 – 87. https://doi.org/10.1177/1359104598031009.

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At Roamers Therapy, our psychotherapists are here to support you through anxiety, depression, trauma and relationship issues, race-ethnicity issues, LGBTQIA+ issues, ADHD, Autism, or any challenges you encounter. Our psychotherapists are trained in Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, Psychodynamic Therapy, Acceptance, and Commitment Therapy, Person-Centered Therapy, and Gottman Therapy. 

Whether you’re seeking guidance on a specific issue or need help navigating difficult emotions, we’re ready to assist you every step of the way.

Contact us today to learn more about our services and schedule a session with our mental health professionals to begin your healing journey. To get started with therapy, visit our booking page.

First, decide if you’ll be paying out-of-pocket or using insurance. If you’re a self-pay client, you can book directly through the “Book Now” page or fill out the “Self-Pay/Out-of-network Inquiry Form.” If you’re using insurance, fill out the “Insurance Verification Form” to receive details about your costs and availability. Please let us know your preferred therapist. If your preferred therapist isn’t available, you can join the waitlist by emailing us. Once your appointment is confirmed, you’ll receive intake documents to complete before your first session.

This page is also part of the Roamers Therapy Glossary; a collection of mental-health related definitions that are written by our therapists.

While our offices are currently located at the South Loop neighborhood of Downtown Chicago and Lakeview on Chicago’s North Side, Illinois, we also welcome and serve clients for online therapy from anywhere in Illinois and Washington, D.C. Clients from the Chicagoland area may choose in-office or online therapy and usually commute from surrounding areas such as River North, West Loop, Gold Coast, Old Town, Lincoln Park, Rogers Park, Logan Square, Pilsen, Bridgeport, Little Village, Bronzeville, South Shore, Hyde Park, Back of the Yards, Wicker Park, Bucktown and many more. You can visit our contact page to access detailed information on our office location.