For most kinds of healthcare, we don’t have to worry about when or how often to show up. We go for an annual check-up or drop by the doctor’s office if we feel sick. Dentists send reminders for six month cleanings, and pediatricians have a set schedule of appointments to keep babies and children healthy. Therapy is a little different: we need to attend on a regular basis in order to see results, but what “regular basis” really means isn’t always clear. This can be especially true for kids in therapy. In this post, let’s unpack how often children should be seeing a therapist in order to see positive changes in their mental health.
Kids Need to Attend Therapy Regularly to See Change
Children thrive on predictability and repetition. They need time to absorb new ideas and put them into action. The fact that therapy happens on a regular, predictable basis is part of what makes it so effective. Kids know they can count on their counselor to be at the office each week for their scheduled appointment, and that they have a special time set aside to work through their feelings. This helps to reduce anxiety about the therapy process, and builds trust in the therapist-client relationship.
The positive changes that happen in therapy don’t happen all at once: they are usually gradual and incremental. Each session builds upon the next one. This is why it’s extremely difficult for kids who only attend therapy occasionally to make any meaningful progress. With these kids, so much time has to be spent reviewing old skills and getting caught up on current events that there isn’t much time left for “deeper” work. It’s also hard to establish trust and feel comfortable with your therapist when you only see them once in a blue moon.
Weekly Therapy Sessions Work Best for Most Children
In my own child counseling practice, I recommend that nearly all kids start therapy with weekly appointments. This how often most experts recommend that you see a therapist, and for good reason. Making therapy part of a child’s weekly routine helps them to mentally plan ahead and look forward to appointments. It means that kids and parents are setting aside time for regular self-care, just like they set aside time for piano lessons, sports practice, or any other activity in a child’s life.
I use cognitive behavioral therapy with children, and meeting weekly gives kids a chance to practice coping skills between appointments, without forgetting what we talked about last session. This gives us plenty to talk about the following week! For most kids, weekly CBT is a good balance between feeling supported and having enough free time to participate in the extracurriculars that keep life fun.
Younger Children Need More Frequent Therapy
Meeting weekly is especially important for younger kids. Preschoolers and early elementary-aged children can’t retain information over long periods of time the same way that older kids can, so repetition is key. This is especially true for young children who have separation anxiety about leaving Mom or Dad in the waiting room when they come to therapy. Getting regular opportunities to practice separating makes it much easier, and it’s common for young children to feel a bit nervous about coming to therapy if they have been away for a while.
In general, I still think most little kids do just fine with weekly appointments, and it’s rare they need to meet more often. However, if you’re having a parent session with the therapist one week, consider scheduling an additional appointment for your child in order to keep the momentum going.
Older Kids Can Sometimes Be Seen Less Often
Every once in a while, I will suggest that a kid who is 12 years or older can start therapy on an every-other-week basis. As kids approach the teen years, their ability to retain information and practice skills independently increases. Kids in this age range also face more demands on their time from school, sports, and other extracurriculars, which can make it a little more difficult (and stressful) to schedule regular therapy sessions.
While it’s still usually best (and fastest) to meet weekly, every-other-week sessions can sometimes be a good compromise for busy kids. However, there are a few times when this might not be a good idea. Kids who are experiencing severe symptoms of anxiety or depression really need more consistent therapy in order to feel better. This is also the case for children who have survived a trauma or stressful event. Finally, preteens or teens who have thoughts of suicide or self-harm absolutely need to be seen more frequently until they’re in a safer, more stable place.
Do Kids Ever Need Therapy More Than Once a Week?
There are some situations where kids really need to be seen two or more times a week for therapy sessions. Often, this is a short-term plan designed to help kids get through an extremely difficult time. The goal is always to help children strengthen their coping skills enough that they can function independently for longer, and come to therapy less often.
Here are a few circumstances that could affect how often a child needs to be seen, and require more visits:
A child has just experienced a new trauma or loss, such as a death in the family
Severe anxiety or depression prevents a child from doing important daily activities, like attending school
A child or teenager has expressed serious thoughts of suicide, or has made a suicide attempt
A child is “stepping down” from more intensive therapy, like inpatient therapy at a hospital
Going More Often Might Mean Fewer Sessions Overall
This is purely based on my own experience as a child therapist, although I’m sure there’s research out there to back me up. I have noticed that my clients who come to therapy on a weekly basis usually end up needing fewer sessions than those who come less often. Weird, but true!
Sometimes, parents request every-other-week or even monthly therapy sessions due to financial concerns. I totally get it—therapy can be a big investment of both time and money. However, I’ve noticed that kids who come to therapy every other week often need to stay in therapy much longer, because we have to spend more time playing catch-up. In the long run, this makes therapy more expensive: more sessions are needed to achieve the same result.
Are You Considering Child Therapy in Charlotte, NC?
Now that you know how often you can expect your child to go to therapy, maybe you’re thinking about next steps. If your child is struggling with anxiety, my online course can help her learn coping skills as you consider your options. You can check out Worry-Free Tweens here.
If you live in the Charlotte, NC area and have a child struggling with anxiety or stress, I’d love to help at my Lake Norman office. You can learn more general information about child counseling here, learn more about me, or contact me to book an appointment. I can also see kids for online therapy throughout the states of New York, North Carolina, and Florida.
