Many readers will disagree with the premise of this article. I’ve lost clients over this point, even long-term clients who generally agree with the family systems perspective. Certainly, there are literally thousands of therapists who hold an opposing opinion. But over time I’ve become more clear on this issue: Minor children can’t legally drink alcohol, drive cars, or enlist in the military. Therefore, they shouldn’t be responsible for solving the family’s emotional problem.
Children are as likely as adults to have emotional health struggles. If therapy is helpful for adults, why not for their children too?
Here are 10 reasons why therapy is not kids’ play:
1. Symptoms in a child reflect an emotional process filtered down from the parents or other adults.
2. Once the problem is identified as being in the child, it is more difficult for the adults to take responsibility for the family emotional environment, and easier for the family to continue to locate the problem in the child.
A good example of this process is when parents “go through” a high-conflict divorce and the kids subsequently develop emotional/behavioral symptoms. Then the parents, and sometimes the courts, put the children in therapy rather than insisting the adults get their act together. (The system acts like it’s given up on the irresponsible adults.) I’ve heard parents go on and on about the problems in their child at the same time they are having affairs, drinking too much, arguing about the kids, and engaging in all types of other dysfunctions. Even though the connection is obvious to most outsiders, the family insists on getting treatment for the child, while continuing the anxious patterns in which their child’s difficulties are embedded. In cases like this, not only is the therapy for the child bound to be ineffective, by making them the focus of treatment the therapist is unwittingly supporting the problematic status quo.
4. A mental health diagnosis given to a child can remain with them for life, governing how they and others view them and their capabilities.
5. The introduction of the new triangle* with the child therapist may temporarily calm the family system, decreasing motivation for the adults to take responsibility.
6. The best resource for a child is their own parent or caregiver.
You may be thinking, ‘But my child needs someone to talk to, to say things they can’t say to me’. To which I ask: ’What gets in the way of your child talking to you? Are you willing to work on that?’
7. Children don’t have the power to interrupt the family emotional process. Even financially dependent adult children will be constrained in their efforts to modify their position in the family dynamic.
8. Behavior problems in children often mask marital problems. According to Dr. Bowen:
…if the parents could define and modify their relationship, the children’s problems would automatically disappear. (p. 245)
9. Therapists who perceive themselves as advocates for their child clients may, deliberately or not, alienate them from their parents. Even in cases of family violence and abuse, (including situations where children need to be separated from the family for their safety) it is harmful to turn the child against the family. If the parents or primary caregivers are unable or unwilling to take responsibility, extended family may be mobilized. When foster families become the best option, those are the parents who become the focus of intervention.
10. Many child therapists conduct therapy with minor clients and young dependent adults with nearly as much adherence to confidentiality as they would with their adult clients. This practice hampers the parent(s) ability to assist their child and can damage their relationship. I believe this situation creates a heightened level of risk for the child and the family over time. If you decide to put your child in therapy, be very clear about your expectations regarding communication with the therapist and their policy about including parents in the process.
Have I changed your mind yet? No? Well, consider this:
You may feel powerless to help your child, but you’re not powerless! By shifting your focus from your child (or any other family member) to yourself, you can have a positive impact on everyone. Then, even though they still can’t drink, drive, or enlist, your child can get back to the very important job of just being a kid.