One of the most common questions we encounter as Child and Adolescent Psychologists is “What can I do if my child doesn’t want to come to counselling?”.
This is very common and the child’s attitude can range from a little bit of trepidation to full blown refusal.
It can be tempting to give in and hope that all the concerns you have about your child’s emotional and mental wellbeing will just blow over and resolve themselves. But, more often than not, the very fact that the child is resistant to counselling is a sign that something is troubling them that they might find uncomfortable to face.
So, what should you do and say to them? And, of equal importance, what should you NOT do or say?
What should I do?
The first step is to find a child psychologist who you think might be suited to your child’s personality and needs. You may need to meet with more than one person in order to find the right fit.
Consider what types of approaches they use, where they are located, how long the sessions are, what the consulting rooms look like and ASK THEM how they approach resistance in their clients.
For example, if your child is sensitive and quiet, you may not want them to see a psychologist who is quite forthright and will challenge them. On the other hand, if your child has a strong personality themselves they might benefit from someone who is direct and won’t beat around the bush.
Find out what the limits to confidentiality are. How much will you know about what happens in counselling? Do you want to know? Ask them for advice about how to get your child to the office in the first place.
What should I say to them?
It’s important to acknowledge the child’s resistance and to try to find out more about their concerns. Have they had a bad experience with counselling in the past? Are they worried about who will find out?
A lot of teenagers report that the main reason they don’t want to go to counselling is because they are worried about confidentiality. Some younger children report that they think they are going to a psychologist because they have done something wrong. And there are those who conjure up images of candles and Freudian-like explorations of their subconscious.
Once you know what their concerns are, you can help to reassure them. But, it is still important to be upfront and honest about why you think counselling is important and what you think they can achieve. If possible, ask your child or teenager to come up with their own goals of what they would like to achieve from counselling. It’s okay if these are different from your goals.
Tell them what to expect in detail. Describe the consulting rooms and what the psychologist is like. You may even want to look up the clinic’s website together. Give them an idea about what to expect in the first counselling session, depending on what the psychologist has discussed with you. The more your child knows about what will happen, the less anxious they will feel.
Sometimes it may be necessary to make a “deal” with your teenager. For example, say “How about you attend for four sessions and, if you don’t like it, we can stop.”
Remember that counselling is most effective when there is a good relationship between your child and the person they are seeing. In fact, it is reported that the effectiveness of therapy is 80% determined by the client-therapist relationship and the trust they establish. Give your child the option to change counsellors if they have not established a good relationship within a few sessions.
What should I NOT say to them?
Okay, it may sound obvious but we really need to avoid making it sound like the child or teenager has a problem (or IS the problem). Saying, “You are going to the psychologist because you are a bad boy.” is unlikely to convince them that this is something they want to do.
Children won’t want to attend counselling if they feel like the psychologist is just a representative for their parents, who is trying to “fix” them. They need to feel like they are working on a problem together, as a team, and that it is something that they want to do.
It is also best to avoid fibbing to your child or being deliberately vague in order to get them to the psychologist. Kids are smart, they will work out the ruse pretty quickly and will become suspicious!
What can I expect from the psychologist?
What the psychologist will do during the session will vary a lot from therapist to therapist so it is a good idea to ASK them, rather than making assumptions. Hopefully, your psychologist will explain the session plan to the child before they begin, so there are no surprises. They may want the parents to attend for some, none or all of the sessions so it is good to find this out before you start as well.
If your child is quite young, the psychologist may use activities such as drawing pictures, telling stories, sand-play with different figurines, reading books together, role-playing and different games that can be aimed at achieving different goals. For example, one of my favourite games to play is “Stop that Angry Thought” or using Angry Bird toys to discuss things that make us mad. Hopefully, the therapist will be guided by what the child is interested in and feels comfortable with.
If you are bringing your teenager to see a counsellor, the focus may be more on discussion and worksheets, but approaches can also vary widely. They can include: solution-focused counselling, coping strategies, cognitive-behavioural approaches, psychodynamic approaches, social skills and problem-solving, relaxation or emotion-centred therapy amongst others.
It may be useful for the counsellor to acknowledge the child’s reluctance at attending. For example, if a child enters the room looking particularly uncomfortable, I might sometimes ask them how much they want to be here on a scale from 0 to 10, where 0 = “this is the worst thing in the world, I can’t believe my parents brought me here!” to 10 = “I’m so excited to be here, this is the best thing ever!”. Making it into a bit of a joke can also help to break the ice.
The most important thing to remember when bringing a child to counselling is that everyone should be on the same page. It’s best to externalise the problem and to approach it as a “team” – the child, the psychologist, the family and sometimes also the school – working together have the best chance of success.