Updated: Aug 2
If you are reading this blog, you probably want to find the right help for your child. However, knowing what kind of professional is a good fit for you and your family can be challenging, especially given the high number of therapists with variable qualifications available. Therefore, I want to share some MUST questions to ask this professional before committing to therapy.
Question#1. Are you specialized in children and youth?
If the answer is yes, follow up with additional questions about how many years of experience they have, how much supervision they received before becoming an independent therapist, and the type of approach they use. Typically, the more age-restricted they are in working with young populations, the more specialized they also are. Be aware that if a therapist indicates they work with all ages or couples and families, they may not be considered "specialized in children and youth."
Question #2. What are your qualifications to work with children and youth?
In the past few years, the number of counselling/mental health clinics has dramatically increased in the lower mainland of BC, particularly in Port Moody, where our clinic is located. One of the reasons seems to be that getting an online master's degree in counselling in Canada has become easily accessible for many due to its flexibility, minimal enrollment requirements, and short duration compared to traditional and more reputable universities.
Thus, when looking for a therapist, it will be essential to know:
What kind of degree does the therapist hold? Is it a bachelor's only, a master's or a doctoral-level degree? Be aware that terms like "therapist" or "psychotherapist" can be used by individuals with no graduate-level training who obtained some professional certification from a professional college.
What type of program did the therapist attend, and from which university (reputable or not)? The Canadian Psychological Association (CPA) is the psychological body in Canada that sets very high standards for programs and internships to become accredited by them. Therefore, professionals who attended a CPA-accredited program come from easily recognizable universities that require hundreds of supervised clinical hours, rigorous course work, and associated research to obtain a master's or a doctoral-level degree. So, take a look at the CPA-accredited programs to help with your decision.
What kind of supervised practicum and previous work experience does the therapist have? To determine if the professional has sufficient knowledge to work with your child, you must also inquire about their prior clinical experience in the field. Be aware that many recent grads now have an "RCC" or "CCC" designation and little counselling experience. Just looking at their credential titles can be misleading! Therefore, it is critical that qualified clinicians fully supervise these new professionals until they gain more experience in the field.
Are you still confused about terms such as psychologist, social worker, or counsellor/therapist? Here are a few points to keep in mind regarding their qualifications:
Doctoral-level psychologists (Ph.D./ Psy.D) have significantly more extensive graduate training than master's level clinicians. They typically spend +7 years in graduate school and go through an arduous process of exams to register with their regulatory College. In BC, registered psychologists belong to the College of Psychologists of British Columbia (CPBC). They also have a strong research background, typically provide evidence-based treatment (rather than talk therapy) and may conduct psychological evaluations and provide mental health diagnoses. Please note that CPBC regulates the use of terms like "psychology," "psychologist," and "psychological" because these are restricted titles.
Social workers typically have a master's degree. Asking about (a) which university they attended, (b) how many courses they took in mental health, (c) how much time they were supervised before becoming registered with their College, and (d) the places and populations they worked with are important factors in determining the level of mental health training and work experience they have.
Counsellors, therapists, or psychotherapists can have a master's degree or not. These terms are not regulated in BC. However, to obtain credentials such as "RCC" or "CCC," professionals need to have a master's degree and apply to their association, which doesn't require them to undergo licensure examination like registered psychologists or social workers do. Therefore, asking about (a) which university the therapist attended (online versus not), (b) the duration of their degree and supervised practicum and if they still are being supervised, and (c) the places and populations they worked with are critical factors in determining their qualification to work with young populations.
Question #3. What type of treatment do you offer?
This is a crucial question, as evidence-based treatments are much more likely to be successful than talk therapy. Below are three of the gold-standard treatments for children and youth (however, there are more):
Cognitive Behaviour Therapy (CBT)
This approach teaches children and youth how their thoughts, behaviours and emotions are connected. It uses relaxation techniques to calm the body, cognitive restructuring to change negative thoughts into more positive or realistic thoughts, and exposure exercises (behaviour action) to improve symptoms of anxiety, OCD, depression and more. In this approach, research has shown that exposures are the key ingredient for symptom improvement. Therefore, when seeking a therapist, ensure they actively engage clients in exposure exercises rather than only focusing on relaxation or cognitive restructuring techniques. Please know that thinking positively or doing breathing, mindfulness, or progressive muscle relaxation are not enough skills to help your child face challenges and manage their big emotions. Action (gradual exposure) is needed to teach their brains that they can do it!
Acceptance and Commitment Therapy (ACT)
ACT derives from CBT and teaches young people how to make room for uncomfortable thoughts and feelings ("Acceptance") while engaging in actions that matter to them ("Commitment"). This is a practical approach that focuses on awareness, being present in the moment, and taking action toward values. ACT is effective for a range of psychological challenges, including anxiety, depression, OCD and more.
Dialectical Behavioural Therapy (DBT)
DBT is also a form of CBT that help individual manage intense emotions that can result in impulsive and problematic behaviours, such as self-harm, addiction, suicidal ideation, and more. It teaches mindfulness, effective problem-solving, distress tolerance and other skills to help people respond with flexibility to challenging and stressful life experiences.
Question#4. Does my child feel connected with you?
Beyond finding a qualified therapist, the therapeutic connection is essential for positive results. While therapists have different styles and experiences, feeling heard and engaged and having fun during sessions are important components for successful treatment. Below are a few more points to consider:
Does the approach match my child's developmental level? Young children need much more interactive activities than teens. Thus, the younger, the more active and engaging the sessions should be.
Does my child feel comfortable opening up? Warming up to a new person to talk about personal things can be challenging at first. However, if, after a few sessions, your child continues to have a hard time talking or engaging, it might be a red flag.
Is the therapist empathic and a good listener? Of course, therapists need to talk and teach skills during sessions. However, they should also be curious and listen to what you and your child have to say. If you or your child don't feel heard, you may need to give the therapist some feedback.
Does the therapist offer parental support or involve the parent in the treatment process? Even though therapists must be cations and compliant with protecting their client's confidentially, it is also essential to have some degree of parental involvement (when possible) during treatment to improve communication between the parent and child and for the child to practice strategies and receive support outside of the sessions. The younger the child, the more parental involvement is recommended, as parents can serve as great coaches to help their child manage their emotions and face their fears.
Was the therapist recommended through word of mouth? Knowing other families who had a positive experience with a therapist can be helpful. A quick Google search can also help you gather more background information about a professional before scheduling a consultation call. However, please consider questions 1-3 while doing your research.
Overall, finding the right help for your child is not an easy task. In addition to checking the therapist's credentials and areas of expertise, having a connection and looking forward to the sessions (even if talking about challenges can be tricky) are good indicators that the professional is a good fit for your child.
I hope this blog helps you make an informed decision about which mental health professional you will choose for your child.
NOTE about the author: Dr. Juliana is the clinic director of Beacon Psychology Clinic and a Registered Psychologist passionate about mental health. She works as a clinician, researcher, supervisor, trainer, consultant, and public speaker. Her clinical approach is grounded in research and based on individual and family CBT and ACT.