Is Psychological Therapy For Children Effective?
Question: You seem to be opposed to putting children into any sort of psychological therapy. That’s curious, especially given that you’re a child psychologist. What is your explanation for this and are there any situations in which you would be in favor of therapy for a child?
Answer: As I said in a recent column, I was trained as a child therapist, to talk to children about problems they were having or were a part of. Rather early on in my career, however, I concluded that such conversations were largely unproductive and potentially counterproductive. Parents never – no exceptions – told me that problems with their children abated after I talked with them. The question then became: Was that due to something about me or was the process itself problematic? I eventually concluded the latter, but before the reader begins laughing out loud, let me explain.
What the average layperson does not know is that no consistent body of research done by people who, as we say in the South, have no dog in the hunt confirms the reliable efficacy of any psychological therapy. Outcome studies consistently find that about as many consumers report dissatisfaction with therapy as report satisfaction. Studies on outcomes with children are lacking (not to mention that they are difficult to measure), but over the years a significant number of parents have reported to me that putting their children in therapy made the problem(s) in question worse rather than better. My personal finding has been that therapy with children is a general waste of not only everyone’s time but also parents’ money. (Before I go any further, I must mention that my thoughts on child therapy are not regarded as mainstream in my profession.)
The problem begins with training and philosophical biases that dispose therapists to talk to children about their feelings. Such conversations are very likely to give children the impression that their feelings concerning certain issues or topics are not only legitimate but should also govern their parents’ behavior.
Children’s emotions are as undisciplined as their thought processes. Just as children think incorrectly, so do their feelings often reflect nothing more than immaturity and an inclination toward self-drama. To this one can add two further truths: children (a) often misinterpret events and (b) are highly susceptible to suggestion. When all is said and done, the rather inescapable conclusion is that a child’s emotions (or opinions of how adults in his life conduct themselves in certain situations) are rarely a valid indication of anything more significant (or presumably obvious) than his need to grow up.
A process – therapy – that involves the risk of confirming a child’s feelings, of assigning credence to them, is potentially counter-productive if not downright harmful. It is, in my estimation, a risk that therapists should undertake with great caution, if they undertake it at all.
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I will concede that there may be a small minority of situations involving a small minority of children in which child therapy can be justified for a conservative length of time. But child therapy is not, in my estimation, justified when the problem is primarily the result of the child’s refusal to accept the legitimacy of adult authority, the child’s immaturity (which explains most childhood fears and anxieties), or parents who have not insisted, from a relatively early age, on emotional self-control (frequent tantrums occurring past the third birthday, for example).
During my private practice years, I would sometimes consent to see a child in a private session if the child expressed what I thought was a sincere desire to talk to me. I must add, however, that the kids in question rarely had anything of note to say, and I was not about to ask them how they felt about something. As a result, said conversations turned out to be nothing more than costly one-offs.
Family psychologist John Rosemond: johnrosemond.com, parentguru.com.
*About the Author: Rosemond has written nine best-selling parenting books and is one of America's busiest and most popular speakers, known for his sound advice, humor and easy, relaxed, engaging style. In the past few years, John has appeared on numerous national television programs including 20/20, Good Morning America, The View, Bill Maher's Politically Incorrect, Public Eye, The Today Show, CNN, and CBS Later Today.