As parents of pre-teens know well, every child moves at a different pace. Some children feel like little teenagers at the age of nine and others still act fairly childlike until they reach their teens. How I conduct therapy with pre-teens depends on what feels comfortable to the child.
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Some pre-teens prefer to use toys to symbolically talk about what is going on with them because it is less revealing than just talking directly (in much the same way as adults will sometimes say, “A friend of mine was wondering…”). In those cases, I handle therapy with the child in many of the same ways that I handle therapy with younger children, trusting that if and when the pre-teen is ready to talk directly they will do so. Other pre-teens are happy to talk directly as long as they have something to fidget with (drawing, working on puzzles, handling play dough, tossing balls, shooting nerf guns). In these cases I handle therapy more like I do with teenagers.
It is usually during the pre-teen years that children start to have things they want to hide from their parents. Children need to develop an identity for themselves apart from their parents. Keeping secrets is just one part of that separating process. In order for pre-teens and teens to feel comfortable in counseling, they normally want to know that what they say in the counseling room won’t go straight back to mom and dad. However it is important that parents can be informed and involved in the counseling process. In many cases, the child’s therapy is greatly benefited if they are allowed to have a level of confidentiality. When this is the case, I suggest that parents agree to let me give general information from the session instead of reporting the details of what is said in therapy. (There are important exceptions to this. I will tell parents details if a child reports that they have had thoughts of or have engaged in: illegal activities, harming themselves, or harming others.) At the beginning of the first session I discuss with the parents the particulars of how to handle confidentiality for their child.
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