“What if my teenager refuses to go to any of the sessions?”
Just because your teen refuses to go for counseling doesn’t mean you are stuck with the problem as is. In such instances, I’ll encourage you to set up your own appointment, and invite your son (or daughter) to join you. If he declines, there is still a lot that we can do together to help him, as well as to help others in the family who are affected by what is going on. Some kids who have refused to go change their minds when they realize that digging their heels in won’t stop the counseling from taking place and will mean only that they’ll be absent from conversations and decisions that have to do very directly with them.
“My kid swears she’s not going to say anything. What good will therapy do then?”
Don’t make an issue of it or try to arm wrestle your kid into agreeing to talk. Just say that you’d like her (or him) to be open-minded, but that whether or not she talks is between her and me. Then, let it be and bring her to the appointment. I’ll find a way to make use of our time together and get some kind of conversation going. If it’s a session with your teen and you together, I’ll start off by talking with you, while respecting the presence of your teen in the room, as well as her message that she’s not talking. Often, just the experience of being taken seriously and treated respectfully in the face of their defiance softens kids up, and they begin to join the conversation.
“How long is this going to take?”
People usually preface this with, “I know you can’t really tell me, but….”
It’s understandable—you want some idea of what you’re getting into when you sign on for counseling.
Yes, it is hard to tell, especially without having met a client, but here’s what I can say about how long therapy takes:
Therapists have gotten more incisive in their thinking and more efficient in intervening than in days past when therapy could go on and on with too little definition or sense of purpose. That said, I believe that how long counseling takes depends as much on how a therapist thinks about the ways in which people change as it does on the client and the problems he or she comes in with.
Personally, and borrowing a line from Kevin Kline in the extraordinary movie My Life as a House, I believe that change can “happen in a moment.” It may take a lot of work on the therapist’s part, but that “lot of work” can take place in all of one session—or it could take a few sessions. In families where there is a lot of defiance or chronic anger, I have found the most rapid and enduring results to come out of being able to compassionately, but unequivocally, hold all members accountable for the impact of their choices on those around them, as well as from helping parents to balance that same expression of compassion and appeal for accountability with their teens once they return home.
That was the long answer to that question. The short one is this: Generally (and not including severe or chronic problems or mental illness), a handful of sessions to a few months.
“How do you work with younger children?”
I work with children as young as four years of age, and always meet with them and their parent, parents, or other primary caregiver together, certainly at first. If there are things I think the parents can do to help or even resolve the problem, I will likely meet with them alone for a second session, after which they schedule two or three follow up visits at two week intervals. For more distressing or severe issues (unrelenting tantrums, anger/violence, panic), I may want to meet with the child alone as well, and the family and I may work together for a slightly longer period of time, and/or meet more frequently. I am always available to speak with a child’s pediatrician or other physicians, as well as school personnel.