School, daily, 7:00am to 4:00pm. Soccer, Tuesdays and Thursdays, 5:00pm to 7:00pm. Add on flute lessons, karate, time with friends. Eating, doing homework, and sleeping. That leaves Saturdays at 11:00am for therapy! Wait, why aren’t there teen therapists that work on Saturdays?
Am I allowed to say that kids (and their parents) these days are overscheduled? How did we all get so busy? On top of the hustle and bustle of life, we also have a generation of kids who are struggling with their mental health like nothing we have seen before.
There are some types of therapy (play therapy, or what I would call supportive counseling) that might be able to be scheduled one hour a week as just another activity. Go in, talk to the counselor, rinse, repeat. Go for a year and never see improvement.
As we talk about evidence-based treatment for mental health conditions, it is not that simple. If someone is truly suffering from a mental health condition to the point that they require therapy, that means their functioning at home, school, or in social situations is impaired. In this case, treatment needs to take priority over extracurriculars and, in some cases, over school.
In cognitive-behavioral therapy (CBT), “homework” is essential. Homework is not completing a worksheet, but, rather, practicing the therapy skills daily throughout the week. This is seen as more essential to treatment than the therapy session itself. Whether the child/teen or the parent is the focus of treatment, therapy will involve completing daily assignments and then reporting back on how they are going. Because of this, therapy is not an hour-a-week commitment. Outpatient therapy will likely require at least an additional hour of practice outside of session time.
Another thing to add: I cannot guarantee this is true for other child therapists, but in my practice, at least one parent is required to be present for each session. It is not a dropoff and parents are seen as essential to the process.
One thing to remember is that outpatient therapy is meant to help prevent escalation to a mental health condition so severe that it requires even more intensive treatment, such as hospitalization, residential treatment (living at a mental health facility), or intensive outpatient treatment (~15 hours per week). It is worth the investment in terms of time saved!
Therapy should end up saving you time in your daily life. Let’s say your child is having two 30-minute tantrums per day and you are involved in them. That’s an hour of your day taken up by this behavior. Those 2 hours a week of therapy attendance and practice will save you 5 hours a week in precious time.
Another example: A teenager with OCD is spending 4 hours per night doing rituals, staying up way past her bedtime and not being prepared for school the next day. Getting that time back is going to be so impactful!
Evidence-based therapy is generally short-term. Families might need to re-arrange their schedules for 4-6 months. If there is enough going on impacting the child/family, it will be worth the investment. If your child/teen’s concerns are not having much impact on their day-to-day life, then maybe therapy is not needed at all. In my opinion, you either jump in the deep end of the therapy pool, fully investing in the commitment, or you decide that now is not the right time for therapy.
I know it is more challenging than this sounds! Just the amount of homework and school pressure teens face these days is daunting. Then you add in these extracurriculars, which are much more “professional” than back in the day. You might also sprinkle in a little Atlanta traffic, if you’re in my area. But, if we have such a tight schedule that it is not possible to make changes, maybe that is a bigger problem than even the mental health concern.
Thoughts? Comment below!
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