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My Child Was Referred to a Therapist:
What Can I Expect?
For parents or caregivers, having their child referred to a health specialist of any kind can be a frightening experience. Referral to a mental health specialist can bring up many worries - some because of the love and care you have for your child and others from social stigmas of mental health. Firstly, it is important to know that you are not alone. Around 1 in 7 young people meet diagnostic criteria for a mental health diagnosis. Secondly, understand that, as medical and psychological treatment have expanded, we in the clinical field often look towards being proactive rather than reactive to symptoms a child might be experiencing. A LCSW or LCPC has gone through a minimum of 6 years of specialized study in a college and graduate school and thousands of hours of supervision to get their license. They exclusively studied mental health, neuroscience, cognition, and the integration of mental and physical health. While it can be helpful for a parent to read self-help books or get advice online, using a licensed clinician will be more effective when it comes to getting your child into a safer and more functional way of living.
Some clinicians offer a short consultation prior to accepting new patients. If that is the case, these consultations are 10-20 minutes long and you are encouraged to ask the therapist questions regarding their expertise in certain subjects that are relevant to you. In general, you will be developing a professional relationship with your therapist, so it’s important to find a therapist who is familiar with your particular needs, as well as the type of evidence-based treatment they provide (more on this later). At Healing Mountain Mental Health, we put most of our mission statements, education and focus on our website - but we are still open to consultation!
Some clinicians offer a short consultation prior to accepting new patients. If that is the case, these consultations are 10-20 minutes long and you are encouraged to ask the therapist questions regarding their expertise in certain subjects that are relevant to you. In general, you will be developing a professional relationship with your therapist, so it’s important to find a therapist who is familiar with your particular needs, as well as the type of evidence-based treatment they provide (more on this later). At Healing Mountain Mental Health, we put most of our mission statements, education and focus on our website - but we are still open to consultation!
First Appointment (Psychological Evaluation)
A full evaluation is done during either the first or second appointment. This usually takes 60 - 90 minutes. During this evaluation, the therapist will obtain a great deal of information about early childhood, any significant health injury or illnesses, family history, cultural or ethnic information, identity surrounding gender and sexuality, religious affiliation, and more. Some of this information can be gathered in intake paperwork, but it is important that your therapist gather all the details for current living situations and past living situations, as well as any family history of mental health diagnosis. They will create what is called a “biopsychosocial” that summarizes all of this information. This document is useful for coordination of care between medical and other clinicians if necessary (i.e. occupational therapists, psychiatry, etc.)
After this evaluation, your therapist will give you a general summary of initial diagnosis. They will also typically talk about any behaviors or patterns that they want to watch in order to rule out more complicated diagnoses such as attention deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), post-traumatic stress disorder (PTSD), bipolar disorder, or others.
If, for any reason, you or your child feel like the therapeutic relationship will not be a good match, you can let your therapist know so they can make an appropriate referral.
After this evaluation, your therapist will give you a general summary of initial diagnosis. They will also typically talk about any behaviors or patterns that they want to watch in order to rule out more complicated diagnoses such as attention deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), post-traumatic stress disorder (PTSD), bipolar disorder, or others.
If, for any reason, you or your child feel like the therapeutic relationship will not be a good match, you can let your therapist know so they can make an appropriate referral.
Moving into Treatment
Treatment for most individuals is once a week for 12 - 16 weeks, then moving to a maintenance phase and graduation/discharge. Maintenance phase can be different for different individuals, but usually looks like 1 time every two weeks for another 2-3 months.
For complicated diagnosis, treatment can last longer (sometimes several years) while the clinician helps their client work towards mental and behavioral health in a variety of areas such as healthy relationships, work/education, finance, health goals, and gain general independence in their life.
Please note: In our practice we prefer to have at least one family session per month for children we provide therapy to.
This session is typically ONLY the parents/caregivers and the therapist without the child present. This is so that we can talk about a variety of subjects without worrying about “what will my child think if they know I have these questions/concerns”. This is also for the therapist to get another opinion about any questions/concerns that are happening in the home (a child is not always the best objective source for this information). This session is NOT for the therapist to share everything the child has talked about or is doing in therapy. If the therapist DOES have concerns about serious mental health such as suicidal or homicidal ideation, current trauma or abuse, criminal activity or others, the parent/caregiver will be immediately informed unless it puts the child in danger.
If the child and parent regularly are unable to communicate in the home setting, treatment will include family sessions with parent(s)/caregiver(s) and child present.
For complicated diagnosis, treatment can last longer (sometimes several years) while the clinician helps their client work towards mental and behavioral health in a variety of areas such as healthy relationships, work/education, finance, health goals, and gain general independence in their life.
Please note: In our practice we prefer to have at least one family session per month for children we provide therapy to.
This session is typically ONLY the parents/caregivers and the therapist without the child present. This is so that we can talk about a variety of subjects without worrying about “what will my child think if they know I have these questions/concerns”. This is also for the therapist to get another opinion about any questions/concerns that are happening in the home (a child is not always the best objective source for this information). This session is NOT for the therapist to share everything the child has talked about or is doing in therapy. If the therapist DOES have concerns about serious mental health such as suicidal or homicidal ideation, current trauma or abuse, criminal activity or others, the parent/caregiver will be immediately informed unless it puts the child in danger.
If the child and parent regularly are unable to communicate in the home setting, treatment will include family sessions with parent(s)/caregiver(s) and child present.
Types of Therapy Used for Children
At Healing Mountain Mental Health, our emphasis is on evidence-based treatment. For children under the age of 12, we often will focus on play therapy and/or expressive arts. While this may seem like “just play” to a parent, what the therapist is doing is focusing on establishing a trusting relationship so that the child can communicate openly to the clinician. Additionally, the therapist is often looking for key elements within play or art expression that could assist with diagnosis and/or underlying reasons for mental or behavioral health issues. Often a younger child can express their worries, trauma experiences, or simply anxiety or depression through interactive play or art where they would not have the cognitive development to express with words.
As the child gets older, expressive arts can be used to explore confusing or complicated emotions as well as identity formation. These are both delicate areas in a child’s life, and the therapist will use the art as a means to help them reinforce their ideas concerning themselves, their families, school, etc. When a larger issue makes itself known through art, the therapist can often use this to segue into a more formal type of therapy such as cognitive behavioral therapy (CBT), cognitive processing therapy (CPT), acceptance and commitment therapy (ACT), dialectical behavior therapy (DBT) or eye movement desensitization and reprocessing (EMDR). These types of therapy are used typically with ages 12-15.
Treatment for children ages 15-17 is usually revised versions of more formal talk and neurological treatment such as CPT, CBT, and EMDR. At times we will use expressive art therapy to open new ideas of processing and learning better ways to both express, regulate and communicate more difficult emotions or thoughts both in therapy and at times to be able to share with others outside of therapy.
As the child gets older, expressive arts can be used to explore confusing or complicated emotions as well as identity formation. These are both delicate areas in a child’s life, and the therapist will use the art as a means to help them reinforce their ideas concerning themselves, their families, school, etc. When a larger issue makes itself known through art, the therapist can often use this to segue into a more formal type of therapy such as cognitive behavioral therapy (CBT), cognitive processing therapy (CPT), acceptance and commitment therapy (ACT), dialectical behavior therapy (DBT) or eye movement desensitization and reprocessing (EMDR). These types of therapy are used typically with ages 12-15.
Treatment for children ages 15-17 is usually revised versions of more formal talk and neurological treatment such as CPT, CBT, and EMDR. At times we will use expressive art therapy to open new ideas of processing and learning better ways to both express, regulate and communicate more difficult emotions or thoughts both in therapy and at times to be able to share with others outside of therapy.
Priority Time Slots
At Healing Mountain Mental Health, we are aware of how difficult and stressful scheduling can be for parents/caregivers and children. That is why we strive to reserve after-school scheduling for those who need it the most. Children that need weekly or twice-weekly sessions due to issues such as suicidal ideation, trauma, or severe emotional disturbances/behavioral difficulties will receive priority time slots (3pm-5pm), if available. However, these slots must be at least once per week, as this allows all clients to have a regular and structured monthly schedule. Clients and caregivers must show a commitment by showing up to sessions regularly and/or canceling at least 24 hours beforehand (except in emergency situations). Preferably, scheduling should go through the client care coordinator (Samantha Martin, (406)-475-2357 or [email protected]) to ensure that the therapist has ample time to focus on treatment.
Graduation/Discharge
Therapy is not meant to be a permanent solution, nor is it a cure for behavioral health challenges. Instead, the therapist acts as a guide to help your child develop tools for coping with stressors, improving self-esteem, and forming healthy relationships. This process relies on trust in the process and in the therapeutic relationship to work effectively.
Childhood is a time of major development and growth, and it is vital that your child receives the care they need to develop into a well-functioning and adjusted adult. Untreated mental illnesses in childhood can lead to higher rates of drug and alcohol abuse, poorer physical health, negative academic outcomes, poor social skills, self harm, and suicidal behavior that can continue into adulthood. Therefore, a solid commitment must be made to show up and try your best for your child and their future by adhering to clinical advice and supporting your child's needs. When clinical advice is followed and treatment is regular and consistent, the child will require less and less therapy and eventually will be able to "graduate" or discharge from therapy. However, when clinical advice is not heeded, this may result in an early termination of services and/or referral to another clinician/outside resource.
Children are incredibly adaptable beings, but being open to change and "doing the work" is half of the treatment process. By putting in the work and making a commitment to your child's future, you are vastly improving their mental and physical health outcomes, and you will be truly amazed at what your child is capable of.
For your child's "graduation", a plan will be put in place. Initially, sessions will reduce to 1-2x a month during the "maintenance phase". Any necessary referrals will be made for medication management or other programs. Natural supports will be identified, such as school groups/clubs, church or spiritual groups, teachers/mentors, supportive family members, and extracurricular activities. A crisis plan will be made in the event that the child is in need of emergency care. At termination, the child will have a final session and say goodbye to the therapist. This goodbye can be difficult and may initially provoke a return to prior symptoms in an attempt to hold onto the relationship. However, this regression is temporary and does not negate the milestones that your child has achieved in therapy. Sometimes, the child and the therapist will write goodbye letters or make pieces of artwork to commemorate their time together and provide closure, which can help with regression and ease the transition. Down the line, if a stressful event happens and the child needs to return to therapy, you may reach out to the therapist and see if they are able to take your child back on as a client or make a referral to another clinician.
Childhood is a time of major development and growth, and it is vital that your child receives the care they need to develop into a well-functioning and adjusted adult. Untreated mental illnesses in childhood can lead to higher rates of drug and alcohol abuse, poorer physical health, negative academic outcomes, poor social skills, self harm, and suicidal behavior that can continue into adulthood. Therefore, a solid commitment must be made to show up and try your best for your child and their future by adhering to clinical advice and supporting your child's needs. When clinical advice is followed and treatment is regular and consistent, the child will require less and less therapy and eventually will be able to "graduate" or discharge from therapy. However, when clinical advice is not heeded, this may result in an early termination of services and/or referral to another clinician/outside resource.
Children are incredibly adaptable beings, but being open to change and "doing the work" is half of the treatment process. By putting in the work and making a commitment to your child's future, you are vastly improving their mental and physical health outcomes, and you will be truly amazed at what your child is capable of.
For your child's "graduation", a plan will be put in place. Initially, sessions will reduce to 1-2x a month during the "maintenance phase". Any necessary referrals will be made for medication management or other programs. Natural supports will be identified, such as school groups/clubs, church or spiritual groups, teachers/mentors, supportive family members, and extracurricular activities. A crisis plan will be made in the event that the child is in need of emergency care. At termination, the child will have a final session and say goodbye to the therapist. This goodbye can be difficult and may initially provoke a return to prior symptoms in an attempt to hold onto the relationship. However, this regression is temporary and does not negate the milestones that your child has achieved in therapy. Sometimes, the child and the therapist will write goodbye letters or make pieces of artwork to commemorate their time together and provide closure, which can help with regression and ease the transition. Down the line, if a stressful event happens and the child needs to return to therapy, you may reach out to the therapist and see if they are able to take your child back on as a client or make a referral to another clinician.
Conclusion
Congratulations on making it this far! Therapy is an amazing option to improve your child's present and future experience. We hope that you will continue along the process and be able to see your child live their life to the fullest and be their most authentic self.