How do I talk to my child about therapy? 

If you are wondering how to introduce the concept of therapy to your child or how to explain to them that they are about to start seeing a therapist, you are not alone. Many parents wonder how to approach this conversation. At Hopscotch, we know that preparing your child for therapy is very important, because it sets the tone for a smooth transition into the relationship they will have with their provider. While every kid is different, here are some basic guidelines you can rely on when preparing your child for therapy. 

1. Choose a good time.

Timing matters – especially with kids! Every child is different, but typically, if you tell a child about therapy too far in advance, they may focus on it anxiously. If you tell them too soon beforehand, it may come as an unnecessarily abrupt shock. We recommend preparing young children for their first therapy session 1-2 days beforehand. Since older children and teens benefit from some additional time to process, they can be told 5-7 days in advance.

When NOT to tell your child:

Moments of conflict or when the child is upset is not a good time for the “preparing for therapy” talk, and therapy should never be used as a threat. Avoid any time when you know your child will be hungry, tired, or stressed, and instead, choose a time where your child’s feelings are neutral or positive. If a child interprets therapy as a punishment, they are more likely to have a hard time trusting the therapist or resent having to attend. 

2. Use a neutral tone of voice.

The key word here is neutral. Children are highly observant and sensitive to emotional language, and they pick up on abnormal tones of voice. When you talk to your child about therapy, it’s important that your tone of voice is not too harsh or overly excited. 

3. Introduce the concept of therapy in an age-appropriate way.

Children under the age of 5 may lack the developmental ability to understand the concept of therapy, but you can help them understand you're going to a 'really caring person that Mom/Dad found who can help us with big feelings'.

Children ages 5-12 are by nature very curious and full of questions. If their most immediate questions about therapy are not addressed, anxiety can form.

A great way to introduce the concept of a therapist to a child of any age is to teach them that therapists are adults that really like talking and playing with kids to help them figure out stress and big feelings. So you may introduce them as a 'feelings doctor' but then shift to actually using the therapist term over time.

How to talk to children under the age of 5 about therapy:

“You know how sometimes if you have a tummy ache a doctor helps you feel better? Well, there are feelings doctors, and if you are worried about something, or if you feel angry or sad, a feelings doctor will help you feel better! We’re going to visit one tomorrow, and it will be a fun time.”

How to talk to children ages 6-12 about therapy:

“A therapist is a feelings doctor. A feelings doctor helps you feel better when you feel sad, worried, or angry. They are not like a teacher or a parent. They’re kind of like a friend, except their job is to listen to you. So you can talk as much as you want and about whatever you want, and they’ll help you find ways to feel better. Lots of children and even adults have a feelings doctor, because they’re so helpful. We’re going to start visiting a feelings doctor once a week to help us feel our best.”

Pro-parent tip: Assure your child that feelings doctors don’t give shots!

4. Explain the process.

Explaining the process helps your child know what to expect in therapy. Be sure to articulate the basic therapy structure, how it works, and how long it will last.

Examples for children 5 years old or younger:

• “We’ll be meeting them in-person/virtually for about an hour once a week.”
• “I’ll be right there with you/outside the door the whole time (or in another room if you're at home).”
• “I think you are really going to have a lot of fun! There’ll be games to play and lots of fun things to do.” 
• “You will get to play with toys and draw.”

Examples for children 6 to 12 years old:

• “We’ll be meeting them in-person/virtually for about an hour once a week.”

• “I’ll be close by for the first session to make sure everything goes ok, and then we’ll decide together what to do for the next time.”

• “I think you are really going to like being able to say whatever’s on your mind, and if you need help, the feelings doctor knows how to help.”

• “If you don’t feel like talking, that’s fine! You don't have to talk the whole time or you can decide what you want to talk about.”

• “You’ll have total privacy. The therapist will meet with me separately to give me ideas or help me learn ways to help you at home. The specifics of whatever you both discuss will be confidential.” 

• “I’m not sure how many times we will go. We’ll figure that out and decide together after the first few sessions.”

5. Reaffirm your supportive involvement.

Depending on your child’s age, need, and unique temperament, it is not uncommon for children to feel anxious or concerned about starting therapy. They may even act out and express anger. It is important for caregivers to normalize therapy and remind their child that we all feel sad, worried, or upset sometimes. It may also be helpful to explain that many people go to therapy or have a feelings doctor, including adults and parents. Use inclusive language and give them confidence by reminding them that you will be available every step of the way to ensure they feel safe, heard, and supported. Encourage communication by asking your child if they have any questions, how they are feeling about therapy, and validating their feelings: "I know it can be scary to meet someone new" or "I know you will miss playing with your friends tomorrow after school."  Also it's important to remind them that this is private and none of their friends will know, if that is a concern.

6. Stay calm.

Children tend to mirror their caregiver’s emotions, so if you stay calm, empathetic, and matter-of-fact, the conversation with your child about starting therapy will likely go better than you anticipate. 

Keep learning about child therapy

• The top 4 types of child therapists
• How to find a child therapst
• How child therapy works: what parents need to know
• How to determine the type of therapy your child needs