What Does It Mean to Be a Child & Adolescent Therapist?

When most people picture therapy, they imagine two adults sitting across from each other, talking. But working with children and adolescents looks entirely different — and that's exactly what makes it one of the most dynamic, creative, and rewarding areas of mental health care.

Being a child and adolescent therapist means constantly adapting. It means getting on their level, playing games, drawing pictures, and sometimes sitting in comfortable silence with a teenager who doesn't want to be there (yet). It means holding space not just for the young person in front of you, but for the whole family system around them.

Here's a closer look at what this work actually involves and some of the systems I use during my sessions.

It Starts with Building Rapport

Before any "real" therapy can happen, a young person needs to feel safe with you. And for children especially, safety is built through play, not words.

In early sessions, a therapist might introduce board games, card games, or art activities. Games create a low-pressure environment where a child can show you how they handle frustration, how they respond to losing, whether they follow rules, and how they relate to others, all without being asked a single direct question. It's information-gathering disguised as fun.

With adolescents, rapport-building often looks more like casual conversation. Asking about music, school, friendships, or what they're into before jumping into anything heavy. Teens are perceptive. I do my best to let them know that I'm not there to judge them or report everything back to their parents before they'll let you in. And it's important to remember that trust doesn't happen in a first session; and it doesn't need to.

What Is Play Therapy?

Play therapy is a structured, evidence-based therapeutic approach that uses play as the primary medium for communication and healing. Because children haven't yet developed the language or cognitive capacity to verbalize complex emotions, play becomes their language.

In play therapy, a child might use puppets to act out a conflict they've experienced at home, create a sandtray scene that mirrors their inner world, or paint something that they couldn't explain with words. The therapist doesn't simply observe — they engage, reflect, and gently guide the child toward insight and healing through the play itself.

Play therapy is particularly effective for trauma, anxiety, behavioural difficulties, grief, and transitions like divorce or a new sibling. It respects where the child is developmentally and meets them there, rather than expecting them to function like a miniature adult in a therapy room.

Adolescent Therapy: A Different Kind of Space

Working with teenagers requires a different approach altogether. Adolescents are in the middle of figuring out who they are: their identity, their values, their relationships. If you can think back to your teenage self, it can be a trying time. The last thing most of them want is to feel analyzed or patronized.

Effective adolescent therapy often blends structured talk therapy with creative tools like journaling, worksheets, or art. The therapist's role is less about directing and more about walking alongside. Many teens respond well when the therapist acknowledges that therapy can feel weird or uncomfortable — it normalizes the experience and lowers defenses.

Common focuses in adolescent therapy include managing anxiety and depression, navigating peer relationships and social pressure, processing family dynamics, identity development, and emotion regulation.

Therapeutic Interventions: DBT, Play Therapy, and More

Child and adolescent therapists draw from a range of evidence-based interventions depending on the young person's age, presentation, and needs.

DBT (Dialectical Behaviour Therapy) Skills for Kids is one of the most valuable toolkits in this work. Originally developed for adults with intense emotional dysregulation, DBT has been adapted beautifully for children and teens. Skills like TIPP (Temperature, Intense exercise, Paced breathing, Paired muscle relaxation) for managing overwhelming emotions, or DEAR MAN for communicating needs effectively, give young people concrete strategies they can use in real life: at school, at home, in conflict. DBT for youth is skills-based and often taught in fun, accessible language that children and teens actually connect with.

Cognitive Behavioural Therapy (CBT) helps young people notice the connection between thoughts, feelings, and behaviours. With children, this is often done through creative formats — thought bubbles, feeling wheels, and worksheets with characters they can relate to.

Somatic and body-based work is increasingly recognized as essential for children who carry stress and trauma in their bodies with techniques like breathing exercises, grounding, and movement woven into sessions.

No single approach is used in isolation. We will always practice these skills together in session to build confidence.

Parent Guidance Sessions: An Essential Part of the Work

Here's something that surprises many families: therapy for a child involves more than just the child.

Parent guidance sessions are a core component of child and adolescent therapy. These sessions recognize that parents and caregivers are the most powerful agents of change in a child's life. What happens in the fifty-five minutes of therapy each week matters far less than what happens in the other 10,000 minutes at home.

In parent guidance sessions, the therapist might share what they're working on with the child (in age-appropriate, confidential terms), offer psychoeducation about a child's developmental stage or diagnosis, and provide concrete strategies that parents can use at home to reinforce what's being learned in therapy. Topics might include how to respond to a meltdown without escalating it, how to talk to a child about anxiety, or how to hold consistent boundaries without damaging connection.

These sessions can also be a space for parents to process their own feelings, like feeling worried, guilt, exhaustion, that come with raising a child who is struggling. Because when a child is in pain, the whole family feels it.

Consent in the Netherlands: What Parents Need to Know

If you're in the Netherlands and considering therapy for your child, it's important to understand how consent works under Dutch law — specifically the Medical Treatment Agreement Act (WGBO).

Under 12: Parents or legal guardians give full consent on behalf of the child. The child is involved and heard as much as possible, but parents are the legal decision-makers.

Ages 12–15: This is a dual consent system. Both the child and the parents must consent to treatment. The child's voice carries real legal weight here, which means a child who genuinely does not want therapy cannot simply be brought in and treated. Equally, if a child clearly wants treatment but a parent refuses, exceptions can be made, particularly if withholding treatment would seriously harm the child's wellbeing.

Ages 16 and older: From the age of 16, young people are allowed to make their own decisions about treatment under Dutch law. Only the young person has the right to information and access to their patient record; if a parent wishes to view it, they need their child's permission. Parental consent is no longer legally required, though staying connected to the family is usually still encouraged where the young person agrees.

One important practical note: if you're working with children under 16, consent from both parents is mandatory before starting therapy. This means that in situations of separated or divorced parents, both parents with parental authority typically need to be on board, something worth clarifying before a first session.

A Few Things Worth Remembering

Child and adolescent therapy is slow, relational work. Progress often isn't linear, and it rarely looks the way parents expect. A child might seem to get "worse" before they get better — because the therapy room is giving them permission to finally feel things they've been suppressing.

It also takes a village. The therapist is one part of a network that includes parents, teachers, and sometimes other professionals. The most effective child therapy happens when everyone is working together, communicating openly, and putting the young person's wellbeing at the center.

And above all, starting early matters. Children who learn emotional regulation, communication, and coping skills young carry those tools for life. There is no age too early to invest in a child's mental health.

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Questions about whether therapy might be right for your child or teenager? Feel free to reach out — every family's situation is unique, and finding the right fit is always the first step.