Deciding that your child might benefit from therapy can take a lot of courage. Then comes the next hurdle: how do you pick the right person? Directories are full of names, and it can be hard to tell who actually knows how to work with children.
I’m a Licensed Professional Counselor, and much of my work is with children and teens. Here is what I would want to know if I were in your shoes, including the questions worth asking on that first phone call.
What training and experience should a child therapist have?
Start with the basics. Your child’s therapist should hold a current state license to practice independently. In Oregon, that might be a Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), licensed clinical social worker, psychologist, or psychiatric provider.
A license alone doesn’t tell you whether someone is experienced with children. Working with a 5-year-old is very different from working with an adult. Children often can’t explain what is bothering them in words. They show it through behavior and play. As the American Academy of Child and Adolescent Psychiatry puts it, for children “playing, drawing, building, and pretending, as well as talking, are important ways of sharing feelings and resolving problems”.
So it’s worth asking how much of the therapist’s caseload is children, which ages they see most, and what approaches they use with each age.
If you are looking for play therapy, ask what play therapy training and supervision the therapist has had, which ages they see in the playroom, and how they involve parents along the way.
For teens, the picture is a bit different. Many teens prefer to talk, and approaches such as cognitive behavioral therapy (CBT) and mindfulness-based skills are often a good fit. Ask how the therapist adapts their work for adolescents.
How do I check a therapist’s license in Oregon?
This takes two minutes and is worth doing. Oregon’s Mental Health Regulatory Agency has a license verification page where you can look up a licensed professional counselor, licensed marriage and family therapist, or registered intern through the Board of Licensed Professional Counselors and Therapists. Psychologists and clinical social workers are licensed by their own separate boards.
Questions to ask on the first phone call
Many therapists, including me, offer a free phone consultation. It’s a chance for you to get a feel for the person as much as for them to hear about your child. Here are questions worth having on a sticky note:
- How many children or teens of my child’s age do you see?
- What approaches do you use with a child like mine, and why?
- Will you meet with me first, or with my child?
- How will I be kept informed about my child’s progress, and how can I help at home?
- What do you keep private between you and my child, and when would you tell me something?
- How often are sessions, and roughly how long might therapy last?
- Do you offer in-person sessions, telehealth or both?
- What are your fees, and do you take my insurance?
Several of these come straight from AACAP’s list of questions for parents, which also includes asking why therapy is being recommended, how often the therapist will see your child, and whether they will meet with just your child or the whole family.
Pay attention to how you feel during the call, too. Do you feel heard? Does the therapist explain things in plain language? Would your child feel comfortable with this person? Fit matters.
How involved will I be as a parent?
With children, parents are part of the work. You know your child better than anyone, and you are the one there at bedtime, at breakfast and in the car after school.
In my practice, I begin by meeting with the parent on their own. That gives you space to share your child’s history and your worries without your child listening. Once therapy starts, I keep parents informed about the themes I’m seeing and how things are going, and I offer guidance for home. The details of what happens in each session usually stay between me and your child, because that privacy is part of what helps a child feel safe enough to open up.
Different therapists set this balance in different ways, so ask about it directly.
What about confidentiality for teens?
This is one of the questions parents ask me most, and Oregon law is a little different from what many people expect.
Under Oregon law (ORS 109.675), a young person aged 14 or older can get outpatient mental health diagnosis or treatment without a parent’s knowledge or consent, from certain licensed providers, including licensed professional counselors. The same law says the provider should involve the parents before the end of treatment, unless the parents refuse or there are clear clinical reasons not to, which must be documented. There are exceptions, for example where a young person has been abused by a parent.
In practice, most teens come to therapy with a parent’s support, and involving parents is usually helpful. But knowing their conversations are private matters a great deal to teenagers. Many will only speak openly once they trust that what they say won’t be repeated word for word.
Private does not mean secret when safety is at stake. Counselors’ ethical codes allow confidentiality to be broken when there is a risk of serious and foreseeable harm, such as suicidal intent, as the American Counseling Association’s Counseling Today describes. A good therapist will explain these limits to both you and your teen at the very start, so no one is surprised later.
If you are worried about your child’s safety right now, call 911. You can call or text 988 for the Suicide and Crisis Lifeline, or call the Washington County Crisis Line at 503-291-9111.
Does insurance, including OHP, cover child therapy?
Many plans do cover outpatient therapy for children and teens, but coverage varies. Before your first session, it helps to ask the therapist whether they are in network with your plan, and to call your insurer about any copay or deductible.
I accept the Oregon Health Plan (OHP) through several coordinated care organizations, as well as some commercial plans. You can see the current details on my insurance and fees page.
In-person or telehealth?
Both can work well, depending on your child’s age and needs.
The Child Mind Institute notes that telehealth can address many common concerns, including anxiety, depression and behavior problems, but that very young children and those with developmental delays may have trouble staying engaged on a screen. Teens often do well with video sessions, as long as they have a quiet, private space where siblings can’t overhear.
For younger children, I find that play therapy works best in person, in a real playroom with toys, art materials, a sand tray and games. For teens, and for parent sessions, telehealth is a good option anywhere in Oregon.
A quick checklist
Before you commit, you want to be able to answer yes to most of these:
- The therapist is licensed, and you’ve checked the license.
- They regularly work with children or teens of your child’s age.
- They explained their approach in a way that made sense.
- You know how you will be kept informed.
- You and your child both understand what stays private and what doesn’t.
- The practical details (location, telehealth, fees, insurance) work for your family.
- You felt comfortable talking with them.
If a first therapist isn’t the right fit, it’s okay to try someone else. That’s not failure. It’s part of finding the right help. You can also read more common questions on my FAQ page or learn about my work with children and teens.
Talk it through with me
If you’re trying to decide whether I might be the right therapist for your child, the easiest next step is a free phone consultation. You can ask me any of the questions above, and I’ll be honest about whether I think I’m a good fit. Call 503-495-5072 or send me a message. My office is in King City, a few minutes from central Tigard.
Sources
- American Academy of Child and Adolescent Psychiatry. Psychotherapy for Children and Adolescents. Facts for Families No. 53, updated February 2017. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/What-Is-Psychotherapy-For-Children-And-Adolescents-053.aspx
- Oregon Mental Health Regulatory Agency. Verify a License. https://www.oregon.gov/mhra/pages/verify.aspx
- Oregon Legislative Assembly. Enrolled Senate Bill 491 (2013), amending ORS 109.675. https://olis.oregonlegislature.gov/liz/2013R1/Downloads/MeasureDocument/SB491
- Bray, B. (2022, October). Confidentiality comes first: Navigating parent involvement with minor clients. Counseling Today, American Counseling Association. https://www.counseling.org/publications/counseling-today-magazine/article-archive/article/legacy/confidentiality-comes-first–navigating-parent-involvement-with-minor-clients
- Sheldon-Dean, H. Telehealth for Kids’ Mental Health. Child Mind Institute, last updated October 2, 2024. https://childmind.org/article/telehealth-for-kids-mental-health/