Brooke Schmaling, MSSW, LCSW
A strong therapeutic relationship is a key to the success of psychotherapy. My first priority is always to provide an atmosphere of warmth and comfort in which to undertake the sometimes challenging work of therapy. Finding the “right fit” in a therapist is essential to the process. I offer a free initial phone consultation so you may determine if you feel I can offer the services and “right fit” you, your child or your family need.
Our work together will consist of an initial evaluation, followed by individual therapy, family therapy or parent coaching, or some combination of the three. I often find it helpful to consult with pediatricians, schools, and any other helping professionals involved, and I may ask your permission to do so. I may also attend school meetings or prepare documentation for schools at your request.
Our work together will begin with an intake, or initial evaluation, session. This session generally lasts about an hour and is an opportunity for me to gather information and begin to think about how best to help you, your child or family. At the initial session for child, adolescent, or family therapy, I like to see a parent or parents without children. This allows parents to speak freely about their concerns and ensures that I have all the necessary history and background prior to meeting a child or teen. Parents are also better equipped to prepare their children for what to expect after having visited my office and met me in person.
During our intake session, it will be helpful for us to talk about many aspects of your or your child’s health and development, daily life and functioning. If there are medical or school records that you feel may be pertinent to our work together, please feel free to bring them to your initial visit to share with me. For children and families, the initial visit will be followed by a meeting with the child or children.
Preparing Children and Teens for Therapy
Many children and adolescents I have seen over the years have expressed a desire to see a therapist because they are experiencing pain or distress that they have been unable to manage. Sometimes, children are reticent or downright opposed to the idea of therapy and have come to see me at their parents’ insistence, or on the recommendation of a pediatrician or other professional. Ultimately, it is up to parents, as it is with all medical treatment for their children, to make the decisions about starting and ending therapy. It is my job as a therapist to engage children and teens in the process of therapy, regardless of what brings them to see me.
Being frank and honest with kids about why you have sought out my consultation is really the best policy. Children are usually aware when their struggles are impacting the family, or when their parents or families are experiencing a crisis or are under a great deal of stress. Most appreciate a straightforward explanation about who I am and why they’re seeing me. When I meet them, I will also explain more to children about how I help, and answer any questions they may have about therapy. Please feel free to ask me if you would like more guidance about talking with your child about therapy.
It can be helpful for kids to know a little about what to expect ahead of time. During a first visit with a child or adolescent, my focus is on helping them feel comfortable and putting them at ease. Sometimes kids are worried that I will ask them questions they won’t know how to answer, or they are understandably nervous about meeting someone new or addressing issues that are uncomfortable to think about or discuss. I want them (and you!) to know that my job is not to judge! I want to understand and help, but not criticize or blame anyone.
Treatment Planning and Ongoing Therapy
The process of assessment is ongoing and will continue during the entire course of our work together. Our initial evaluation sessions will be followed by a discussion about my initial impressions and treatment recommendations. At this point, we will make a treatment plan, which consists of a schedule for visits, treatment goals, and the types of therapy we will use to work toward these goals. This is a collaborative process! Therapy is most effective when everyone is on board about what we are trying to accomplish and how we will get there. Often, beginning treatment goals involve improving a specific aspect of functioning or reducing suffering.
We will frequently discuss the progress we are making, and periodically update our goals. Depending upon the treatment focus, the length of a course of therapy can be as short as a few visits or as long as many years. Therapy may be mostly individual, or entirely family-focused. Each situation is different. Most will involve some combination of individual therapy and family therapy.
Ideally, we will come to an agreement about when our work together is finished. Through our ongoing evaluation of progress toward goals, we will know when and how to make changes in our treatment plan, including decreasing the frequency of sessions over time. Often, after a course of therapy is complete, it can be helpful to schedule periodic “booster sessions” or even begin another course of therapy as the need arises. I will make every effort to be available to you or your child for as long as you need me.
Individual therapy sessions are generally 45 minutes in length and focused on addressing specific symptoms, for example, anxiety that is interfering with school, work or relationships, depressed mood, or difficulty managing stress. Individual therapy can be focused on understanding problems and patterns, or focused on developing skills to manage symptoms or behaviors, or both. We may discuss specific tools or techniques for you or your child to practice between sessions, or target specific tasks that will be accomplished between sessions. We call this “homework,” but for kids I make sure to explain that although it is work, it is not the same as the writing or math homework they bring home from school. Many of the practices that will help bring about lasting change are things best done on a regular basis, like the nightly reading kids are asked to do for school.
Parents and other caregivers play an essential role in therapy for children and teens. I welcome parents’ feedback about their children’s functioning and will offer parents time at each session to update me regarding their observations and concerns. A note about confidentiality for children and teens: you as a parent are entitled to feedback about how your child is doing in therapy. I will give you periodic updates and you are always welcome to ask me for general feedback about progress. If your child is in danger, I will absolutely let you know. At the same time, in order for children to feel they can speak freely with me, it is critical that they know their words are not being “reported back” to parents or used for any purpose other than their healing. At the start of therapy, I will explain to children, and especially teens, the limits of confidentiality and the specific situations in which I am required to disclose certain information. I will also let them know that if an issue arises that we must discuss with parents, I will speak with the child or teen about it first.
Family Therapy and Parent Coaching
Family therapy sessions are usually 45-60 minutes in length and focused on addressing patterns of interaction or communication in the family that are not working for one or all members of the family. Family therapy sessions frequently involve all members of the family, but sometimes may just be one child and a parent or parents. Often it is while discussing specific issues of concern to a parent or child that we discover patterns and relationship dynamics that need attention.
I will often recommend family therapy with parents only when a child’s behavior is the focus of our work together. Parent training, or coaching, is a common name for this type of family work, and it can be an extremely effective tool for changing family dynamics. This kind of therapy almost always involves specific homework between sessions.