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4 Points to Consider Before Sending Your Child to Counseling

September 13, 2016

Question:

Gary, I heard another psychologist state that counseling is not beneficial for children under 12 because they see things so literally and are not able to consider the concepts and abstract. Would you agree? ( I think I paraphrased her correctly). I am curious about your thoughts on this subject. Thank you.

Answer:

Like so many other issues in life, the answer is, “It depends.”

Let me unpack that:

  1. Preschool and school-aged children (at least under 12 and easily into adolescence) do not have a developed cognitive capacity for self-reflection or insight. This is not to say that some cannot necessarily figure out what’s bugging them, but not what makes them tick. The child and many adults alike rarely wake up to say, “You know, that experience when younger has impacted me in this way, causing me to see the world such and so and needs changing.” So looking to develop insight the result of counseling in a child is misguided.
  2. Children in distress between separated parents experience a loyalty bind. Children brought to counseling to discuss their distress between separated parents are at risk for one or both parents seeking to coach the child or be interrogated after as to the content of their discussions with the therapist. To add, some separated parents bring their child to counseling hoping to gain new information to support the parental position in a custody/access battle. The child seeing a counselor in these circumstances then escalates the very conflicts to which the child is already exposed to and distressed about.
  3. Children have limited agency with regard to the greater world around them. This means they have limited control in their lives. They do not choose when to go to bed, dinnertime, school, expectations, how their parents get along, etc. Attending counseling to have a child get something off their chest yet offer no change to the conditions that lead to distress can be akin to emotional teasing. While the counseling provides the allusion of doing something for the child, it is a little like arranging the deck chairs on the Titanic. It looks good but doesn’t address the conditions leading to distress. This is often the case of children distressed by parental conflict in intact or separated families.
  4. Whether we like it or not, counseling is still stigmatizing. While people may be appreciative of my services or any other counselor for that matter, few clients ever leave the office to extol the virtue of their service provider to friends or family. Many will do that though about their dentist, doctor, accountant, lawyer, etc. Children are exposed to stigma too. Children will worry about being perceived differently by peers and adults alike. If the child is so young so as not to realize there can be a stigma, the issue can still crop up come adolescence or adult life. The child now an adult may worry about how an early counseling experience may be interpreted by friends or intimate partners.

In view of the above, counseling for children shouldn’t be treated like water and should not be entered into lightly.

Care and forethought must be given to the context in which the child’s issues, emotions or behavior arises. Given that so much of a child’s distress is contextual, rather than seeing the child in counseling, address the context giving rise to the child’s issues.

All this is not to say that counseling or mental health or psychological investigation isn’t at times necessary and helpful.

For instance, some children have learning challenges that are best determined through a psycho-educational assessment. Some children may have developmental, medical or physical issues that too can create challenges that in turn affect performance, behavior and emotions. Hence medical investigations may be helpful and even sight and hearing examinations let alone language processing assessment by a speech-language pathologist.

If counseling is sought for trauma, emotional distress that persists over time, under-developed social skills, adjustment to significant change or loss then I suggest attention be paid to coping skills. Coping skills may be facilitated in various individual therapies and group therapies. There are advantages and disadvantages to both and far too many methods and types of approaches to provide for in this brief blog.

Before a child is signed up for counseling, I suggest that both parents see a counselor or mental health professional first. I recommend that the counselor take a bio-psycho-social perspective to suss out (British slang for investigate) the source of the child’s distress.

A bio-psycho-social assessment requires the assessor to ask a multitude of questions of both parents to review matters from a biological, developmental, psychological (cognitive, emotional, behavioral, educational) and social-familial perspective.

When requiring both parents to attend, depending on the parental circumstances, this requirement can quickly bring parental issues to the fore if one or other is fully unavailable, uncooperative or unsure. There may be issues of parenting or the parental relationship underlying concerns regarding the child. This forms the data as part of the bio-psycho-social assessment.

As demonstrated, there are so many issues that can create concerns over the children. Before the rush to counseling, make sure the child would be going for the right reasons and that the intervention will do more good than harm.

So please do not read this blog as anti-counseling for children. This blog is actually neutral on the matter. Counseling may be appropriate and good and it may be inappropriate and contraindicated. It depends.

The real issue is making sure the child receives the right service for the right issue. Hence start with the parents and obtain a bio-psycho-social assessment.

Lastly and by way of analogy, imagine a child has a pain in their side. Would a surgeon provide an appendectomy on the basis of the parent calling asking for surgery?

Before cutting, at least examine.

I hope this addresses your question.

I am Gary Direnfeld and I am a social worker. Please check out my services and then call me if you need help with child behavior, relationship issues or an upsetting life event. Need Help? Please get help.

If you know someone who may benefit from this information, please share this blog with the links below.

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Gary Direnfeld, MSW, RSW

gary@yoursocialworker.com
http://www.yoursocialworker.com

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Gary Direnfeld is a social worker. Courts in Ontario, Canada, consider him an expert in social work, marital and family therapy, child development, parent-child relations and custody and access matters. Gary is the host of the TV reality show, Newlywed, Nearly Dead, parenting columnist for the Hamilton Spectator and author of Marriage Rescue: Overcoming the ten deadly sins in failing relationships. Gary maintains a private practice in Dundas and Georgina Ontario, providing a range of services for people in distress. He speaks at conferences and workshops throughout North America.

If your relationship is faltering, then set it as your priority.

Read: Marriage Rescue: Overcoming ten deadly sins in failing relationships

4 Comments
  1. Thanks a lot Mr. Grary for writing on this topic. It is really helpful to understand the different dimensions of counseling and How it might impacts children’s life.

  2. Hi Gary, I have some strong disagreements on this one. There is more than one kind of counseling/therapy. Many of the developmental risks and deficits that impact children of high conflict cases are evident early and much more responsive to intervention then. So the suggestion that preschoolers cannot benefit from APPROPRIATE therapeutic intervention seems inconsistent with available research. “Insight” often follows behavior change and there is a solid research base of family systems and behavioral interventions on many of the issues we deal with. I agree with a multi-factor perspective including family systems elements, and I also think it’s critical that a family therapist engage in, and support, the variety of other activities in a child’s life that can support healthy social skills and the abilities that support resilience. Finally, I think the analogy to surgery is misplaced and in some respects a bit inflammatory. There is a risk-benefit analysis to be conducted here, always. Many doctors – most, in fact – attempt low-risk therapies before referring a patient to therapy. The risks of some interventions are much greater than others, and one must also consider the risks of doing nothing. Interventions that may be more effective, less costly, and more integrated with children’s daily lives are much more likely to work when children are younger. I’m not suggesting that all young children should be rushed into therapy, but that a careful risk-benefit analysis should be conducted. A child who is demonstrating developmental regression, particularly in response to parental conflict, is at significant risk, and potentially at greater risk if intervention is delayed. One does not need a “surgical level” diagnosis to assist these kids and, in fact, observing the parents’ and childrens’ response to intervention often aids assessment processes. I agree that all interventions should be carefully planned. We have an article upcoming on this in family court review.

    • Hi Lyn. I am pleased my blog post caught your eye and that you are advancing the discussion. Clearly it struck a nerve.

      Here is where we are on the same page and is at the heart of my blog – when you say, “a careful risk-benefit analysis should be conducted”. In the absence of that risk-benefit analysis, the risks I outline are operant.

      The analogy is not to say we need surgical level diagnosis as you ascribe to me, but that there must be investigation before intervention. My apology to you if that came across otherwise.

      Lastly and I hope this came across reasonably, I am not downplaying the role of therapy or counseling what-so-ever. I am cautioning about treating these intervention like water without forethought that such intervention also carries risk. Going back to a medical analogy, “first do no harm.”

  3. This makes sense. Interview parent (s)
    Discover who they are first. What is the dynamics. The need for therapy could be more about parenting style then the child.
    The need for therapy in skills or treating a physical need is different than assuming there is a psychological need with a child.

    Each case is different especially where trauma has occurred.
    I enjoyed and will contemplate my client relationship more after reading. Thank you.
    Jodyie Lanser, MS
    Mental Health Counselor

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