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Ask the Expert: What do I do if my child refuses to participate in therapy?

02 Oct 2019 1:10 PM | Anonymous member (Administrator)

by Beth Mishkind Roth, a licensed clinical social worker/therapist, and owner of Cleveland Integrative Counseling

As a therapist, I am frequently asked the question, “what should a parent do if their child/adolescent refuses to come to therapy, let alone actively participate?” More often than not, this question comes from the exasperated parents of children with anxiety and obsessive compulsive disorder. Up until recently, I would encourage the parents to emphasize the importance of self care to their child, educate them on ways to model anxiety reduction techniques, and find ways that the school system can augment support (if they are not already refusing to attend). Fortunately, I am now able to respond with SPACE.

SPACE, Supportive Parenting for Anxious Childhood Emotions, helps parents learn supportive ways to respond to their child’s anxiety and communicate their confidence in their ability to cope with their feelings. SPACE is conducted with the parents, not the child, thus bypassing the obstacle of the child’s willingness to attend and/or practice newly learned skills. Over the course of several months, parents work with a therapist to identify ways in which accommodating behaviors (e.g. not inviting friends over if their child has social anxiety, buying more soap if they have contamination OCD, or repeatedly answer the phone if child has separation anxiety) may be perpetuating their child’s symptoms, and develop a plan to reduce these accommodations. Parents are also given problem-solving strategies for responding to their child’s reactions to the changes.

Through SPACE, parents learn that by changing their own behavior, they can avoid much of the escalation that stems for trying to force their child to act differently. Studies show, not only does SPACE reduce anxiety symptoms in the child just as well as conventional therapy, but parents also report a much better relationship with their children. Moreover, there is an increase in therapeutic engagement, both in attending therapy and practicing skills, amongst the formerly resistant children/adolescents.

Beth Mishkind Roth is a licensed clinical social worker/therapist, and owner of Cleveland Integrative Counseling, who specialize in evidenced-based treatments for children, adolescents, and families. Beth’s has a strong passion for working with the siblings of children with developmental disabilities, special healthcare needs, and significant mental illness. She also works closely with children/adolescents struggling with anxiety, depression, OCD, low self-esteem enhancement, and high-functioning ASD. To schedule an appointment with Beth, please call (216) 600 - 8008 or visit www.clevelandint.com

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