When a child is struggling, therapies are often the best way to resolve the barriers blocking them from success. But which therapy is the right one? Here’s a not-quite-exhaustive list of therapy options and when to use them.
Psychotherapy/Counseling
This is a big umbrella term. There are many different interventions used to help manage mental health conditions.
Play Therapy
A therapist will play with a child, follow their lead, and use play to communicate problems and work out solutions.
Best suited for: Kids under 11 who have had traumatic events which are impacting their quality of life. Kids with anxiety and depression can also benefit.
Not well suited for: Older children and teens, who may feel infantilized.
Skills required: The ability to play and express emotions through play.
Cognitive Behavioral Therapy (CBT)
A form of talk therapy, where triggers for anxiety or depression are identified and new thinking patterns are developed and practiced. There is also a variant called Trauma-Focused Cognitive Behavioral Therapy, which focuses on anxiety and depressive symptoms triggered by traumatic events.
Best suited for: Anxiety and depression or trauma (TF-CBT only)
Not well suited for: Those with limited interoception (the ability to sense what is going on inside the body, like rapid heart rate, sweating, abdominal pain).
Skills required: The ability to articulate the thoughts that accompany symptoms, whether by speech or augmented communication. Also requires some interoception skills to detect physical symptoms that may be the sign of an impending anxiety attack. Some ability to write/type may be necessary, as this method leans heavily on workbooks and written logs.
Notes: CBT is a tricky thing when used in abusive relationships. There is a possibility of unintentional self-gaslighting, as this therapy tends to assume that all bad feelings are self-generated and not the result of external forces beyond our control. For this reason, TF-CBT cannot be substituted by CBT. Training in trauma-focused therapy is essential to keep this modality safe for trauma survivors. Likewise, those with anxiety provoked by sensory sensitivities may not be good candidates for this therapy.
Dialectical Behavior Therapy (DBT)
DBT is a kind of CBT, which focuses on mindfulness and the identification and management of difficult emotions. The goal is to integrate a sense of self-acceptance while still changing problematic thought patterns.
Best suited for: Anxiety and depression or trauma. A better choice than traditional CBT for those with limited interoception.
Not well suited for: Those who are unable to participate in group sessions, as this is often a large part of DBT.
Skills required: The ability to articulate the thoughts that accompany symptoms, whether by speech or augmented communication. Some ability to write/type may be necessary, as this method leans heavily on workbooks and written logs.
Eye movement desensitization and reprocessing (EMDR)
A form of psychotherapy in which the person being treated is asked to recall distressing images; the therapist then directs the patient in one type of bilateral stimulation, such as side-to-side eye movement or tapping either side of the body. Eye movements and tapping allow the brain to process but limit the physiologic traumatic response.
Best suited for: Those with a history of psychological trauma
Not well suited for: anxiety and depression unless trauma also exists
Skills required: Very few. The ability to move the eyes or body (usually hands or feet) at will.
Emotional Freedom Technique (EFT)
Uses tapping on various parts of the body, combined with recall of past events or focus on feelings, to relieve symptoms. Less focus on trauma than EMDR. EFT does not have a huge body of evidence supporting it like EMDR does, but studies are emerging.
Best suited for: teens and adults with anxiety or depression. May be useful in trauma as well. Good for those who feel more traumatized by reviewing and discussing past traumatic events.
Not well suited for: severe trauma.
Skills required: Very few. The ability to move the hands at will and follow a multi-step sequence.
Skill-Based Therapies
Physical Therapy (PT)
Focuses on strengthening and muscle balance during gross motor activities.
Best Suited for: those with gross motor delays, problems with coordination, weakness, poor balance, or other motor dysfunction
Not well suited for: fine motor activities (see below)
Skills required: none
Occupational Therapy (OT)
Focuses on fine motor coordination and strength. Also manages sensory profiles, meeting sensory needs, and exploring sensitivities to both environment and food-related stimuli.
Best suited for: those with fine motor delays, poor coordination, weakness in fine motor movements. Also good for those with sensory processing issues who need guidance on meeting needs and addressing sensitivities.
Not well suited for: gross motor delays, though often works in partnership with PT for these issues.
Skills required: none
Speech Therapy (ST)
Addresses language for both receptive and expressive phases of communication. Generally focuses on spoken words, but may use sign language or assistive and augmented communication (AAC) devices to aid in communication. Also involved in feeding abnormalities, including motor dysfunction and sensory sensitivities.
Best suited for: those with speech or feeding delays, poor articulation, or oromotor dysfunction
Not well suited for: N/A
Skills required: none
Early Intervention
Combines aspects of PT, OT, and ST, as well as early education resources, to assist with parental interactions and managing daily tasks.
Best suited for: complex developmental concerns with psychosocial contributing factors
Not well suited for: older children
Skills required: none