Since children are not simply small adults, psychotherapy unfolds with them in ways that differ from work with adults. Drawing and painting, playing with toys and building with blocks, and acting out scenes they imagine or have experienced can all play important roles in therapy with children. These forms of expression provide ways for them to communicate their inner experience of the world and their relationships with others which they may not be able to describe by using words alone. They also reveal crucial information about strengths and difficulties in a child’s physical, cognitive and emotional development.

Parents always need to be part of the treatment of a child, and exactly what the nature of that participation is depends on the specific situation. Especially with a young child, the initial evaluation would include several meetings with the child alone as well as several meetings with only parents, in order to learn about the background of the child and the immediate family. Meetings with each parent separately are also part of the initial evaluation, in order to sketch out the larger landscape of the extended family and intergenerational themes. How often parents meet with the therapist during ongoing therapy would be guided by what would serve the particular goals of the child’s therapy at a given time.

Adolescents are more likely than children to engage in therapy in ways that are similar to work with adults. Although they have a greater developmental need for privacy and independence, their parents have a role in the treatment. As is the case with children, the nature of the engagement of parents depends on the goals of the treatment and what would serve them, and the adolescent’s discussion of that with the therapist can be its own valuable aspect of the therapeutic work.