The 5 Differences Between Child and Adult Psychotherapy (explained)

In recent years there have been many changes experienced in society in terms of mental health. Talking about psychological problems is no longer a taboo subject so that more and more people are inclined to go to a professional to receive the help they so desperately need.

If in the past it was difficult to talk about mental health as an adult, the situation for children and adolescents was even more complicated. Until not long ago, children were considered second-class people, without the right to complain or give their opinion like adults. This has been determined, among other things, by the myth of the happy childhood.

This alludes to the widespread belief that the first years of life are always happy and innocent, an idea that has deeply penetrated collective thinking. However, the reality is that emotional distress can appear at any time in life, including childhood. In other words, being a child does not guarantee feeling good, so minors also often need professional help.

The recognition of psychological problems in childhood has implied an increasing demand for professionals specialized in child and adolescent psychotherapy However, psychologists who work in this area work in a totally different way from those who focus on accompanying adult patients. This is because there are important differences between the two types of therapeutic processes, which we will comment on in this article.

How is psychotherapy different in children and adults?

Next, we are going to comment on some important differences between child and adult psychotherapy.

1. Participants in the therapeutic process

In therapeutic processes with adults, generally the professional will carry out their work only with the client who has requested the services. Occasionally, a family member who wishes to collaborate to help the patient may be included in a session, but it is not essential. In fact, many people prefer not to involve couples and family members in their processes because they do not want to worry them, because they have not told them that they are going to therapy or because they simply do not have a good relationship with them.

On the contrary, the therapeutic process with children and adolescents necessarily requires work on several different axes Essentially, the professional will have to include the parents or legal guardians in the treatment, since they are the ones who have responsibility for that minor. Furthermore, with minor patients an indirect intervention is often carried out, so that guidelines are provided to adults to modify possible problematic dynamics that harm that child or adolescent.

Added to this, it is also usually advisable to have the collaboration of the school, since the patient spends many hours a day in this space. Thus, frequent contact with the school counselor is common for a child and adolescent therapist. In this way, the intervention to help the patient is coordinated taking into account all the important areas in which he or she develops.

2. Decision to go to therapy

When an adult goes to therapy, they always do so of their own free will. It is possible that his decision may have been influenced by the opinion of third parties, but he is the one who has the last word. However, this is not at all the case when we talk about children and adolescents. When the patient is a minor, he always goes to therapy because his parents have decided so. If his parents are not satisfied, he will hardly be able to see a professional.

In fact, child and adolescent therapists must have a thorough knowledge of the legal nuances and everything surrounding adult consent. When the parents are separated, it is important to keep in mind that both will have to express their agreement in writing unless one of them is deprived of parental authority for some reason

The fact that a child or adolescent goes to a consultation without this being their decision implies that the professional will have to work to form a good therapeutic bond with them. Although there are those who go to the psychologist without problems, others may present themselves at the first session with a lot of rejection. The therapist will have to achieve a comfortable and trustworthy atmosphere, so that the patient feels in tune with him. Although difficulties in bonding may also arise with adults, the reality is that with them you at least have the certainty that they are in the consultation because they want to.

3. Game versus words

Therapy with children and adolescents should be based on dynamics of play, movement and symbolism. On the other hand, with adults, words are usually used as a central element, so that the sessions take the form of a conversation. Child and adolescent therapists should always have their office full of dolls, games and open spaces that allow them to move, play, have fun and connect.

Treating a child as if he were a miniature adult is a guarantee of failure, since his reasoning is not abstract like that of an older person The little ones have concrete reasoning, which focuses on the tangible and the particular. Especially before the age of 7, they may have difficulty making inferences and keeping their attention focused on something for a long period of time.

Their thinking can mix fantasy with reality, in addition to having an egocentric aspect in early childhood. It is not until the age of twelve that more abstract forms of reasoning begin to take shape. Knowing these particularities is necessary for the therapist to learn to deal with child patients. The way of working with the little ones is therefore totally different from adult therapy.

4. Particularities of the evolutionary moment

As we mentioned in the introduction to this article, just a few years ago children were considered miniature adults. However, nothing could be further from the truth. Problems that are out of the ordinary in an adult can be perfectly natural in childhood or adolescence, so it is key for the professional to have knowledge of evolutionary psychology.

To understand this point we will give an example. An adult may be afraid of being alone or meeting new people It is a fear that prevents her from living her life normally and causes her a lot of suffering, since she is expected to be independent and capable of maintaining normal interactions with different people.

However, fear of strangers and separation anxiety are natural reactions in babies and children up to three years of age. These evolutionary fears are not accidental, but constitute survival mechanisms that favor the proximity of human offspring to their caregivers. As you can see, the same fear is a cause of problems in an adult, while in a small child it is an indicator that development is following a normal course.

5. Reason for consultation

The reason for consultation is something like the main reason that led the patient to ask for help. With adult patients, it is possible that one problem is emphasized initially and, as therapy progresses, deeper issues are discovered. In the case of children and adolescents, the reason for consultation should be asked to their parents and to them separately. This is important because, sometimes, there is no congruence between what each person says.

This is because parents are great experts at identifying problems in externalizing behavior, that is, what others can see. However, adults are often oblivious to internalizing symptoms, that is, those that belong to the child’s internal world and are not always evident to others Therefore, interviews with both parties will allow the information to be compared and better understand what the real demand is.

In this article we have talked about some differences between child and adult therapy. Just a few years ago, children were considered miniature adults. Furthermore, they were expected to be naturally happy, since childhood has always been associated with innocence and carefreeness. However, the reality is that children and adolescents also have problems and have the right to suffer like adults. Beginning to recognize their discomfort has led to a growing demand for psychology professionals specialized in childhood and adolescence.

However, the development of therapy with both types of populations is radically different. Doing therapy with the little ones involves building an interaction based on play, symbols, movement, drawing, etc. On the other hand, with adults the focus is usually on the word, so that the sessions flow apparently like a conversation. It is also important to keep in mind that in child-adolescent therapy, parents and the school must be involved, since these axes are part of the child’s life Furthermore, children are not the ones who decide whether or not to attend the session, which can make it difficult for them to motivate and bond with the professional at the beginning.