Seeking Help For Your Child: Part II
Gregory K. Moffatt, Ph.D.
The first part of this article addressed four questions one should answer in deciding whether or not to seek professional help for one's child. The four questions were: (1) Can the child do everything he or she needs to do, despite the concern you have? (2) Is there a presenting issue that is almost always serious for children? (i.e. sexual abuse, physical abuse, other trauma) (3) Does this child present any of the three symptoms known as the 'terrible triad? (bed-wetting, fire-setting, or cruelty to animals) (4) Does the parent need help and/or reassurance? If so, a counselor/psychologist may be helpful.
Once a decision has been made to seek a therapist, finding a competent helper is your next challenge. I don't recommend using the yellow pages to find a counselor. You might find a good therapist in the phone book, but as with any profession, there are many therapists who are not very good and some who are down right incompetent.
Instead, talk with people that you know who have used therapists and ask for their recommendations. You will want recommendations for a therapist who regularly works with the age child you have. Therapy is very different at different ages. For example, a counselor who is very good with adolescents may not be skilled with young children.
License is an important issue. In Georgia, there are several levels of licensure. Licensed Professional Counselors, Clinical Social Workers, Marriage and Family Therapists are overseen by the state licensure board. They must have at least a master's degree, several hundred hours of supervised clinical work, and they must pass the state licensure exam. Licensed Psychologists have even more requirements as do psychiatrists who are also medical doctors. Most licensed counselors accept insurance payments and are overseen by the state licensure board. Licensure does not guarantee a counselor is a good one, nor does the lack of licensure mean one is unqualified. However, in the state of Georgia, with the exception of clergy, only those who are licensed can legally practice therapy.
Once in therapy, the therapist should work with you to evaluate the problem(s), set goals for therapy, and establish criteria as to how you will know when those goals are met. Goal- and criteria-setting are crucial to therapy. For example, a goal might be to reduce aggressive behavior in a child. This is the focus of therapy. A criterion might be "five or fewer incidents at school in a month." This is the way you will know you have succeeded in therapy.
Goals and criteria are individually tailored to the client. Goals can be added or changed as therapy progresses, but if you and your therapist cannot at any point in time identify your goals and how you will know when you get there, something is wrong. In fact, your therapist should regularly remind you of your goals and provide a verbal or written progress report. I make it a point every week or two to discuss the goal(s) with the parents of my clients and let them know where I think we are. If your therapist has not reviewed your child's progress, ask. If he or she can't answer your questions regarding progress and goals, you may need to find another therapist.
Don't expect a therapist to give you an exact number of projected sessions for a problem. I try to give my clients a rough idea, but how long therapy takes depends on the skill of the therapist, the responsiveness of the client, and the level of involvement of the parent. One should not expect problems that have existed for five or ten years to be resolved in one or two visits. I usually require at least one or two sessions just for evaluation. Therapy begins after that.
Keep in mind that counselors are not the only ones that
can help your child. With some issues, I would rather the child
be involved in scouting, his/her church or religious organization,
or some other social group that has the child as a focus than
I would to see the child in therapy. These relationships can be
very productive, provide long-term coping help, social skills,
and mentoring. Plus, they are far less expensive than seeing a
counselor once a week. Therapy can be time consuming and expensive,
but the earlier problems are dealt with, the easier they are to
correct.