You've done some soul searching and decided that your child or teen with a learning disability (LD) might benefit from therapy. But with so many options available, what's the best approach to take?For some kids, just having a supportive place to go where they can talk and feel understood and validated is helpful, says Dominick Auciello, PsyD, neuropsychologist with the Learning and Diagnostics Center at the Child Mind Institute in New York City. That's especially true for a kid who has taken a "beating" or been bullied due to his or her learning disability. "But good treatments, in general, combine both validation and strategies to help promote change," he says.
Common Types of Therapy for Kids
Understanding the source of the emotional difficulty is very important, says John T. Beetar, PhD, ABPP, director of Psychological Services for School Programs at the Kennedy Krieger Institute in Baltimore, MD. "If social skills are a problem area, for example, then attendance at group therapy focusing on social skills can be helpful," he says. Two other common approaches are solution-focused counseling and cognitive behavioral therapy.Social skills groups. These are common and many schools offer them says Rebecca S. Martinez, PhD, NCSP, associate professor of the School Psychology Program at Indiana University in Bloomington, IN. So start here first, she says. "This isn't therapy as we tend to think of it, but is still addressing the 'nonacademic' side of a child."
Social skills groups can help children learn how to take turns, initiate conversations, regulate their emotions, and make and keep friends. Seventy-five percent of kids with LD have social skills deficits, says Martinez.
Groups can also create a sense of camaraderie and belonging around others who are struggling with a similar challenge, says Auciello. "They've also been effective in helping overcome social anxiety." For a child with LD who is particularly introverted or anxious, Auciello recommends a smaller group of no more than three to five kids. A speech and language pathologist who has a good understanding of both social communication and language development might facilitate such a group, he says.
Where groups may fall short, says Auciello, is in not having a means of transferring skills learned in the group to everyday life. It can also be difficult to find a group that addresses a student's particular challenge and is also targeted to the right age range.
If a social skills group is not available, a school counselor or other therapist may use role-playing and modeling techniques to promote social skills and help overcome communication problems, says Beetar.
Solution-focused counseling. This type of counseling is a more practical approach than some types of therapy, says Martinez. Rather than prompting a child to focus on childhood dreams and expectations to get to the bottom of a rift with a classmate, she says, a solution-focused counselor might have a child focus simply on the interactions she's distraught about. What's working? What's not? How can you make this better?
"This is especially helpful as kids enter middle school when they are learning how to initiate conversations and ask for help when they don't understand things," says Martinez. "I'm not against private practitioners," she says, "just trying to save parents money and anguish. Sometimes parents go to the Yellow Pages, and find six or seven local practitioners with PhDs. But they may have very little experience working with children and less experience working with schools. Parents can shell out hundreds of dollars when the issue is simply, "I don't know how to make friends."
Cognitive-Behavioral Therapy. Also very practical and solution-oriented, Cognitive-Behavioral Therapy (CBT) focuses on looking at how your thoughts cause your feelings and your behaviors, says Martinez. "It really helps empower the person – whether child, teen, or adult – to make changes," she says. "The next day, you can implement something you've learned."
Auciello finds that CBT is a particularly effective approach for developing skills when anxiety is an issue. A type of behavior therapy called STOP and THINK can be helpful in cases where a child's impulsiveness is affecting learning. "It provides a good set of strategies to help kids slow down and not work too quickly," he says. It also can help socially in cases where kids tend to react to others too quickly. "It's very activity-based and game like," says Auciello. "But you practice it in the context of therapy and it tends to generalize to everyday life."
Tailoring the Therapy. Regardless of age, many of the same principles apply, but the skills taught need to be developmentally tailored, says Auciello. "If you need to help a kid become less impulsive, you may use the very same strategies to help them pause and think – you just might talk to them using a different vocabulary, depending upon age."
Or, with social skills intervention, therapy might help a younger child know how to play around other kids and interact more in their play. "With adolescence, it will be more about conversations and negotiating conflicts that might come up," says Auciello. "The social world is more complex in adolescence than in childhood."
Is It Helping?
"In the end, it is probably best to take your cues about counseling from your child," says Beetar. If your child doesn't want to attend sessions, and you don't see an obvious benefit, then it might be time to reconsider the therapist or the approach.You might want to look for another therapist, attempt rewards for participation, or temporarily abandon counseling, he says. "The right reinforcement or reward, though, can result in a significant amount of change in behavior."
But if it is not working out, parents often have a pretty good instinct about that, says Auciello. But first, make sure you've also had some interaction with the therapist. "Sending a child week after week probably isn't what's going to be most helpful." Then, if you have concerns about how treatment is going, bring it up with the therapist. Be honest. You might ask questions like these:
- I'm concerned and I'm not seeing the benefit – can we discuss this?
- The behavior seems to be getting worse. Can you explain why that might be happening?
- What are the goals of the therapy? In what direction are we going?
"You may feel the answers make sense or the person doesn't quite understand your child the way you thought they did, and it's time to move on," says Auciello. But, by all means, communicate to your child that it isn't their fault if things don't work out. Just don't give up. There are many resources available, and it is likely just a matter of time before you find an approach that benefits your child.
Annie Stuart is a freelance writer and editor with nearly 25 years of experience. She specializes in consumer health, parenting, and learning disabilities, among other areas.
Additional Resources
- American Academy of Child & Adolescent Psychiatry
- KidsHealth from Nemours: "Taking Your Child to a Therapist"
- National Association of School Psychologists
Annie Stuart is a freelance writer and editor with nearly 25 years of experience. She specializes in consumer health, parenting, and learning disabilities, among other areas.
