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Dueling Docs: Should Children Ever Go to a Therapist?

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The Issue:
Do Kids Belong in a Therapist's Office?

The Facts:

When a kid acts up at school, what happens? He gets sent to a therapist. Parents getting a divorce? It's the children who go to a shrink. And when a child is bullied, off to the therapist she goes. With so much stress on kids nowadays--and on their hovering parents--it's no wonder that children get carted off to therapy at any sign of trouble.

But should they be? A small, but growing group of child psychologists argues, no. Rather than placing children in a therapist office, it's the parents, they say, who should go in for therapy so they can learn for themselves how to help their kids.

Two doctors debate the issue: Carol Wachs, psychologist in New York City and co-author of Parent-Focused Child Therapy (2006); and Marc Nemiroff, psychologist in Potomac, MD and co-author of A Child's First Book About Play Therapy (1990)

You can listen to Dueling Docs on radio, too!

The Debate:

Carol Wachs

"Therapy for kids is not benign. There are risks, but no one considers them. Therapy is expensive, time-consuming and worse, it can disrupt the complex relationship between children and their parents. Once a child goes to a therapist, there's always the elephant in the room at home.

"And, once parents hand over their expertise to a therapist, it's the therapist who is often viewed by the child as the better, more competent adult while the parent is left out. Parents are not even told what goes on in therapy sessions.

"I see it all the time: parents feel bullied into sending their children to a shrink. The therapist will say things like 'if you can't make your child come, it's your fault.' Parents become so anxious and feel terribly guilty. And then parents are maligned in the therapists' office, while the child and therapist develop an alliance. Yet, it's the parents who are the real experts about their kids. They are the ones who should be talking to the therapist for help. Not the child. And it's the parents who the child needs to talk to - not the therapist.

"Don't kid yourself, even the youngest children know they are being sent to a doctor. Meantime, there are many things in life that are therapeutic without being therapy. If a child is having a social adjustment issue, he might really benefit more by getting on the soccer team than going in for a time-consuming expensive process with a stranger that might be disruptive to family life.

"If you can get the same or even more benefit without the negative consequences of putting a child in therapy, you can help a child in a much more abiding way. When parents are working with a therapist, they really have to think about what the child is experiencing in his mind and this is extremely helpful. Parents need to know how to be therapeutic with their own children. Not only will it help the child, but it will help the parent feel competent, too."

Marc Nemiroff:

"Just seeing the parents doesn't do the child's internal life justice. Often the parent is the best informed about the child, but often not. They tend not to be the best observers of a child's private life. Nor do parents know how to interpret their young children's play. Playing is how a young child will express what's on his unconscious mind. It's a play therapist who can provide a translation of that play - not a parent.

"What I find is the enormous relief a child feels when they see someone that's neutral, especially when there are warring parents.

"Things come up in therapy that a child can't express to the parent. Kids are very happy to bring in what's on their mind. A child could be afraid of his parent dying and he doesn't want to tell his parent. Or an 8-year-old may want to kill himself and he doesn't want to upset his parents. My job is to relieve the child and help the parents understand their child better. Like many therapists, I don't just see the child. I also see the parent every few weeks.

"The idea of working exclusively with the parents is as if I came in for therapy and the therapist met with my wife because she knows me more than anyone else. And then my wife worked with me. Would I want that? Of course not! I want to be understood. I want my own story told and I want to be seen by a trained person.

"Yes, it's true that a child has confidentiality with regard to what's specifically said in the therapist's office unless there's danger- even for a four year old. But in my experience, in 90 to 95% of cases, the children grow closer to the parents when they go into therapy and the therapist become obsolete.

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