In Therapy, Who Comes First, the Child or the Parent?

There is growing evidence that introducing children and adolescents to therapy can prove beneficial in a host of areas; in fact, recommendations have been made that most, if not all, young people undergo some sort of professional screening for feelings of depression. The effort to help curb unnecessary suffering in youth is undoubtedly important, and mental health professionals from many different fields are keen to lend their knowledge and expertise to the health and well-being of kids. But as for engaging in actual therapy sessions, there is some contention between those who assert that the child is the most apt representative of their person, and those who prefer to glean the most information from the parents.

This issue has recently come up for a professional in Israel, who has discussed the virtues of meeting with parents prior to meeting with the child, and adds that meeting with the child may not be necessary at all. While it is generally accepted that parents who are concerned about their relationships with their children can benefit from meeting with a therapist, the idea that a child who could realize greater well-being from therapy can be treated in a vicarious manner is cause for questioning for some professionals. With that said, experienced marriage and family therapists have known for years about the positive impact made on the lives of children as a result of their parents being in therapy or marriage counseling. And although family therapy has gained in popularity over the past 40 years, treatment absent of the person for whom the treatment is intended is not nearly as accepted by professionals outside the realm of marriage and family therapy.

As therapists, counselors, and other professionals sound off on their perspective over whether the child or the parent (or some combination) is the primary focus of therapy, it is clear that the psychotherapy community is striving to provide better service to its more youthful clients.

© Copyright 2009 by By Noah Rubinstein, LMFT, LMHC, therapist in Olympia, Washington. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Lucy


    July 16th, 2009 at 3:59 PM

    I’m aghast to hear it mentioned that outside the MFT field it’s less accepted that you can treat parents and see an effect on their children.. The fundamental concept underlying this is systems theory. I guess that’s why it’s best to leave treatment of families to MFT’s and VERY important for isolationist child psychotherapists to get some family systems training.

  • Hannah


    July 17th, 2009 at 11:51 AM

    Ha! Treat the child without ever seieng the child? Sorry but that is a joke to me. Sounds like someone not wanting to get down to the nitty gritty of the problem. Should parents be involved? Yes I think that is key. But to ignore the child is irresponsible at best.

  • Francis W.

    Francis W.

    July 18th, 2009 at 11:26 AM

    What’s next, drive-thru psychology? Never meeting the child means you never get to hear their side of the story. Parents, like children, can be convincing liars. To deny the child a voice of their own isn’t fair.

  • Aileen


    July 19th, 2009 at 12:29 PM

    But parents are going to be better able to articulate the problems than a child might be able to do. Does not sound bad to me at all to get the parental point of view. Do not ignore the child outright but I think that the parents can be a valuable resource here.

  • Felixa


    July 20th, 2009 at 1:52 AM

    Wouldnt it be easier to pretend a GIJOE or a BARBIE is the child requiring therapy.

  • Deborah


    July 20th, 2009 at 10:50 AM

    As the parent of a child who has been through therapy for behavioral issues for some time now, I cannot imagine her going through this alone, nor could I imagine my husband and I in therapy alone and resolving the issues without our child as a part of the solution. That does not make good sense to me. We have learned so much with our therapist and the programs our daughter has taken part in, and we are working on these things together as a family, because there are some ways that we had been contributing to the behavior without ever realizing it- how on earth would we have ever been able to reach that conclusion if we had not all been willing to sit down and work on this all together?

  • Lacey


    July 20th, 2009 at 5:15 PM

    All parties deserve the time to talk to the psychologist, either with or without each other present. I feel both parents and children would be more forthcoming knowing the other isn’t listening.

    If a child was to share information the parents didn’t want to or didn’t know about or vice versa, it could change the whole course of the therapy.

  • Phyllis_D


    July 21st, 2009 at 3:08 AM

    What a difficult thing to do. Treat a child, yet the child is not there to get their take on things. How can one evaluate a child, even if parents are in therapy? Sometimes it can be the parents against the child. I really don’t see how this could work without first talking to both sets, parents and then the child.

  • Betsy Davenport, PhD

    Betsy Davenport, PhD

    July 30th, 2009 at 4:06 PM

    When working with parents who have concerns about their child/ren, I do not ask to see the child. If the work is to help the parents develop their parenting relationship, develop their own skills, reaffirm their values and get some help turning the values into actions at home, the child need not come to the office.

    In other words, the child is not the client, the parents are. I think, unless there is trauma to the child or the parents seem over their heads for some reason, that parents are their children’s best “therapist.” They are usually adequate to the task of helping their children develop and – when needed – repair.

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