Navigating Therapy: Finding the Right Fit for Your Child

Article for Supporting A Child

Navigating Therapy: Finding the Right Fit for Your Child

Author: Linda Armstrong

Co-Author: Jesse Hanson, Ph.D.

Editor: Carrie Steckl, Ph.D.

The Decision That’s Been Haunting You

You’ve been thinking about it for months. Maybe years. “Does my child need therapy?” Every time they have a meltdown, you wonder. Every time they come home from school in tears, you wonder. Every time they say they hate themselves or they wish they weren’t here, you know the answer. But actually taking the step—actually finding a therapist, making the call, bringing your child to a stranger’s office and saying “Please fix what I couldn’t fix”—that feels overwhelming. You’re worried about:

Stigma (what will people think?)
Cost (can we afford this?)
Your child’s reaction (will they refuse to go?)
Whether it will even work (what if we try and nothing changes?)
Choosing the wrong therapist (what if we waste months with someone who doesn’t help?)

So you wait. You tell yourself maybe it’ll get better. Maybe they’ll grow out of it. Maybe you can handle this yourself. But deep down, you know: If your child had diabetes, you wouldn’t hesitate to get them treatment. Mental health is no different. This article will walk you through everything you need to know about getting your child into therapy—how to find the right therapist, what to expect, how to make it work, and what to do when it’s not working.

When Does Your Child Need Therapy?

Not every childhood struggle requires therapy. But here are the signs it’s time:

Seek therapy if:

✓ Symptoms persist for more than 2-4 weeks without improvement ✓ Functioning is impaired (can’t go to school, has no friends, can’t complete daily tasks) ✓ They’re expressing thoughts of self-harm or suicide ✓ Behavioral problems are escalating (aggression, defiance, running away) ✓ Anxiety or depression is interfering with daily life ✓ They’ve experienced trauma (abuse, neglect, witnessing violence, loss) ✓ Family can’t manage the situation alone (you’re overwhelmed, nothing you try is working) ✓ School is recommending it ✓ Your gut tells you something is wrong

You don’t need to wait for a crisis.

Early intervention is more effective than waiting until things are severe. Think of it like physical health: You don’t wait until someone has a heart attack to address high blood pressure. Therapy can be preventive, not just reactive.

Types of Therapy: What Works for Kids

Not all therapy is created equal. Different approaches work for different issues and different ages.

1. Play Therapy

Best for: Ages 3-10 (sometimes older) What it is: Children process emotions and experiences through play instead of talking. The therapist uses toys, art, sand trays, puppets, etc., to help the child express and work through issues. Why it works for kids: Young children don’t have the language or cognitive capacity to do traditional talk therapy. Play is their language. Good for:

Trauma
Anxiety
Behavioral issues
Divorce or family changes
Grief and loss

What it looks like: Your child plays in a therapy room with various toys. The therapist observes, reflects, and gently guides the play to help the child process emotions.

2. Cognitive Behavioral Therapy (CBT)

Best for: Ages 7+ (though CBT can be adapted for younger kids) What it is: A structured, goal-oriented therapy that focuses on identifying and changing negative thought patterns and behaviors. Core concept: Thoughts → Feelings → Behaviors. By changing thoughts, you change feelings and behaviors. Good for:

Anxiety disorders
Depression
OCD
Phobias
Social anxiety

What it looks like: Therapist teaches your child to identify negative thoughts (“I’m going to fail”), challenge them (“Is that true? What’s the evidence?”), and replace them with more realistic thoughts (“I’ve studied hard. I’ll probably do okay”). Includes homework assignments, worksheets, and skill practice. Evidence: One of the most researched and effective therapies for childhood anxiety and depression.

3. Dialectical Behavior Therapy (DBT)

Best for: Teens (ages 13+), though can be adapted for younger kids What it is: A type of CBT that focuses on teaching skills in four areas:

Mindfulness (being present)
Distress tolerance (handling crisis without making it worse)
Emotion regulation (managing intense emotions)
Interpersonal effectiveness (healthy relationships and communication)

Good for:

Self-harm
Suicidal behavior
Borderline Personality Disorder (in teens)
Emotional dysregulation
Impulsive behavior

What it looks like: Individual therapy + skills group. Focus is on building specific, practical skills. Evidence: Highly effective for teens who self-harm or have suicidal behavior.

4. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

Best for: Ages 3-18 who have experienced trauma What it is: A specialized type of CBT designed to help children process traumatic experiences. Components:

Psychoeducation (understanding trauma)
Relaxation and coping skills
Emotional regulation
Cognitive processing (changing unhelpful thoughts about the trauma)
Trauma narrative (gradually telling the story of what happened)
Parent involvement

Good for:

Physical, sexual, or emotional abuse
Witnessing violence
Loss of a loved one
Natural disasters
Serious accidents

What it looks like: Child works with therapist to gradually process the traumatic event at their own pace. Often includes play or art for younger children. Evidence: Gold standard for childhood trauma treatment.

5. EMDR (Eye Movement Desensitization and Reprocessing)

Best for: Ages 6+ (can be adapted for younger children) What it is: A therapy that uses bilateral stimulation (eye movements, tapping, sounds) to help the brain reprocess traumatic memories. Good for:

PTSD
Trauma
Phobias
Disturbing memories

What it looks like: Child thinks about the traumatic memory while following the therapist’s hand movements with their eyes (or using tappers or sounds). This helps the brain reprocess the memory so it’s less disturbing. Sounds weird, but it works. Research shows it’s highly effective for trauma.

6. Family Therapy

Best for: All ages when family dynamics are part of the issue What it is: Therapy that involves the whole family (or relevant family members) working together. Good for:

Family conflict
Communication problems
When one child’s mental health is impacting the whole family
Divorce or blended family issues
Behavioral problems

What it looks like: Everyone attends sessions together. Focus is on improving communication, understanding each other, and changing family patterns.

7. Parent-Child Interaction Therapy (PCIT)

Best for: Ages 2-7 with behavioral problems What it is: Parent training therapy where parents learn specific techniques to improve the parent-child relationship and manage behavior. Good for:

Defiance
Tantrums
Aggression
Attachment issues

What it looks like: Parent and child play together while therapist coaches the parent (often through an earpiece) on specific techniques. Evidence: Very effective for young children with behavioral issues.

How to Find a Therapist

This is often the hardest part. Here’s a step-by-step process:

Step 1: Determine what your child needs

Ask yourself:

What’s the primary issue? (Anxiety, trauma, behavioral problems, depression, etc.)
What age is my child? (Determines whether they need play therapy, talk therapy, etc.)
What type of therapy might help? (Based on the above)

Step 2: Check insurance

Call your insurance company: Ask:

“What mental health providers are in-network for children?”
“Do I need a referral from my pediatrician?”
“What’s my copay?”
“How many sessions are covered per year?”

Get a list of in-network providers.

Step 3: Search for therapists

Resources: Psychology Today Therapist Directory: psychologytoday.com/us/therapists Filters:

Age (child/teen)
Issue (anxiety, trauma, ADHD, etc.)
Therapy type (CBT, play therapy, EMDR)
Insurance
Location/telehealth

Other directories:

TherapyDen.com
GoodTherapy.org
NAMI Provider Database
Your pediatrician (ask for referrals)

Ask for referrals:

School counselor
Friends who have kids in therapy
Your own therapist (if you have one)

Step 4: Create a shortlist

Look for: ✓ Licensed (LCSW, LMFT, LPC, or psychologist) ✓ Specializes in children/teens ✓ Has experience with your child’s specific issue ✓ Takes your insurance or offers sliding scale ✓ Good availability Make a list of 5-7 therapists to contact.

Step 5: Make initial contact

Call or email: “Hi, I’m looking for a therapist for my [age]-year-old who is struggling with [anxiety/trauma/behavioral issues]. Do you have availability? Can I schedule a brief consultation call to see if you’d be a good fit?” Many therapists offer a free 15-minute phone consultation.

Step 6: Ask the right questions

During the consultation, ask:

“What’s your experience working with [specific issue]?” You want someone who specializes, not someone who “sees everyone.”
“What type of therapy do you use?” Make sure it’s evidence-based for your child’s issue.
“How do you involve parents?” Some therapists include parents in every session. Others rarely do. Find out what works for you.
“What does a typical session look like?” Especially for younger kids—will it be play-based? Talk-based?
“How long does treatment typically take?” No one can give an exact timeline, but they should be able to give a general idea.
“How do you measure progress?” Good therapists track progress, not just “see how it goes.”
“What’s your cancellation policy?” Important to know.
“How do you handle crises between sessions?” Do they have on-call support? Do you call 911? Know the plan.

Step 7: Schedule an intake session

The first session is an assessment:

Therapist meets your child
Gathers history
Assesses symptoms
Discusses treatment plan

Often parents are included for at least part of this session.

How to Prepare Your Child for Therapy

How you introduce therapy matters.

Ages 3-6:

What to say: “We’re going to meet someone called [therapist’s name]. They’re a helper who talks and plays with kids about their feelings. They have lots of fun toys. You can play and they’ll help you feel better about [big feelings/scary dreams/being sad].” Keep it simple and positive.

Ages 7-12:

What to say: “I’ve noticed you’ve been feeling [anxious/sad/angry] a lot lately. I want to make sure you have someone to talk to about that. We’re going to see a therapist—they’re like a feelings doctor. They help kids learn ways to handle big feelings. Lots of kids see therapists. It doesn’t mean anything is wrong with you. It just means we want to help you feel better.” Normalize it.

Ages 13-18:

What to say: “I’ve been worried about you. I think it would help to talk to someone—not me, but someone who’s trained in helping teens with [anxiety/depression/stress]. I found a therapist and I’d like you to try it. You don’t have to tell me everything you talk about. It’s your space. But I think it could really help.” Give them some autonomy and privacy.

What if they refuse?

Try:

“Let’s just try one session. If you hate it, we can find someone else.”
“I know it feels weird, but I really think it could help.”
“You don’t have to talk about anything you don’t want to.”

If they still refuse:

For younger kids: You make the decision. They’ll likely warm up once they meet the therapist.
For older kids/teens: Harder to force. Consider family therapy first, or let them choose the therapist.

What to Expect in Therapy

First few sessions:

Building rapport (getting to know each other)
Assessment
Goal-setting
Beginning treatment

Don’t expect immediate results. It takes time to build trust.

Ongoing sessions:

For younger kids:

Mostly play-based
You might not see what happens (therapist will update you)

For older kids/teens:

Talk therapy, worksheets, skill-building
More privacy (they may not tell you everything, and that’s okay)

Parent involvement:

Varies by therapist and child’s age. Younger kids: Parents often involved regularly Teens: Less parent involvement (to respect their privacy) Good therapists will:

Update you on progress (without violating confidentiality)
Teach you strategies to support your child at home
Include you in sessions periodically

How to Support Your Child in Therapy

Do:

✓ Get them there consistently: Weekly is typical. Don’t skip sessions unless absolutely necessary. ✓ Ask general questions: “How was therapy?” but don’t interrogate. ✓ Support homework: If the therapist assigns practices or worksheets, help your child complete them. ✓ Communicate with the therapist: Share relevant updates (school issues, family changes, medication changes). ✓ Be patient: Therapy takes time. ✓ Model healthy behavior: If you go to therapy, tell them. Normalize it.

Don’t:

❌ Interrogate them after sessions: “What did you talk about? What did you say about me?” ❌ Punish them for what they share in therapy: They need to feel safe being honest. ❌ Expect instant results: Progress is slow and non-linear. ❌ Talk negatively about therapy: “I can’t believe we have to do this,” “This is so expensive.” ❌ Pull them out after two sessions: Give it at least 6-8 sessions before evaluating fit.

How to Know If It’s Working

Signs therapy is helping: ✓ Your child is engaged (talks about their therapist, doesn’t resist going) ✓ You see gradual improvement in symptoms ✓ They’re learning and using coping skills ✓ Functioning is improving (school, friendships, home life) ✓ They seem more self-aware Timeframe: Most kids show some improvement within 6-12 weeks. Full treatment might take 6-12 months (or longer for trauma).

When Therapy Isn’t Working

Sometimes it doesn’t work. Here’s what to do:

Problem 1: No progress after 2-3 months

What to do:

Talk to the therapist: “I’m not seeing progress. What’s your assessment? Should we adjust the approach?”
Consider whether they’re the right fit: Not every therapist is right for every child.
Consider whether the diagnosis is accurate: Maybe it’s not anxiety—maybe it’s ADHD or trauma.
Consider whether therapy alone is enough: Maybe medication is needed.

Problem 2: Your child hates their therapist

What to do:

Give it a few sessions: Kids often resist initially.
If they still hate them after 4-6 sessions: Trust your child. Fit matters. Find someone else.

How to tell the difference between:

Normal resistance (“I don’t want to go” but they’re fine once there)
Bad fit (“I hate them, they don’t understand me, I don’t trust them”)

Problem 3: Therapist isn’t a good fit

Red flags:

Therapist seems disengaged or distracted
Therapist doesn’t specialize in your child’s issue
No clear treatment plan or goals
Therapist is judgmental toward you or your child
No progress and no explanation why

What to do:

Trust your gut. If something feels off, it probably is.
Find a new therapist. You can say: “This doesn’t feel like the right fit. We’re going to try someone else.”

Don’t feel guilty about switching therapists. Fit is everything.

Common Challenges and How to Handle Them

Challenge 1: Cost

Therapy is expensive (

100 -

300/session without insurance). Solutions:

Use insurance: $0 -$ 50 copay
Sliding scale therapists: Many offer reduced rates based on income
Community mental health centers: Low-cost or free
University training clinics: Supervised students, very low cost ( $10 -$ 30)
Online therapy: Often cheaper (BetterHelp Teen, Talkspace)
School-based counseling: Free (though not comprehensive)

Challenge 2: Long waitlists

Many therapists have 2-3 month waitlists. Solutions:

Call multiple therapists at once
Ask to be on cancellation lists
Look for telehealth therapists (larger pool)
Consider out-of-network therapists (if affordable)
Start with your pediatrician (can prescribe meds while you wait for therapy)

Challenge 3: Your child won’t go

For younger kids: You decide. They’ll adjust. For teens: Harder. Try:

Letting them choose the therapist
Offering incentives (not bribes, but “after therapy, we can get ice cream”)
Framing it as “just trying it once”
Family therapy first, then transition to individual

Challenge 4: Confidentiality concerns

Teens need privacy. But you also need to know what’s going on. The balance:

Therapist should keep most things confidential
But will break confidentiality if: Child is in danger (suicidal, being abused, etc.)
Ask for general updates: “How are they doing? Are they making progress?” without asking for details

Therapy + Medication: Do They Need Both?

Sometimes therapy alone isn’t enough. Consider medication if:

Symptoms are moderate to severe
Therapy alone isn’t sufficient after 3-6 months
Functioning is severely impaired
Psychiatrist or pediatrician recommends it

Medication + therapy is often more effective than either alone. (See next article: “Medication Decisions: What Parents Need to Know”)

When to Stop Therapy

Signs it’s time to end (or take a break): ✓ Goals have been met ✓ Symptoms have significantly improved ✓ Child is functioning well (school, friends, home) ✓ They have tools and skills to manage independently ✓ Therapist agrees they’re ready Don’t stop abruptly. Plan a “graduation” with the therapist to ensure your child feels ready. You can always come back if needed.

What You Need to Remember

✓ Therapy is not a sign of failure—it’s a sign you’re taking your child’s mental health seriously ✓ Finding the right fit takes time—don’t settle for someone who isn’t right ✓ Progress is slow and non-linear—be patient ✓ Your support matters—get them there consistently and support homework ✓ Therapy works—but only if you give it time Getting your child into therapy might be one of the best decisions you ever make. It won’t fix everything overnight. But it will give your child tools, support, and a safe space to heal. You’re not giving up. You’re getting help. And that’s exactly what your child needs.