Hopscotch Blog

Anxiety seems pretty unavoidable these days—whether you’re a parent or a child, you’re probably experiencing it at least every once in a while. But what’s the difference for children, in particular, between run-of-the-mill anxiety and we-should-see-a-therapist anxiety? It’s a tough question to answer—especially knowing how prevalent anxiety is now: it is one of the most commonly diagnosed mental disorders in children, affecting around 9% to 10% of children, according to the Centers for Disease Control and Prevention (CDC).

Therapy is often considered to be the most effective way to treat anxiety in children. However, traditional in-person therapy may not always be accessible or feasible, or even the best choice for your child. Fortunately, online therapy for anxiety can offer the same benefits as in-person therapy, while removing many of the barriers that can prevent parents and children from receiving the help they need. Many parents actually find that online therapy works better for their child.

We spoke with Sheryl Ziegler, Psy.D., a licensed clinical psychologist and founder and managing director of The Child & Family Therapy Center at Lowry, to get her insights into how to know if your child needs therapy, the benefits of online therapy for anxiety, and how to find a child therapist who specializes in anxiety. 

How to know if my child needs therapy for anxiety?

Everyone deals with some feelings of worry or anxiousness from time to time. But when these feelings begin to affect your child’s everyday life, it may be time to get professional help.

According to Dr. Ziegler, common signs that it's time to look into therapy for your child's anxiety include:

• Bedwetting, nightmares, and difficulty around falling asleep and staying asleep
• Frequent temper tantrums, outbursts, and difficulty being calmed or soothed
• Separation anxiety, clinginess, and tearful goodbyes
• Excessive worry and fears as compared to other children of the same age
• Asking for help or saying that there is something wrong with their brain

However, she adds that all children with anxiety can benefit from therapy.

How to find a child anxiety therapist

When searching for a child anxiety therapist, it’s important to consider the type of therapy that your child may need. "Children aged eight years and younger should be in play therapy, while children aged nine and older can benefit from cognitive behavioral therapy (CBT) for anxiety," explains Dr. Ziegler.

When searching for a therapist, consider reaching out to the following people for recommendations:

• Your child's pediatrician or primary medical doctor
• Close family and friends
• You child's school's guidance counselor
• Local parenting groups

You can also find licensed therapists online at Hopscotch, which offers online and in-person therapy sessions covered by most insurance plans. This means no long waiting periods or complicated payment plans to get your child the specific treatment they need for their anxiety. Simply enter your location and insurance or payment type to see the available therapists for children and teens.

“No matter which route you choose, keep in mind that therapy is all about fit, so if one person isn’t the right connection for your child, keep looking,” advises Dr. Ziegler. 

Benefits of online therapy for anxiety

Therapy can be an important tool to help children learn to manage their anxiety. Not only can it help uncover and address the underlying cause of your child’s anxiety, but it can also provide them with coping strategies and tools for managing these thoughts and feelings in a healthy way.

For children with anxiety, online therapy is often a more effective option than traditional in-person therapy for many reasons.

According to Dr. Ziegler, some benefits of online therapy for anxiety include:

• Accessibility: Online therapy reduces barriers to treatment such as after school schedules, distance, and transportation.
• Convenience: Online sessions just require a computer or phone, along with Wi-Fi or internet connection. Sessions can be done from anywhere, including a car, making it extremely convenient for both the parents and the child. Parents can also come in and out as needed while tending to other kids or work.
• Less intimidating: Some children are more comfortable doing online therapy than in-person therapy. These children are able to open up more easily from the comfort and privacy of their own home. They can even surround themselves with whatever makes them feel the most comfortable, such as stuffed animals or a certain blanket.
• More connection topics: Home-based sessions allow the therapist to use the child's home as a way to connect, like seeing their family pet, bedroom, and favorite toys. This can make the child feel more comfortable and give them an opportunity to connect with the therapist on a deeper level.
• Flexibility: Online therapy allows for more flexible hours and location. It also removes sickness as a barrier, making it easier to schedule and keep appointments. And we know how important this is for parents juggling so many things at all times.

What should you expect during online therapy sessions?

Initial online therapy sessions for children with anxiety are usually spent breaking the ice and getting to know each other. This is also a time to start building some trust between one another. In some cases, the therapist may be able to identify where the child wants some support from the initial session. However, this can sometimes take two to three video sessions, Dr. Ziegler explains. 

At the end of each session, there is usually a discussion of what the therapist and child will work on in the coming weeks. This may include strategies for calming down during difficult times, or some type of role-playing that the child and therapist can practice.

It's important to remember that managing anxiety is a process and it does not happen overnight. However, with the help of online therapy, you can provide your child with the support they need to work through their anxious thoughts and learn how to better manage them.

Additional resources

• Data and Statistics on Children’s Mental Health, Centers for Disease Control and Prevention

If your child is struggling with anxiety, they aren’t alone—although it can certainly feel isolating at times. In fact, anxiety is one of the most commonly diagnosed mental health disorders in children, affecting an estimated 9.4% of children aged 3 to 17 years old. 

Parents often feel helpless when trying to help their children manage anxiety, but there are natural options available that can be beneficial for the whole family. And with the right strategies and support, you can help ease your child's anxiety in a safe and healthy way.

To get insight into expert-approved options for child anxiety treatment at home, we spoke with Michelle Rigg, LCSW, RPT, the Director of Community at Hopscotch. Read on for her top tips for natural anxiety relief for kids, as well as when it may be time to seek professional help from a therapist.

Expert tips for natural anxiety relief for kids 

When addressing your child’s anxiety at home, the first step is to create an environment of understanding and empathy. It’s important that you make sure they know they are not being judged or criticized.

Once your child feels comfortable and secure, you can begin to focus on building effective coping skills to help manage the anxiety. Rigg recommends starting with a biological assessment to ensure your child is getting enough sleep, staying hydrated, consuming a healthy diet, and staying physically active.

Aside from the basics, Rigg suggests a few specific tips for managing anxiety in children. These include:

1. Manage social media, television, and game usage. Pay attention to how much and what type of screen time your child is engaging in. Research suggests that excessive screen time could be associated with an increased risk for anxiety.
2. Externalize the worry. Help your child understand and express their anxious feelings by giving the emotion a physical presence, like a balloon or monster. By externalizing it, they can talk about it in third-person and take away some of the power of the feeling.
3. Avoid reassurance. While it’s natural to want to offer reassurance, this can actually reinforce the anxious thoughts and make them worse. Instead, encourage your child to problem-solve or come up with alternative solutions that don’t involve reassurance. 
4. Avoid getting caught up in the "content" of the worry. In other words, don't try to address the worry itself. Instead, focus on helping your child learn how to process and manage worries when they come.
5. Practice mindfulness. Make time for mindfulness activities, such as yoga or meditation. There are plenty of kid-friendly apps and online resources available to help get started.
6. Take deep breaths. Deep breathing is one of the most effective tools to help manage anxiety. Taking slow, deep breaths helps to signal the body that everything is okay and can help reduce feelings of stress or anxiety.

Rigg adds that anxious children often have anxious parents. So although it's common for parents to focus on their child, it can be helpful to remember that your child will take cues from you. Showing your child how to self-regulate through deep breathing and mindfulness will help them learn more effective coping strategies.

When to talk to a therapist

While focusing on learning healthy relief and coping techniques will go a long way in helping to manage your child’s anxiety, there are times when seeking professional help is necessary.

Rigg says it may be time to talk to a therapist if you and your child are experience any of the following:

• Lack of improvement, despite putting forth the effort 
• Negative effects on multiple areas of life (eating, sleep, school, social) or one in a really big way
• Lack of enjoyment in activities once found pleasurable, such as sleepovers or sports
• Child tells you they need help
• Extreme clinginess 
• Suicidal thoughts
• Panic attacks
• Negative impact on child-parent relationship
• Refusal or meltdowns at bedtime or school
• Over-reactions to transitions or last-minute changes
• Interference with a parent's ability to work, provide attention to the rest of the family, etc…

While therapy may feel a little intimidating at first, it can be a beneficial addition to your child's anxiety treatment. An experienced therapist can work with your child to develop effective techniques and coping skills they can use at home. They will also provide insight into the root causes of their anxiety and help them learn to manage it in a healthy way. 

The bottom line

Anxiety can be difficult to manage, especially for children who are likely still learning how to express their regular day-to-day emotions. Fortunately, there are steps that you can take to help put your child at ease.

If you feel like your child needs more help than what you are able to give, don't hesitate to seek out a professional therapist who can provide additional support. In many cases, at-home coping mechanisms and therapy can work alongside each other to provide an effective way to calm your child's anxiety. 

And no matter how difficult it may be, remember that with the right strategies and support, you can help your child learn techniques for managing their anxiety that they can carry with them throughout their entire life.

Additional Resources:

Data and statistics on children’s mental health, Centers for Disease Control and PreventionAssociations between screen time and lower psychological well-being among children and adolescents: Evidence from a population-based study. National Center for Biotechnology InformationHow to calm anxiety in kids, Lynn Lyons

Separation anxiety is normal in young children, but as parents, that doesn't make it any easier to drop your child off at school. And unfortunately, the pandemic has only increased the number of children struggling with these feelings.

Although most children will eventually outgrow separation anxiety, there are many things you can do to ease your child's fear and make dropping them off at school easier.

To better understand how to help kids with separation anxiety, Hannah Slattery, LPC, NCC, a Hopscotch educator and licensed professional counselor shares the signs of separation anxiety, as well as eight expert tips for helping your child work through their separation anxiety surrounding school.

What is separation anxiety?

It's common for young children, especially those aged 18 months to 3 years, to feel some worry, fear, and anxiety when separated from their parents or caregivers. But when those feelings become more intense and interfere with daily activities, such as sleeping, it could be an indication of separation anxiety disorder (SAD). SAD is a mental health condition that causes severe distress and fear when separated from their loved ones. 

What are the signs a child may have separation anxiety at school?

According to Slattery, separation anxiety can manifest in physical and emotional responses, such as:

• Clinginess
• Frequent crying
• Refusal to go to school
• Trouble sleeping on school nights
• Stomach aches or headaches
• Difficulty concentrating while at school
• Tearful goodbyes
• Tantrums
• Difficulty adjusting

Tips for how to help a child with separation anxiety at school

Slattery shares 8 tips for helping your child with separation anxiety at school.

Be empathetic.

If your child tells you that their stomach hurts or they are worried about leaving you, it's important that you believe them. "Empathy is key in connecting with your child and also allowing your child to feel heard. This doesn't mean you can’t go anywhere without your child, but just giving a few moments of your time to hear and acknowledge them will help build the relationship," says Slattery.

Manage your own emotions.

"As a parent, you need to be able to manage your own emotions so that when your child starts to throw a tantrum or scream when attempting to separate you don't lose your cool," she explains. Remember to stay calm and consistent, so that your child can learn what to expect from you.

Prepare ahead of time.

When it nears time to return to school, it's important to prepare your child for the separation. Talking about school with your child, and even practicing the drive and walk up to the school can help them feel more comfortable. You can also practice the goodbye ritual so it will become less anxiety-provoking.

When school is back in session, Slattery advises that you start to prepare your child for the separation during the drive to school. Walking with them to the door can also help them feel more secure—even if you don't walk all the way inside. As your child starts to feel more comfortable, slowly begin to part ways with them sooner, so eventually they are able to walk to the door on their own.

Provide a comfort item.

Allow your child to take their favorite comfort item to school with them. This may be a stuffed animal, a blanket, or anything else that helps comfort and calm them. But make sure you communicate with your child's teacher and inform them that your child brought an item from home, as some schools may have policies against this.

Explore additional resources.

There are so many resources for children—and parents—struggling with separation anxiety. Check out your local library or online for books or videos that can help prepare your child to make the leap back to school, or to school for the first time.

Work with a school representative.

Looping in a school representative that the child feels comfortable with can be an excellent way to help your child adapt and work through their separation anxiety. Many schools have a school counselor or social worker that would be willing to work with you to develop a plan that encourages your child to build anxiety management skills, says Slattery.

You can also talk to your child’s teacher or another school representative and plan for them to meet you at the school doors during drop off. Immediately going to another trusted adult may help ease some anxiety around you leaving. 

Consider therapy.

Therapy is a great way to help your child develop coping skills for social anxiety. A therapist can also provide tangible tools for parents and teachers to use with the child at home or school, such as breathing exercises or relaxation techniques. Keep your teacher informed of any tools your child is learning, so they can work on incorporating them throughout the school day.

Online therapy through a platform like Hopscotch can be effective in helping children feel more comfortable and less anxious than in traditional in-person therapy sessions, while still working through their social anxiety.

Be consistent and follow through.

When the time comes to say goodbye at school drop-off, know that it's okay to leave your child, even if they are still crying, says Slattery. In time, they will begin to understand that they are safe at school and that you will always come back for them. Consistency will help speed this process along, although as parents, it can be difficult to leave when all you want to do is stay and comfort your child. 

The takeaway

Anxiety affects children of all ages, and as a parent it can be difficult to manage. Fortunately, there are ways to improve separation anxiety and help your child feel more comfortable and secure during school.

Additional resources

• Separation Anxiety: Going Back To School During The Pandemic, Anxiety & Depression Association of America
• Separation Anxiety Disorder in Children, Stanford Medicine

Does my child need therapy? How do I find a child therapist? What are the questions to ask a therapist? If you find yourself asking these questions, you are in the right place.

The search for a child mental health care professional can feel daunting and confusing for many caregivers. That’s why we are here. At Hopscotch, we know that caregivers want what is best for their child, and we believe that finding a therapist who has the specific qualifications necessary to help your child should be easy. If you are a caregiver searching for a child or teen mental health professional, here is a complete, seven-step overview for how to find the therapist your child needs.

Step 1: Determine if your child needs therapy.

It is normal for children and especially teens to feel sad, anxious, or stressed intermittently. Bouts of anger, nervousness, or irritability caused by school or family life are part of growing up. But as a parent, how do you know if your child’s struggles are typical or something more serious? And when should you find a therapist for your child?

There are many symptoms that signal a child may need professional mental health support, but here are some primary indicators that finding a child therapist may absolutely be beneficial:

• Major changes in sleep, appetite, or relationships.
• Sudden loss of interest in activities or friendships they used to enjoy.
• More angry, sad, or anxious days then neutral or happy days.
• Expressing thoughts of self-harm or suicide. (Even if it is in a joking manner, verbalizations of thoughts about self-harm or suicide must be taken very seriously.)
• Prolonged increase in regressive behaviors such as frequent bedwetting, toddler/child aggression, tantrums, or immature ways of talking.
• Intense inability to concentrate, focus, make decisions, or remember instructions.

Step 2: Identify your child’s specific needs and the particular type of therapy they will require.

Once you have discerned that your child could benefit from professional mental health support, the next step for parents is to educate themselves about the different types of therapy and types of therapists that exist. In many cases, the age and specific need of your child/adolescent will determine what types of therapeutic methods or clinicians may be needed.

Step 3: Learn the ins and outs of your healthcare coverage.

There is a preconception that mental health treatment is expensive, and while this certainly can be the case, it is not always true. We recommend caregivers take the time to learn the ins and outs of their healthcare coverage, because many factors can impact therapy costs substantially, especially if there are school or government benefits available.

A great place to start is to simply call your insurance provider directly and ask what types of services are covered vs. not covered. Taking some time to become an expert in the premiums, copays, and deductible costs for in-network and out-of-network benefits will arm you with the information necessary to make your child’s mental healthcare manageable and sustainable. At Hopscotch, we work with major national insurance carriers, so that your child can see a provider who is in your network. Our customer support team is here to help you navigate the insurance coverage process.

Step 4: Research your child provider options.

There are several ways you can go about searching for a child or teen therapist: You can search through your insurance company’s network. You can ask your pediatrician or school counselor or a trusted friend for a recommendation. You can search on local community or online parenting groups. And you can search a provider network like Hopscotch. We take your location and concerns about your child into account to suggest a number of therapists who would be a good match. Browse our child therapist directory here and begin creating a list of options.

Once you have a list of child therapists you think may be a good match for your child’s behavioral needs, it’s time to determine fit. Here are 14 great questions to ask a child therapist before scheduling an initial consultation with them:

14 Questions to Ask a Potential Child Therapist 

1. What current openings are available? Is there a waiting list? If so, how long is the wait? 
2. Please confirm that you accept __________ (name) insurance?
3. Do you charge any additional service fees, testing costs, or copays?
4. What is the billing cadence? (At Hopscotch we handle all billing.) 
5. What certifications, qualifications, experience, licenses, or training do you have?
6. Do you have a list of services/programs you offer?
7. Are there any services/programs you do NOT offer? (IE: Medication, family/group therapy, etc.)
8. How many years of experience do you have treating this issue/topic?
9. Do you provide accommodations for children/adolescents who require extra support such as _____________ (state your child’s specific needs)?
10. Does your program have any unique features, benefits, products, or utilities?
11. What is the cadence for progress updates? Are progress updates given in-person, in writing, or over the phone? 
12. Would you be willing to provide two current or former client references?
13. What is your expectation for parental involvement? 
14. How do you approach diagnosis and treatment planning?

Step 6: Look out for red flags.

Hopscotch’s therapists are all carefully vetted - we complete background checks, interview them, verify their license and education and approve them through an internal credentialing committee. But as a general rule, it is always best for parents to exercise a degree of caution when seeking a child therapist. Here are five common red flags to be wary of:

1. Lack of appropriate licensure – Be mindful of false marketing of qualifications. 
2. Violating boundaries and/or confidentiality in treatment – Boundaries and confidentiality must be honored and respected by therapists at ALL times. 
3. Ineffective communication skills – The mark of an effective therapist is that they are a superb communicator. 
4. Excessive oversharing or self-disclosure – Sharing a certain amount of personal information may occasionally be appropriate, but if the therapist is relying heavily on their own personal, non-professional experiences, then this is ultimately detrimental. 
5. Tardiness – Therapists are accountable for consistently starting/stopping sessions on time. 

Step 7: Select a provider and book your first appointment.

By this step, you will have the information necessary to make an informed decision and schedule either a consultation (Hopscotch offers free 15 minute calls with our providers) or schedule your first appointment. All that is left to do is to prepare your child/adolescent for what therapy will be like before their first appointment. 

Keep learning about child therapy

• The top 4 types of child therapists
• How to talk to your child about therapy
• How child therapy works: what parents need to know
• How to determine the type of therapy your child needs

Once you begin noticing signs that your child may have anxiety, it's important to talk to them and help them understand what anxiety is, as well as how to manage their feelings in a healthy way. Unfortunately, explaining anxiety to kids isn't always easy. In fact, it can be quite difficult and daunting at times—especially when it comes to younger children.

Hopscotch’s Head of Clinical Programming  Andrew Jatau, MS, LPC, a licensed professional counselor, offers his expert advice on how to explain anxiety to a child.

What is anxiety?

Anxiety is an emotion that makes us feel scared, overwhelmed, or worried. While it's normal to have some worries and fears in life, when these feelings become so strong that they start to interfere with everyday life, it may be considered an anxiety disorder. And unfortunately, children can experience these feelings just like adults.

"There are a lot of resources that can provide parents with a basic understanding of anxiety. It's helpful to be knowledgeable because it makes you more mindful of how you interact and intervene when your child is experiencing anxiety," explains Jatau.

And in most cases, he finds that children are typically able to understand the concept of anxiety when it’s explained to them in a developmentally appropriate way. “It’s all about putting in the time and effort to figure out how to explain it in a way that your child will understand,” he shares.

Signs and Symptoms of anxiety

"Make sure you have a full understanding of the symptoms of anxiety and which ones your child may be exhibiting. Observe and understand first before making an attempt to intervene," says Jatau. But keep in mind, anxiety can present itself differently from child to child. 

According the Jatau, common signs and symptoms of anxiety include:

• Difficulty falling and staying asleep, or nightmares
• Difficulty concentrating due to the overwhelm of thoughts and worries
• Physical complains, such as stomach aches or headaches
• Fidgeting or restlessness
• Avoidance or refusal to engage in certain activities or be around a certain group of people
• Clingy behavior around parents 
• Increased irritability or anger, which can lead to tantrums

How to explain anxiety to a child

So now that we’ve established what anxiety is and common symptoms, here are 8 expert tips for explaining anxiety to kids.

Address the conversation in an age-appropriate manner.

When approaching the conversation of anxiety, Jatau first suggests tailoring the conversation based on where your child is developmentally. Young children will struggle to understand these big feelings in the same way an older child would be able to. Take this into consideration and explain it in a way that they can understand.

For example, young children tend to be imaginative and creative. Jatau says, "You can create an imaginary character to embody their anxious thoughts,” he explains “Externalizing anxiety separates these thoughts from your child and makes it easier for them to confront. For example, 'Is Myra making you feel worried again? What should we tell her to make her go away?'" 

Older children will likely respond better to a conversation, without the use of characters, says Jatau. Explain to them that anxiety is an emotion, like how they may feel happy or sad, but it’s a feeling that can become extremely overwhelming at times. 

Consider your relationship with the child. 

Before you address the topic, take a look at your relationship with your child. It’s important to understand how a child processes information, how comfortable they are in discussing tough topics, and how to make sure that your words are understood. 

Start by asking open-ended questions about how they feel and what kind of things make them worry or scared, Jatau advises. Ask how they would like you to help them when they start feeling this way.

Consider the timing. 

Choose the right time to start the conversation: "You want to make sure that you are approaching them in a moment when they are not experiencing anxiety and are feeling relaxed and willing to engage," says Jatau. This will help them open up more quickly and be more open to the conversation.

Address specific observations. 

“You can start by leaning on the observations that you’ve made, and bringing up a particular symptom or behavior that you might have noticed,” says Jatau. For example ‘Hey, I’ve noticed that sometimes your stomach starts to hurt right before your soccer game’ or ‘It looks like you don’t look forward to going to school in the mornings’.. 

Allow them time to share. 

Talk openly and honestly with your child. "Allow them to share their thoughts and feelings about your observations and continue to ask questions and respond to them in a non-judgmental manner," says Jatau. 

Keeping the lines of communication open will help you better understand how they are feeling, what their triggers are, how to best support them, and how to move forward in managing anxiety together. 

Focus on anxiety as a feeling.

“When speaking with your child, it is easier to focus on teaching and exploring anxiety as a feeling,” Jatau says. You can compare it to similar feelings that are easier to understand, such as worry or fear. 

Encourage them to explore their thought process. 

Encourage your child to explore their thought process when they start to feel anxious. Jatau advises asking questions like, “What are some of the things that you think about right before your soccer game? Which of these things make you feel more worried?” This can help show your child how their thoughts are connected to their feelings.

Normalize their feelings.

It’s important to let your child know that anxiety is normal. “By focusing on anxiety as a feeling, you have the opportunity to normalize their experience and share examples of times when you’ve experienced anxiety as well,” shares Jatau. 

How to help your child cope with anxiety

“Helping your child understand anxiety and recognize what’s going on in their head in moments when they feel anxious is a huge first step in helping them cope. When kids are able to identify the thoughts that are making them anxious, this empowers them to learn how to remove and replace those thoughts,” explains Jatau. 

Other techniques used to cope with anxiety may include: 

• Deep breathing and mindfulness
• Yoga or other physical activities
• A technique known as the “5 senses”
• Therapy with a licensed mental health professional. Find one through Hopscotch now. 

He adds, “At the end of the day, it’s important to know how anxiety is specifically impacting your child, while keeping in mind that not every coping skill may work for them. You want to continue to try new tools and interventions, and work collaboratively with your child to understand what really helps them cope and feel better. Always continue to check in with them and encourage them to come to you with any concerns they may have.

For more information on how to help your child ease their anxiety, check out our article on natural ways to help calm your child’s anxiety at home.

Additional resources

• Anxiety, American Psychological Association

When mental, emotional, or behavioral concerns affect your child’s ability to function optimally, child therapy can provide the developmental support needed. Depending on your child’s unique needs, certain types of child therapy may work better than others. As a caregiver, it can feel overwhelming to figure out which type is right, and chances are you have a ton of questions. At Hopscotch, we're here to answer all of them. Here, we outline the seven most common types of child therapy and how to determine which one is right for your child. 

One of the number one questions that caregivers have when they discern that their child needs some professional mental health support is: What type of therapy does my child need? 

Considering the various types of therapeutic methodologies out there, this question is an important one. Child psychology is one of the most nuanced fields in psychotherapy, so there are a lot of options available. In our experience, if you have a child age 5-17 who you suspect would benefit from some psychological or behavioral support, then chances are your child will likely benefit from one of these seven most common types of child therapy. 

1. Cognitive Behavioral Therapy (CBT)
2. Play Therapy (PT)
3. Art Therapy (AT)
4. Family Therapy (FT)
5. Parent-Child Interaction Therapy (PCIT)
6. Solution-Focused Therapy (SFT)
7. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

Note that while these seven therapy methodologies are some of the most common forms of child therapy in practice today, there are many other types of child therapy that certainly do exist. Hopscotch’s exclusive directory features qualified child therapists who are highly skilled in these seven therapy modalities along with many others, and you can browse our provider list here. 

The top 7 most common types of child therapy

1. Cognitive Behavioral Therapy (CBT)

What is Cognitive Behavioral Therapy?

Cognitive Behavioral Therapy (CBT) is one of the most popular methods of psychotherapy and focuses on how thoughts, feelings, and emotions affect behavior. CBT is a helpful methodology all by itself for managing a variety of symptoms (from stress to mental health disorders), and it can work alone or in combination with other forms of therapy. 

How does Cognitive Behavioral Therapy (CBT) work?

In a structured environment over a set number of sessions, CBT is designed to explore ways in which inaccurate or unhealthy thinking may be blocking optimal functioning. By replacing problematic thought patterns with more helpful ones, Cognitive Behavioral Therapy provides children and adolescents the opportunity to reframe unhelpful perspectives and process life’s challenges successfully. Ultimately, CBT helps children navigate challenging situations and emotions with clarity while developing positive self-concepts. Your child will play and engage in fun behavioral activities to improve their mood or anxiety, as well as develop their reasoning skills to understand the relationship between thoughts, feelings, and behaviors and “talk back” to negative thoughts.

2. Play Therapy (PT)

What is Play Therapy?

Play Therapy is a very common therapy methodology for children ages 3 to 12, however, there are benefits of Play Therapy for teenagers and adults as well. Because children typically lack the ability to communicate and process their own emotions using words, a child’s primary form of communication is play, and in a play therapy session, toys take on a symbolic meaning for psychotherapeutic interpretation and dialogue.

How does Play Therapy work?

Play is used in Play Therapy as an age-appropriate means to discover, process, and resolve psychological, emotional, or behavioral issues. The Play Therapist may want to observe the child play at first, or else, toys may be used to act out and resolve fears and/or to problem solve anxieties. How the play is facilitated in-session may vary based on the age and the unique needs of the child, as well as the theoretical approach of the therapist. However, it is worth briefly mentioning the four foundational stages of Play Therapy that typically evolve throughout the therapeutic relationship:

Stage 1 – The Exploratory Stage: A foundation of trust is established between the Play Therapist and the child.

Stage 2 – The Resistance State: A normal phase of therapy where the child is confronted with the difficult reality of unhelpful behaviors or thoughts.

Stage 3 – The Therapeutic Growth Stage: This is where the majority of the work takes place and where the child is empowered to achieve resolution for maladaptive behaviors.

Stage 4 – The Termination Stage: Once behavioral adaptation is sustained, a transition of separation away from the therapist begins.

3. Art Therapy

What is Art Therapy?

Art Therapy is based on the concept that creative expression can cultivate healing and inner growth. Art Therapy techniques allow for self-exploration and foster healthy coping skills for children struggling with anxiety, depression, self-esteem, Post-Traumatic Stress Disorder (PTSD), and a slew of other behavioral issues. By utilizing the creative process, Art Therapy allows participants to gain deeper self-awareness and post-traumatic growth through self-expression.

How does Art Therapy work?

Artistic methods have been used to treat psychological disorders and enhance mental well-being for thousands of years, but it became a formal therapeutic methodology in the 1940s. Medical professionals began noticing that mentally ill patients would often express themselves using art methods, which led many therapists to explore artistic methods as a healing strategy. 

Since then, art has proven its use as an effective therapeutic methodology and has been relied upon as a means of exploring complex thoughts and feelings. During an Art Therapy session, participants will be guided through exercises relying on a variety of therapeutic artistic practices including drawing, painting, sculpting, or other expressive forms of art such as music, dance/movement, and writing to explore complex thoughts and emotions. 

4. Family Therapy

What is Family Therapy?

Family Therapy is a highly specialized method of therapeutic treatment that is designed to support specific issues that impact the mental health and wellbeing of the entire family unit. Whether a family is going through a major change or transition, grieving the loss of a family member, endeavoring to support a family member coping with a physical illness or mental illness, or just trying to improve the quality of family interaction and communication, Family Therapy provides support for just about any need. Family Therapy is an excellent resource for any family that desires to reduce conflict, improve the quality of home life, and develop healthy communication techniques.

How does Family Therapy Work?

The goal of Family Therapy is to improve communication and family interaction quality by focusing on healthy communications strategies, boundaries, and conflict resolution. Rather than focusing on one individual or problem, Family Therapy works to identify patterns or systems within the overall family unit that would benefit from optimization so that strong family dynamics can flourish. Multiple family members generally need to participate in family therapy at different times, as opposed to just the therapist and the child or caregiver.

5. Parent-Child Interaction Therapy (PCIT)

What is Parent-Child Interaction Therapy (PCIT)?

Parent-Child Interaction Therapy is a method of behavior-based therapy that is designed to improve the parent-child relationship through therapist-coached interactions. Parent-Child Interaction Therapy is especially useful for children who have PTSD, children who have experienced abuse, and/or children who exhibit severe behavioral issues such as aggressive tantrums and destructive conduct.

How does PCIT work?

The ultimate goal of PCIT is for caregivers to help troubled or at-risk children transform unhelpful or disruptive behaviors into more beneficial and healthier behavior patterns. PCIT relies on a variety of techniques, namely positive reinforcement practices, and most PCIT programs typically feature two phases: (1) a relationship cultivation phase and (2) a discipline and compliance phase. 

In each phase, caregivers will have the opportunity to learn new parenting skills and techniques. During a standard Parent-Child Interaction Therapy session, the caregiver will interact with their child in a play environment while the therapist observes the interaction through a one-way mirror, all while providing live coaching to the caregiver through an ear bug device. Via telehealth, the observation would occur through the virtual platform and live coaching through headphones/earbuds connected to a computer/device. In this way, a child’s behavioral concerns can improve as the bond between caregiver and child is strengthened.

6. Solution-Focused Therapy (SFT)

What is Solution-Focused Therapy?

Solution-Focused Therapy is a form of talk therapy that offers a short-term, goal-oriented approach to treatment. Solution-Focused Therapy is an evidence-based approach, which means it has been clinically studied in a scientific setting and research concluded it was effective. Solution-Focused Therapy prioritizes creating a solution for a specific challenge over gaining self-awareness or internal insight regarding the issue. The discussion of a Solution-Focused Therapy session will focus on a specific problem, how the participant’s life would be if the current issue was resolved, and what would need to happen for that desired future to become a reality.

How does Solution-Focused Therapy work?

Solution-Focused Therapy is a form of short-term psychotherapy that works by strengthening participants with the cognitive tools necessary for creating the future they desire. Rather than exploring past experiences or working to discover the root cause or the “why” behind a current challenge, the goal of SFT is to cultivate already-existent strengths to improve harmful patterns, habits, or behaviors, manage difficult situations, and achieve future goals. The core principles of SFT rely on creative exploration and problem-solving to promote solutions that would bring about the participant’s desired outcome. Your child will need to be able to use their reasoning skills to understand the relationship between actions and consequences and engage verbally in problem-solving discussions with the therapist in SFT.

7. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

What is Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)?

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an evidence-based method of psychotherapeutic treatment that is designed to support children and adolescents who have experienced trauma. Whether the treatment is sought for a single traumatic event or for multiple, the goal of TF-CBT is to help children and teens learn more about the trauma process, develop adaptive coping strategies, progressively develop the ability to process their trauma, then heal from and overcome the effects of trauma. Because the emotional, relational, and psychological difficulties a child/adolescent may experience as a result of trauma may vary, the therapist will custom curate a TF-CBT session to meet the specific needs of the child/adolescent. TF-CBT is highly effective, and studies found that over 80% of traumatized children saw improvement within 16 sessions.

How does Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) work?

TF-CBT requires the child to be out of an ongoing traumatic environment or exposure. TF-CBT generally works in three phases: 1) stabilization (emotional, physical, and psychological), 2) trauma narration and processing, and 3) integration and consolidation. Throughout these three phases, TF-CBT will offer participants a safe space for navigating trauma and will also provide education about child trauma including trauma trigger management techniques, cognitive coping skills, and trauma narrative processing strategies.  

Still have questions?

At Hopscotch, we know that caregivers have lots of questions. We are here to help you navigate the world of child therapy and connect you to quality providers. Continue browsing our other helpful articles, search our provider directory, or contact us for more information.

Keep learning about child therapy

• How to find a child therapist
• How to talk to your child about therapy
• How child therapy works: what parents need to know
• The top 4 types of child therapists