Hopscotch Blog

As a parent, you might be wondering: “How many types of child therapists are there, anyways?” The answer is…a lot. Understanding the different types of child therapists out there can be a bit overwhelming. (Seriously… Why so many abbreviations? LCSW, LISW, LPC, LPCC, LMHC… the list goes on.) At Hopscotch, we know how exhausting it can be to find the exact therapist your child needs. There are just so many questions, namely: Who helps with what? And, (most importantly) which type of therapist does my child need?

Having foundational knowledge of the different types of pediatric behavioral therapists available can help bring you one step closer to securing the support your child needs. In general, a child therapist needs to be fully licensed to practice (not an intern of provisionally licensed therapist) in most states in order to bill insurance. If you have a child under the age of 18 who you suspect would benefit from some psychological or behavioral support, then chances are you will need to find one of these four types of child therapists. 

Pro-Parent Tip: As you explore options, you’ll probably come across the credential, PsyD, which is different than the PhD. A PhD in Psychology is a doctorate degree in Psychology, which can be focused on clinical work with patients, scientific research, or other areas. A PsyD stands for Doctor of Psychology and is a more hands-on approach program of psychological study designed for students on a direct path towards practicing psychology in a clinical setting. Someone with a PsyD or PhD in psychology is considered a Doctor in the same way that anyone with a doctoral-level degree holds the title of Doctor. However, because neither a PsyD or a Psychology PhD is considered a “medical doctor,” generally neither can prescribe medication or conduct medical treatments. 

Who can prescribe psychiatric medication? Generally, only a doctor, such as a pediatrician or a child and adolescent psychiatrist, or Licensed Psychiatric Nurse Practitioner (LPNP) can make professional recommendations on a particular medication and/or prescribe medication. Note that some of these mental health professionals are prescribers only and refer out for counseling services for their clients to places like Hopscotch!

The top 4 most common types of child and adolescent mental health providers 

1. Licensed Professional Counselor (LPC) 

What is an LPC and what do they do?

A Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC), and Licensed Mental Health Counselor (LMHC) are all different titles for the same thing. They are qualified for diagnosing and treating mental and emotional disorders including addictive disorders and can treat a host of psychological and behavioral problems. LPCs are often specialized and may focus on various topics or niches within the mental health industry such as child counseling, play therapy, substance abuse counseling, eating disorder counseling, or general family counseling.

Credentials to look for: Licensed Professional Counselor training & requirements  

• Graduate Degree in counseling program accredited by the CACREP
• Post-graduate supervised clinical work experience (state requirements vary)
• State License (State requirements vary, but it typically requires passing either the National Counselor Examination (NCE) or the National Clinical Mental Health Counselor Examination (NCMHCE). Also note that renewal requirements vary by state, so it is good to confirm the “active” status of a license.)

2. Licensed Clinical Social Worker (LCSW)

What does a Licensed Clinical Social Worker do?

A Licensed Clinical Social Worker (LCSW) may also be called a Licensed Independent Social Worker (LISW), and their range of expertise is generally broader than the services provided by an LPC.  LCSWs are professionals who are trained in the same counseling methodologies that an LPC is, however, the way in which a LCSW will apply psychotherapeutic methods goes far beyond the structured environment of a clinic. Whereas an LPC uses psychotherapy methods to help an individual or family overcome a specific behavioral or mental health challenge, LCSWs are trained to make assessments based on social, economic, and environmental influences that impact the mental and physical wellbeing of their clients. 

Because the support and resources that an LCSW offers is often supplied through government agencies, community agencies, or non-profits, LCSWs are able to go beyond the purview of counseling to provide a wider range of mental health, psychological, and psychiatric support. Specifically, LCSWs are trained to help individuals and families secure social services such as welfare, government assistance programs, government healthcare accommodations, and other related resources that generally don't fall into the category of mental health counseling. 

Credentials to look for: Licensed Clinical Social Worker training & requirements 

In addition to psychotherapy training, Licensed Clinical Social Workers are required to be proficient in topics pertaining to social policy, social justice, and social services administration – topics typically not covered in general counseling programs. Other requirements and credentials to look out for include:

• Graduate Degree in Social Work
• Post-graduate supervised clinical work experience (state requirements vary)
• State license (requirements vary by state, but they typically require passing the applicable board-certified Social Work Examination. Also note that renewal requirements vary by state, so it is good to confirm the “active” status of a license.)

3. Licensed Marriage and Family Therapist (LMFT)

What does a Marriage and Family Therapist do?

In marriage and/or family therapy, treatment is not focused on one specific person, but rather the relational dynamics of the family or relational unit as a whole. Marriage and Family therapy is generally more short-term than individual psychotherapy treatment, and session format is typically very solution focused. Marriage and Family Therapists (MFTs) are trained to improve family communication and interaction quality, and they are able to treat a wide range of concerns including depression, family dysfunction, marital distress, relational conflict, addiction, family grief coping, family transition adjustments, etc. 

Credentials to look for: Marriage and Family Therapist training & requirements

LMFTs are Licensed Marriage and Family Therapists who have specialized in psychotherapy and emotional disorders pertaining to marriage, couples, and family systems. Other training credentials include:

• Graduate Degree in Counseling
• Post-graduate supervised clinical work experience (state requirements vary)
• State license (Requirements vary by state, but they typically require passing the National Examination for Marriage and Family Therapists administered by the Association of Marital and Family Therapy Regulatory Boards. Again, note that renewal requirements vary by state, so it is good to confirm the “active” status of a license.)

4. Licensed Creative Arts Therapist (LCAT)

What does a Licensed Creative Arts Therapist (LCAT) do?

A Licensed Creative Arts Therapist (LCAT) goes beyond the limitations of talk therapy and uses the arts to cultivate self-awareness and facilitate the development of coping skills. An LCAT will rely on a variety of therapeutic art methodologies including drawing, painting, sculpting, and photography, however other expressive forms of art such as music, dance/movement, and writing may also be used. Through the creative process, LCATs help patients explore complex thoughts and feelings through artistic expressions that foster healing and post-traumatic growth.

Credentials to look for: Licensed Creative Arts Therapist training & requirements

Credential requirements are established by the American Art Therapy Association, Inc. (AATA) but generally, to practice Art Therapy, an individual must be both a Licensed Professional Counselor (LPC) and Registered Art Therapist (ATR). Other credentials include:

• Graduate Degree in Art Therapy
• Post-graduate supervised clinical work experience (state requirements vary)
• Certified Registered Art Therapist (ATR)
• State license (requirements vary by state)

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
• How to determine the type of therapy your child needs

Your child was struggling, so you did the research to find a child therapist to support their unique needs. The first appointment has been scheduled, and you’ve prepared your child for their first therapy session. But as the parent or caregiver, how do you prepare yourself? What else do you need to know to be informed? It is important to know what to expect during child therapy, and at Hopscotch, we are here to help you every step of the way. 

The child therapy process

It can be helpful to think of your child’s therapeutic journey as a process with four foundational phases. From start to finish, here is what caregivers need to know about how child therapy works.

Phase 1: How child therapy starts

Technically, your child’s therapy journey began when you become a client—legally, that is when consent for treatment has taken place. At the first session after signed consent is when a therapist's legal obligation begins. However, you may think of your first first consultation with a therapist as the beginning: Whether that was over a preliminary 15-minute consultation call or through e-mail, from the moment communication occurred between you and the provider you selected for your child, the process started.

During this first phase, you will schedule the first appointment known as an intake session, and in preparation, your efforts are best focused on helping the therapist support your child. This might include gathering relevant documentation such as school records, report cards, doctor notes, family history, or any other information you think might provide the therapist with the context necessary to support your child.

Phase 2: The intake session (first meeting)

The intake session is the first, official, full-length appointment with the child therapist. Typically most of the intake session with a younger child is with the parent(s) only. Parents need time to tell their story and for the therapist to gather relevant social and emotional information, as well as family history. Older children may be in some or all of the session.  The intake is really a time for the therapist to gather more details from the parent about the concerns that were mentioned in the 15 minute consultation and intake paperwork.  

As for what happens, the child’s age and needs will determine the functionality of the session itself, but you can expect that the therapist will provide an overview of the treatment to be administered, methodology, and session functionality. The therapist will also articulate caregiver participation expectations for future sessions and provide a structure and cadence for progress updates. Ultimately, the intake session provides you with an excellent opportunity to confirm whether or not the clinician is a good fit for your child.

Note that if your child is a teenager, then talk therapy is likely, however, if your child is under the age of 12, then it is likely that not much “talking” will be happening. Children learn primarily by doing, and their primary form of communication is play. While play therapy and art therapy techniques are sometimes utilized for teenagers and adults, play therapy and art therapy are especially common and appropriate for children ages 3 through 12 years old. In either case, parental session participation may or may not be necessary, and the therapist will clarify caregiver involvement during the intake session.

Phase 3: Subsequent sessions and the course of child therapy

This is where the majority of the therapeutic work and progress occurs: parents should partner with their child's therapist to determine the session frequency and goals, which may evolve over time. It's also natural for your child to resist going to therapy throughout the process. 

The therapist will initially be focusing on making a connection with your child and establishing a rapport with both of you. The goal is for your child to feel safe, accepted, heard, and as comfortable as possible. The functionality and frequency of subsequent therapy sessions will largely depend on the nature of your child’s needs, condition, and the type of therapy being administered. For instance, children may naturally outgrow play therapy and progress into art therapy or eventually talk therapy.

Phase 4: Assessing how long child therapy will last

Child therapy duration varies. Child/adolescent therapy is a proven and effective form of treatment that takes time. The importance of patience with the child therapeutic process is paramount; because the first few sessions are focused on establishing rapport and building a connection with the child, it can take around five to ten sessions before any improvements may be noticed. There is value in trusting the process and giving it some time before evaluating. We recommend caregivers and therapists assess the child/adolescent’s progress on a routine three to six months basis, but keep in mind that some therapy goals may require more (or less) time than others. 

How can I help support my child between sessions or after therapy?

Growth is more likely to be achieved and sustained when the caregiver solidifies in-session progress through at-home practices. Because caregivers and therapists each do their best work when they partner together as a team, we encourage caregivers to consult directly with their child’s therapist on precise ways collaboration may be possible. There are many ways caregivers can positively reinforce therapy session-based learning in the home, and therapists can be relied upon for providing child-specific suggestions to caregivers on how to support their child’s development. Hopscotch's resource center offers our experts' advice and therapeutic interventions you can use when you're at home.

When does child therapy end?

Therapeutic sessions may conclude when the established goals have been achieved and the underlying issues that motivated therapy are no longer prevalent. Like adults, children and adolescents may need a mental health tune up or "booster session" again at some point in the future. But once the child’s skills have expanded, their coping methods improved, their panic attacks subsided, and their emotions recalibrated, then the therapeutic process has successfully run its course.

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

As much as parents try to lean into the joy of the holidays with our kids (the decorations! the parties!) they can be utterly exhausting. And while this time of year can be something kids look forward to—with days off from school, more time with friends and family, and lots of presents—it can also be filled with stress and anxiety.  This is especially true with the increase in respiratory viruses, an election season, and non-stop social media. We talked to Hopscotch Clinical Advisor, Beatrice Wood, Ph.D., ABPP, about how to help your kids manage these challenging feelings so you can create a positive experience for your family.

Encourage Positive Conversations Around the Table

Oftentimes during the holidays, conversations among family members can get tricky as current events, politics, or personal challenges are discussed. These discussions can potentially be detrimental to children and teens (as well as the adults) whether they’re observing or participating in them. Instead, develop strategies to intercede early and redirect such conversations, for example by stating, “Let’s talk about something else today so we can feel good together as a family. We can talk about the other stuff later.”  If the conversations continue, you can  respectfully, but firmly, ask to postpone these discussions to another specified time. You can also choose another family leader, or perhaps the host, to do this if you’re not comfortable.

Prepare for Difficult Interactions

Your kids may have someone that they don’t like who is going to be present during the holidays—it could be a cousin who has bullied them in the past or a relative who asks them personal questions they don’t want to answer. In this situation, it is important to allow the child or adolescent to express their feelings with you (or with their provider if they are seeing one)  before the holidays. This can be an opportunity for you to prepare the child or adolescent for their upcoming interaction with this person. You can work with them to create an actionable plan that they can enact during moments when they have to engage with this person while still feeling good about themselves.                                  

Address Family Loss Compassionately

Some kids may struggle during the holidays due to the association with a significant loss in the family or among their friends. In a pre-holiday session, you can validate the child or adolescent’s feelings and allow them space to talk about their sadness and worries.  If it is a family member, invite the child or adolescent to share more about this family member’s contribution to the family’s life and traditions.  Explore with them how the person’s characteristics and way of being with the family might be continued in the holidays.  You may ask, “How can you bring that person to the table (or to the holiday celebration) even though they aren’t there?”.  It would be an even better experience were the caregivers and siblings to join in such a pre-holiday session.  This allows the family to grieve together, support each other, and also explore ways to keep this person’s memory alive and positive during the holiday season. 

Manage Your Kids’ Expectations

Most kids look forward to gifts during the holiday season, but more expensive gifts may not be feasible this year. Talk to your child about what their expectations are surrounding gifts and what they are hoping to receive.  Plan a course of gift-giving for one another that does not require money. As a parent, you might like having someone do the dishes for a week or wash the car. Your child might like a video game partner for 5 games, baking/grilling together, or having one-on-one time. They can even wrap these gifts by writing what the gift is on paper inside a box. Doing this allows everyone to have something to look forward to, presents to open, and gifts that involve quality time with their loved ones.

The holidays bring unique challenges, but proactively working with your child to create a positive environment and space for them to express their feelings while empowering them with coping strategies can make their holiday season a little brighter.

How do I talk to my child about therapy? 

If you are wondering how to introduce the concept of therapy to your child or how to explain to them that they are about to start seeing a therapist, you are not alone. Many parents wonder how to approach this conversation. At Hopscotch, we know that preparing your child for therapy is very important, because it sets the tone for a smooth transition into the relationship they will have with their provider. While every kid is different, here are some basic guidelines you can rely on when preparing your child for therapy. 

1. Choose a good time.

Timing matters – especially with kids! Every child is different, but typically, if you tell a child about therapy too far in advance, they may focus on it anxiously. If you tell them too soon beforehand, it may come as an unnecessarily abrupt shock. We recommend preparing young children for their first therapy session 1-2 days beforehand. Since older children and teens benefit from some additional time to process, they can be told 5-7 days in advance.

When NOT to tell your child:

Moments of conflict or when the child is upset is not a good time for the “preparing for therapy” talk, and therapy should never be used as a threat. Avoid any time when you know your child will be hungry, tired, or stressed, and instead, choose a time where your child’s feelings are neutral or positive. If a child interprets therapy as a punishment, they are more likely to have a hard time trusting the therapist or resent having to attend. 

2. Use a neutral tone of voice.

The key word here is neutral. Children are highly observant and sensitive to emotional language, and they pick up on abnormal tones of voice. When you talk to your child about therapy, it’s important that your tone of voice is not too harsh or overly excited. 

3. Introduce the concept of therapy in an age-appropriate way.

Children under the age of 5 may lack the developmental ability to understand the concept of therapy, but you can help them understand you're going to a 'really caring person that Mom/Dad found who can help us with big feelings'.

Children ages 5-12 are by nature very curious and full of questions. If their most immediate questions about therapy are not addressed, anxiety can form.

A great way to introduce the concept of a therapist to a child of any age is to teach them that therapists are adults that really like talking and playing with kids to help them figure out stress and big feelings. So you may introduce them as a 'feelings doctor' but then shift to actually using the therapist term over time.

How to talk to children under the age of 5 about therapy:

“You know how sometimes if you have a tummy ache a doctor helps you feel better? Well, there are feelings doctors, and if you are worried about something, or if you feel angry or sad, a feelings doctor will help you feel better! We’re going to visit one tomorrow, and it will be a fun time.”

How to talk to children ages 6-12 about therapy:

“A therapist is a feelings doctor. A feelings doctor helps you feel better when you feel sad, worried, or angry. They are not like a teacher or a parent. They’re kind of like a friend, except their job is to listen to you. So you can talk as much as you want and about whatever you want, and they’ll help you find ways to feel better. Lots of children and even adults have a feelings doctor, because they’re so helpful. We’re going to start visiting a feelings doctor once a week to help us feel our best.”

Pro-parent tip: Assure your child that feelings doctors don’t give shots!

4. Explain the process.

Explaining the process helps your child know what to expect in therapy. Be sure to articulate the basic therapy structure, how it works, and how long it will last.

Examples for children 5 years old or younger:

• “We’ll be meeting them in-person/virtually for about an hour once a week.”
• “I’ll be right there with you/outside the door the whole time (or in another room if you're at home).”
• “I think you are really going to have a lot of fun! There’ll be games to play and lots of fun things to do.” 
• “You will get to play with toys and draw.”

Examples for children 6 to 12 years old:

• “We’ll be meeting them in-person/virtually for about an hour once a week.”
• “I’ll be close by for the first session to make sure everything goes ok, and then we’ll decide together what to do for the next time.”
• “I think you are really going to like being able to say whatever’s on your mind, and if you need help, the feelings doctor knows how to help.”
• “If you don’t feel like talking, that’s fine! You don't have to talk the whole time or you can decide what you want to talk about.”
• “You’ll have total privacy. The therapist will meet with me separately to give me ideas or help me learn ways to help you at home. The specifics of whatever you both discuss will be confidential.” 
• “I’m not sure how many times we will go. We’ll figure that out and decide together after the first few sessions.”

5. Reaffirm your supportive involvement.

Depending on your child’s age, need, and unique temperament, it is not uncommon for children to feel anxious or concerned about starting therapy. They may even act out and express anger. It is important for caregivers to normalize therapy and remind their child that we all feel sad, worried, or upset sometimes. It may also be helpful to explain that many people go to therapy or have a feelings doctor, including adults and parents. Use inclusive language and give them confidence by reminding them that you will be available every step of the way to ensure they feel safe, heard, and supported. Encourage communication by asking your child if they have any questions, how they are feeling about therapy, and validating their feelings: "I know it can be scary to meet someone new" or "I know you will miss playing with your friends tomorrow after school."  Also it's important to remind them that this is private and none of their friends will know, if that is a concern.

6. Stay calm.

Children tend to mirror their caregiver’s emotions, so if you stay calm, empathetic, and matter-of-fact, the conversation with your child about starting therapy will likely go better than you anticipate. 

Keep learning about child therapy

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

Just the word "test" (nevermind "exam") conjures up jittery feelings in many children—especially if they have ADHD or a learning disability.  That anxiety can interfere with their ability to focus and deplete their confidence. By taking a little time before the assessment to do a meditation like this one from Ella Sims, founder of Becoming Women.  As she says, "imagine entering a test confident, calm and comfortable, reassured that you don't need to know the answer to every question." 

Start the Day Calmly With This Meditation

Whether it's the beginning of the school year or halfway through, mornings can be overwhelmingly stressful for kids (and their parents!) Making sure backpacks are packed, homework is done, shoes are tied, catching the bus—the seemingly never-ending list of to-do's can make anxiety levels skyrocket. Doing a short breathing-based meditation like this one from Ella Sims, founder of Becoming Women, can help calm nerves. As she says, "when you focus on your breathing, it quiets the mind and helps you relax, so you can start the day in a calm way." She also offers some positive affirmations ("I can overcome challenges") for kids to say to themselves before the school day begins.

Teaching your child about social skills in a way that makes sense for adults, may not make sense to your kids. Instead, try a game that helps them unconsciously start to think about social skills. 

What child doesn't want to play a fun game of Bingo? 

Our Head of Clinical Programming and Licensed Professional Counselor Andrew Jatau developed this activity to help your kid practice some critical social skills—such as taking turns when playing and starting a conversation with someone new. 

Print out the bingo card download here and see if it gets your child thinking about how they can better engage with the other kids and adults around them.