Psychotherapy with children can sometimes present a few more challenges than working with adults. Very young children may have difficulties expressing what is going on in their lives, while older children or adolescents may be more reluctant to talk about their issues.
Finding alternative ways of working with children can therefore be helpful in the therapeutic setting. Symbolic methods of communication tend to be more effective for understanding what children might otherwise be trying to express through acting out behaviors.
Parents of children who have been referred for therapy are often confused about what type of therapy would work best for their child. The following are different types of techniques that are frequently used when working with children:
- Art therapy: This type of therapy utilizes artwork as a means for children to depict family or social dynamics that are occurring in their lives. They are able to demonstrate in picture form how they see themselves in relationship to family members and/or peers. Drawings can be used to open up discussions about problems that are happening at home or elsewhere that may be upsetting for the child.
- Play therapy: Using play as a means of expression can be helpful, especially for young children, who tend to enact through their play any difficulties they may be dealing with. Therapists who utilize play therapy should be well versed in symbolism and able to engage young children in a discussion related to the themes being acted out.
- Sand tray therapy: In this type of therapy, children or adolescents create a scene with various figures or toys in a box or tray filled with sand. The scene generally depicts what is going on for children symbolically on an inner level. After the scene is set, therapists ask the child to explain what he or she has created, which opens up a dialogue regarding the issues going on in the child’s life. This is frequently a good way to engage kids who might otherwise have difficulties articulating the issues they are struggling with.
- Visualization techniques: When children have experienced traumatic events, having them visualize a safe, inner space that they can access at any time can be helpful in their healing process. Therapists using this technique will ask kids to close their eyes and imagine an inner room or happy place where the child feels safe and at peace. The child can then use this method on his or her own when feeling anxious or upset. Please note that in cases where trauma has occurred, the therapist will also need to first make sure the child is no longer in any danger or being abused in any way.
- Talk therapy: Combining talk therapy with other modalities, such as art therapy or sand tray therapy, can be very effective with teens, especially when they are otherwise reluctant to open up about their problems.
- Family therapy: Including the parents and/or other family members in therapy can be helpful when working with children. Children tend to be very sensitive to others’ emotions and can react to tension between parents or other family members through acting out behaviors. Their actions can sometimes diffuse the tension and divert the focus from the real source of the problem to themselves. Resolving any family difficulties can therefore be critical in making lasting changes within the family system. Even when the problem is not in the home, including family members in the child’s therapy can be extremely beneficial.
Whatever therapeutic modality you choose for your child, make sure you find a therapist who has experience working with children. Some psychotherapists work exclusively with adults. Others work only with adolescents or children above a certain age, so you should ask about the therapist’s expertise in working with children who are your child’s age. The therapist should also have experience with various therapeutic modalities that are effective with children, and understand the developmental stage of your child and the symbolism inherent in his or her play.
Initiating therapy for your child may feel a little scary, but the rewards can be considerable.

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