Young Children + Adolescents

Children who have experienced divorce, bullying, abuse, learning challenges and other difficulties often need help beyond what parents are able to provide in order to deal with the powerful emotions that are part of these difficult life struggles. 

Parents typically reach out to me because they have taken things as far as they can on their own and are looking for help for their child’s anxiety, aggression, meltdowns or sleep problems. I work with both young children and adolescents. Here are some common challenges I see in my practice:

• Young children: separation anxiety, obsessional thoughts, difficulty sleeping alone, hyperactivity, toilet/bedwetting issues, temper tantrums, excessive worry/phobias, hair-pulling, irritability, anger, aggression, defiance

• Older children/teens: anxiety, perfectionism, depression, social withdrawal, suicidal thoughts, self-harming, lack of interest in things, homework overwhelm, meltdowns, school resistance, aggression towards siblings/parents/peers

• Difficult life challenges: divorce, blended families, death/loss of important relationships, bullying, learning difficulties, trauma, abuse, serious illness in the family

Parent Sessions

In addition to working directly with children, I also help parents to identify simple shifts they can make to help the child and family relate better to create a happier home life. Sessions with parents help us to better understand the child’s needs and develop strategies to help him or her in therapy, school and at home. 

Young Children: Therapeutic Talk + Play Approach

My approach with young children looks a little different than the adult style talk therapy that you might be familiar with. I use a combination of talk and play to help children learn how to manage their emotions and navigate difficult life experiences.

Children who are struggling with their emotions act in ways that can be confusing and confounding to adults. Each child’s brain is both unique and still developing. A child doesn’t always respond to adult problem solving and textbook approaches. 

Games and role-plays aren’t just about fun for children. This is where and how they work out challenges. A skillful therapist can use play to help children work through their problems. Directly asking a small child to talk about his or her feelings is often futile. Their brains simply haven’t developed enough to be able to identify what is going on and express it clearly. 

Play can also provide a sort of therapeutic sandbox where I am able to get down on the child’s level to gain insight into what’s going on as well as create opportunities to change behaviors. Through this process, children learn to express feelings and work out struggles in a healthy way that reduces anxiety, acting out and inappropriate aggression.     

How does Play Therapy work?

My office is stocked with a variety of games, therapeutic toys and props for role-play. Working with each child is a very organic and an individual process. Being a Play Therapist is a bit like being an improv actor, game day coach and mama bear all in one! Needless to say, I’m very engaged from the start to finish of each session. 

Before meeting with your child for the first time, I like to have an initial session with you to discuss what’s going on for your child and the rest of the family. Once therapy begins, I typically meet with parents at least once a month, so that we can see how things are going for everyone involved and coordinate efforts to best help your child. 

In sessions with your child, he or she typically will choose a game, toy or play scenario—e.g. checkers, a doll or playing school. Whatever feelings your child is struggling with will come up in the course of play and from there I address them therapeutically. 

My role as a therapist is to identify unspoken emotions and developmental struggles, help the child express feelings in a healthy way and guide the play for therapeutic benefit.

An Example: Play Therapy Case Study

This fictionalized case study draws upon my experiences with multiple clients to illustrate how Talk + Play therapy might look for a child.

“Mike” was a 10 year old boy who had been diagnosed with a learning disability. His parents had divorced a year earlier and his father moved out of state for work. Mike was getting tutoring and other help to address his academic struggles. But he was increasingly resistant to going to school, had frequent meltdowns while doing homework and was aggressive with his younger sibling. His mother was frustrated by the emotional turmoil that was putting everyone in the family on edge.

Through a therapeutic approach to playing games such as Connect Four or Stratego, we were able to increase Mike’s tolerance for frustration and develop a growth mindset where failures are seen as an opportunity to learn. 

Through playing “school,” we discovered that Mike had received some harsh criticism in the classroom that created deep anxiety and anger. By playing the role of student, I was able to reflect Mike’s feelings back to him in a healthy way, serving both as validation for him and a model for expression and response. Together we were able to brainstorm ways to deal with challenges in the classroom and play them out.

Mike also began sharing in therapy that he worried about his mom. With his father leaving, he felt that he was the man of the house. Mike believed it was his responsibility to protect his mom and manage his younger sibling which led to aggressive and controlling behavior. In several sessions we explored his role as a child in the family. With this insight about Mike’s anxiety, his mother and I were able to come up with simple ways for her to assure Mike that she was ok and in charge.       

Over the course of therapy, Mike’s meltdowns at home diminished and his teachers noted that he became more engaged at school. There were fewer aggressive outbursts and his mother noted that he seemed to have more friends. The whole family began enjoying time together because there was less conflict and turmoil. 

Teens

Working with adolescents tends to include more talk, less play. The teenage years are difficult to navigate in the best of circumstances. This transitional time is a bridge between childhood and adulthood. Working with adolescents requires an ability for the therapist to jump between these two developmental stages to bring more child-like thinking and behaving into adult territory.

Adolescence is when we differentiate from our families and explore our own identity. There’s a huge flux in hormones and changes in the brain that create strong and often confusing feelings. Academic and social pressures can be intense. Teens are trying to figure out where they fit with peers, in romantic relationships, on social media and in the greater world. 

Due to the adolescent developmental process, it can be difficult for parents to tease out what’s normal teenage behavior and what is problematic. Some of the signs that your teen may need some additional help navigating his or her emotions and outside pressures include:

• Worrisome anxiety or depression: insomnia/excessive sleep, debilitating worry, social withdrawal, academic decline, procrastination, perfectionism, suicidal thoughts, lack of interest in things
• Excessive anger: fighting, bullying, defiance towards parents and teachers, violence, aggression towards siblings and peers
• Acting out behaviors: food or exercise obsessions, excessive video/game playing, recklessness (including alcohol/drug use), self-harm (including cutting), lying, stealing
• Identity struggles: sexuality, gender, social 
• Difficult life challenges: divorce, blended families, death/loss of important relationships, bullying, learning difficulties, trauma, serious illness in the family 

I bring a warm and engaged presence combined with a deep understanding of adolescent development to my sessions with teens.  I serve as a trusted adult who can understand what they are up against and help negotiate healthy ways forward so that everyone in the family can be happier.