In case you have doubts about whether your child is ready for therapy, here are some dos and don’ts to be mindful of
There’s no easy way to understand the rich inner worlds of children. While Swiss psychologist Jean Piaget was among the first to have mapped the evolving cognitive processes of an individual from infancy to adulthood in the 1930s, in the following three decades, British paediatrician and child psychologist Margaret Lowenfeld produced groundbreaking work on child play therapy. She invented several object-based techniques and tools to therapise children (that is individuals aged 18 or below, requiring adult or parental consent and supervision) that continue to be used in the domain till date.
Lowenfeld became among the pioneers in the field who brought child psychology into pop culture, especially in the aftermath of the Second World War, when filmmakers began delving into children’s psychological experiences more seriously. They turned to Lowenfeld, in particular, as the psychologist had identified the cinematic nature of children’s worlds. In the film No Place for Jennifer (1950) directed by Henry Cass, Lowenfeld’s techniques are used as a crucial narrative device to tell the story of a nine-year-old girl’s trauma of getting over her parents’ divorce.
Children younger than Jennifer are known to have sought therapy for various reasons. But for Kolkata-based Sagar Gupta*, when his five-year-old daughter Ayindrila* was privy to her parents’ divorce, she found herself in a predicament similar to Jennifer’s. When Gupta reconnected with his now wife, Ayindrila’s mother—whom he had known since college—she had already been divorced after being married for a decade to a partner, who turned out to be abusive. “We got married when Ayindrila was three years old. From around the time she turned three-and-a-half, she had to start going through the legalities of her parents’ separation and was forced to go for visitations to her biological father. This caused her significant trauma as her biological father was not the most loving, and manipulated her against her mother and I,” Gupta says.
Soon after these visits commenced, Gupta and his partner noticed a newly formed anxiety in their child, who would complain of feeling hungry, or feel a persistent need to urinate after her time spent with her biological father, which is when they decided to seek therapy for her. It has helped Ayindrila feel calmer, Gupta says. “One of us accompanies her on these sessions at a private hospital near our house, and sits at the back of the room without interfering or taking the lead in the conversation between her and her counsellor.”
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There’s no easy way to understand the rich inner worlds of children. Image: Pexels
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British paediatrician and child psychologist Margaret Lowenfeld produced groundbreaking work on child play therapy. Image: Pexels
Can your child be too young for therapy?
While regular counselling helped Gupta’s child, the right age and reasons behind introducing a child to therapy garners varied responses. For Alaokika Motwane, a psychotherapist practising in Goa and Mumbai, introducing a child to therapy before they can verbally express themselves might be a little too harsh on their impressionable minds. “Child therapy is a broad subject. So unless the child has a learning disability or something on those lines, it’s perhaps not very advisable to have a very young child come into a clinical set-up for therapy, since they can’t concretise their thoughts,” she says. Moreover, Motwane believes working with the parents—instead of with very young children, especially ones who cannot recognise the need to seek help with understanding their emotions—is of paramount importance.
“The child’s nervous system and the parents’ nervous systems are very co-joined. If the parents’ nervous systems make the child feel safe, why will the child not heal?” she asks. In recent years, Motwane has observed parents sending children as young as four or five years old to therapy. This trend worries her. “At that young an age, when a child’s prefrontal cortex (the part of the brain responsible for thoughts, actions and emotions) is not even fully developed, their nervous systems might not be equipped to handle such a clinical set-up that feels alien to them,” she points out.
Making a case for play therapy
However, different approaches can benefit different children, or even the same child through different ages. When Lily Gonsalves* from Delhi was six, her mother, a single working parent, sent her to “an aunty twice every week to play”. Six years hence, at the age of 12, Lily now has the vocabulary for the process she was initiated into. “I now know that it’s called therapy,” she tells The Established. When asked if she knows why she is sent for therapy, Lily takes a moment to find her answer. “I think it’s because I felt lonely all the time, and wasn’t doing well in school,” she says. “I am okay at school now,” she adds. “I still go to the same aunty and we still play—different games though. I started with building with blocks but now I enjoy painting a lot more. I love talking while painting.”
“AT THAT YOUNG AN AGE, WHEN A CHILD’S PREFRONTAL CORTEX IS NOT EVEN FULLY DEVELOPED, THEIR NERVOUS SYSTEMS MIGHT NOT BE EQUIPPED TO HANDLE SUCH A CLINICAL SET-UP THAT FEELS ALIEN TO THEM."
Alaokika Motwane
Play therapy is considered appropriate for children between ages 3 and 12, as it employs a child’s playtime for a therapist to gain insights into their problems. It is what worked for Lily, according to her mother Desna Gonsalves*, a 38-year-old paediatrician. “Until the age of five, Lily loved to talk. But a switch flipped once my practice picked up when she was four-and-a-half or five, and I had to leave her at my mum’s for longer hours. Eventually, she spoke less and less,” Desna says.
But Lily took to therapy quite easily. “Maybe she just really wanted someone who would listen to her. We are lucky the very first therapist we found for her worked out, and we’ve stuck with her for six years now,” says Desna, acknowledging the fact that quality mental healthcare for children continues to be an uphill climb in most parts of India even today.
The reality of therapy for children in India
An effective way to introduce therapy and counselling institutionally to children is through the education system, by installing mental health care facilities and in-house counsellors in schools, colleges and other academic establishments. While this has been prevalent in the West for decades, the Indian education sector—especially in primary, secondary and higher secondary levels—is only waking up to its perks. But there still remain stretches of ground to cover.
In 2014, the Central Board of Secondary Education (CBSE) mandated that all schools under it hire counsellors. However, according to a March 2024 survey by PeakMind, a Bengaluru-based digital platform working in mental healthcare for students, only three per cent schools have managed to do so in a decade. “At times, people who have done courses in reiki and other pseudotherapy claim to be mental health professionals and counsellors, which is a major problem,” says Aachal Jain, a counselling psychologist who works as a pastoral care coordinator at the Aditya Birla World Academy in Mumbai.
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Different approaches can benefit different children, or even the same child through different ages. Image: Pexels
Many schools also have a single counsellor for children across all classes and age groups—a practice that isn’t the most advisable. Every age group has to be tackled differently. “Like all my children in lower kindergarten can engage in mindful breathing, because they have been introduced to it as a tool for anger management, or to handle ‘big emotions’,” Jain says. For slightly older children, art therapy can help, like it has been for Lily. “So it is not so much about when should therapy be started, but what modality of therapy is effective for which age group,” Jain explains. “Some time ago, one of my students in grade one—about six years old—refused to go to class for an extended period of time because his friends had once laughed at him for giving a wrong answer. Talk therapy wouldn’t work for him because the child’s brain isn’t developed enough to understand ‘rational’ conversations, so we asked him to draw his classroom, teachers, and friends to figure out what was troubling him.”
Therefore, besides helping children build on their socio-personal skills and address concerns of coping with academics, topics of friendship, bullying, even romantic relationships aren’t off the table for Jain and her team of five counsellors at the school.
How involved should parents be?
A good rule of thumb to follow for any individual requiring the consent of parents or guardians while seeking therapy is that the younger a child, the more involved their parents should be. Parents should also be informed when the question of harm—whether to self or others—is involved.
However, larger approaches vary from one professional to another, and from one client to another. There’s no one-size-fits-all answer. For Motwane, “finding out the relationship between the parent and child is of utmost importance.” After all, one has to work with the family because the child goes back to the family, and if the stressor belongs in that environment, the only way to make progress is to work through them.
Maintaining a certain level of confidentiality is imperative too, irrespective of the age of the child, according to Jain. “What happens in a therapy session is never discussed with the parent. But since we have to work in tandem with a child’s environment, if something concerns the parent, we have to share it with them,” she explains.
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Therapy helps children build on their socio-personal skills. Image: Pexels
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Maintaining a certain level of confidentiality is imperative too, irrespective of the age of the child. Image: Pexels
Parents, however, can be the toughest nuts to crack, says Ranita Ray, an English teacher for classes six-to-eight at Chirec International School, Hyderabad. Oftentimes, parents simply do not acknowledge that not only does their child need counselling, but so do they. This resistance is tricky to overcome. “A year ago, I had a child in the seventh grade who had a younger brother in junior school. This older sibling would struggle with deadlines, show a lack of responsibility, and had temper issues,” Ray says. When the topic was raised with his parents, they seemed surprised. The child, apparently, displays the exact opposite qualities at home. “Both his parents are working, which makes the children feel neglected. And as you can imagine, that too, in itself, is a form of abuse. So he started acting like a parent to his younger sibling.”
Eventually, the school counsellors and teachers had to convince the elder child and his parents that he, too, is a child who deserves to live his life, much like his brother. “We told him that he should feel responsible for his brother, but not at the expense of his own well-being,” says Ray, emphasising that holistic care for a child comes with collective, and not just individual effort.
However, Ray, at 28, feels hopeful about parents being infinitely more open to introducing their children to therapy now, as compared to when she was in school. “I wish I had these facilities all those years ago.”. Motwane, on the other hand, has observed more and more adolescents seeking out professional mental health care by themselves. Either way, it’s proven beyond doubt that it indeed takes a village to raise a child, and the right therapist might just be a key part of it.
*Names changed upon request to protect the identity of minors and their parents.
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