Double Take: Finding your child a therapist

Dear Dr. Wes and Miranda: What tips do you have for finding a good therapist? We haven’t had much luck in the past with my son on this, and we’d like to try again. He’s 14, if that helps.

Miranda: First, talk to your child’s pediatrician or doctor and see whom he or she recommends. Doctors are medical experts, and, even more than that, they probably know certain therapists on a professional level and can help narrow the field to someone your son will be able to work with.

Talk to friends and family who you know have gone to therapy. A patient’s review of a therapist is pretty honest, and word of mouth is one of the most common ways people find their regular family physician, dentists, etc. Schedule a preliminary meeting with your child’s new therapist before your child ever meets him/her. This way you can work out any worries beforehand and make sure you agree with treatment plans.

Because you mentioned that this hasn’t worked out in the past, make sure that you’re giving any therapist you choose enough time to show results. It’s easy to jump to the conclusions that something doesn’t work after a short amount of time. But therapy takes time and effort for both the child and the family. Make sure you attend family sessions and follow the therapist’s advice until you have a clear reason not to.

It is difficult to watch someone else take care of your child. So remember that therapy is a medical field. If your child broke an arm, you would go to a surgeon because you wouldn’t be able to heal it yourself. There are many talented, qualified professionals out there, and you should be able to find one who is compatible with you and your son.

Dr. Wes: Miranda offers some pretty darn good advice on this topic. However, if you follow her suggestion about a preliminary session without your son, you will run into two issues. The first is cost. Insurance usually won’t pay for any session that doesn’t include the client, and you’d be very unwise to sign yourself into treatment if the issues are with your son. Still, some families find the prelim worth the expense.

The other problem is much harder to overcome. Though things have improved in the last 10 years, some teens are still leery about therapy. That suspicion rises tenfold if they find out you’ve come in ahead of them, especially if the issues involve parent-child conflict. It’s just seen as a huge endplay and gets things off to a bad start.

Finally, your view of a therapist’s greatness may differ substantially from your son’s. So all in all, you might lose more than you gain from a preliminary appointment.

With that caveat, here’s my short list of additional tips:

l Look for someone who specializes in working with teens. This is one thing you can safely do without upsetting your son. Most therapists will provide you with a resume on request.

l Kids need therapists who capture their attention and win their hearts. There has to be a connection, and therapy has to be influential. As but one example, if your son isn’t a talkative guy, the last thing he needs is a therapist who sits in silence and waits for him to speak, and some do exactly that. A skilled therapist knows how to feel her way through a session with a quiet kid. If after two or three sessions there’s no connection, move on.

l Be sure the therapist knows how to involve you. In difficult cases, teens should not routinely be seen in therapy without ongoing some consultation with their parents. This does not mean the therapist downloads everything the kid says. It means he advises you on how to work better with your son and keeps those conversations above board to avoid garnering suspicion.

l Leave with specific strategies. Some therapies can drift, and in many cases that’s a great journey of discovery. But it has to be problem solving, too. The best therapists tend to be “kindly blunt” in directing you and your son on that journey, not just a caring ear or paid friend.