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Grade-Schoolers Their Lives Expand : Distressing Times Coping with death and depression (part 2) - Therapies for children The various options

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Therapies for children The various options

There is a wide range of therapies available, and it can be difficult to judge which one will be best suited to your child and her difficulty. When you’re looking at types of therapy, do check that there is clear evidence, preferably from academic research as well as case studies, that each is effective. Take note of whether the particular approach is recommended for your child’s difficulty. Some, for example, family therapy, are helpful for eating disorders, whereas cognitive behavioral therapy is suggested for depression. There are guidelines available to assist you in selecting an approach. Whichever therapy you choose, the trusting relationship between your child and her therapist will play a central role in the healing process.

Parenting programs

Also known as parent training, these are attended by parents, caregivers, and sometimes grandparents, and are recommended if your child has difficulties with behavior and hyperactivity. They are based on the idea that you are in the best position to help your child by guiding and encouraging positive behavior. Parenting programs are often offered in groups, usually over eight to 12 weeks, during which you will be taught a range of strategies to build up your relationship with your child and manage misbehavior. Parenting programs are based on social learning theory, have been well researched, and are most effective when all sessions are attended and you complete homework tasks. If your child has serious difficulties with attention, then medication may also be used as part of a treatment plan.

Cognitive behavioral therapy (CBT)

This is a widely used approach for difficulties including repetitive habits, depression, and anxiety. CBT helps your child understand how her thoughts affect her feelings and behavior. She will be guided to challenge and replace negative or unhelpful patterns of thought. CBT is usually brief, around six sessions of an hour each, and can be individual or group. Common topics for group CBT would be coping with anger and improving social skills. CBT is well researched and does reduce the duration of your child’s difficulty. It is often offered as the first line of treatment.

Non-directive supportive therapy

Also known as client-centered therapy or counseling, this is commonly used with children who have mild difficulties. It involves the therapist providing an opportunity for your child to express and explore thoughts and feelings with a warm, empathic, and non-judgmental listener. The aim is to enable your child to become self-aware. The number of meetings varies considerably and is negotiated between therapist, child, and parent.

Interpersonal psychotherapy (IPT)

IPT focuses on your child’s relationships, aiming to improve her ability to manage disagreements, loss, and change. Your child will meet individually with a therapist for sessions, usually of an hour’s duration. IPT is time-limited, lasting for 16 to 20 sessions, and is helpful with a range of difficulties such as eating disorders and depression.

Psychodynamic therapies

This form of psychotherapy includes a wide variety of approaches based on the premise that your child will benefit by gaining an understanding of both her conscious and unconscious experience. The psychodynamic therapist will listen to your child’s thoughts, and may comment on or interpret their meaning. The evidence for the effectiveness of psychodynamic approaches with children is limited, although some studies have found it to be beneficial. Psychodynamic therapy is usually of long duration: 30 or more sessions may be needed, depending on progress and the type of therapy used.

Common psychodynamic therapies with children
Play therapy

This allows your child to act out and resolve issues and emotions through play. It is usually offered to children between three and 11 years old and involves sessions once a week with a therapist in a well-equipped playroom. Your child will be invited to play with anything in the room. The therapist will not lead or suggest but may comment on the play. Play therapy may be as short as 12 weeks or take more than a year.

Psychodrama and drama therapy

Both of these approaches use performance arts such as role play, storytelling, and games to enable your child to express and understand her feelings. Sessions are usually in groups, and each may last for an hour or more. In psychodrama your child will often take the part of herself during the exercises, whereas in drama therapy she will act a role, perhaps playing someone with difficulties similar to hers.

Art therapy

Art therapy involves the expression of thoughts, feelings, and events through visual arts, such as painting, drawing, and sculpting. Art is used as an alternative to verbal communication for children unable to express their experience in words, or who do not have the developmental ability to do so clearly. One aim of this therapy is to raise your child’s suppressed emotions.

Family therapy

Your child’s difficulties will be seen in the context of family issues and relationships rather than as her problem alone. This usually involves family members meeting in a group with the therapist although, occasionally, therapy is with each person individually. You will be guided to explore tensions or clashes, your role and your child’s role in the family. Alternative ways of relating to and supporting each other will be considered. Family therapy can be effective in 14–15 sessions, but may take longer, depending on progress. It is often offered as a treatment for eating disorders.

Psychodynamic

Play and drama therapy are common psychodynamic approaches for children. They allow your child to act out her emotions, as she may find it hard to express feelings in words.

Fighting

Very rough and consistently aggressive behavior should be addressed (bottom left). Therapy is an excellent method of helping your child learn to express himself calmly.

Potential signs

If your child seems extremely sad and withdrawn all the time, you may want to consider therapy.

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