Understanding Different Types of Therapy for Young People | Colchester Therapist Guide

One of the most common questions I receive from families in my Colchester practice is: "What type of therapy would be best for my child?" With so many different therapeutic approaches available, it can be overwhelming to understand which might be most suitable for your young person's specific needs.

The truth is, there's no one-size-fits-all approach to therapy. What works brilliantly for one child may not be the right fit for another, even if they're dealing with similar challenges. Understanding the different types of therapy available can help you make informed decisions about your young person's mental health support.

The Foundation: Understanding How Therapy Works with Young People

Before exploring specific approaches, it's important to understand that therapy with young people differs significantly from adult therapy. Children and teenagers are still developing cognitively, emotionally, and socially, which means therapeutic approaches must be adapted to meet them where they are developmentally.

Young people may not have the vocabulary to express complex emotions, they might communicate more through behavior than words, and their understanding of abstract concepts varies greatly by age. Effective therapy for young people recognizes these developmental realities and adapts accordingly.

Play Therapy: The Language of Childhood

For younger children (typically ages 3-12), play therapy is often the most effective therapeutic approach. This isn't simply "playing games" with a therapist—it's a sophisticated therapeutic method that recognizes play as children's natural form of communication.

How Play Therapy Works

Children often lack the vocabulary to express complex emotions or traumatic experiences directly. Through play, they can explore feelings, recreate difficult experiences, and work through problems in a safe, symbolic way.

In my practice, I might see a child who's experienced their parents' divorce repeatedly crash toy cars together, or a child dealing with anxiety carefully organizing and reorganizing the dollhouse furniture. These aren't random activities—they're meaningful expressions of their inner world.

What Play Therapy Looks Like

Typical play therapy tools include:

• Dolls and action figures for family and relationship dynamics
• Art materials for creative expression
• Sand trays for creating worlds and scenarios
• Building blocks for control and mastery
• Musical instruments for emotional expression
• Books and stories for exploring difficult topics

When Play Therapy is Most Effective

Play therapy works particularly well for:

• Children who have difficulty expressing emotions verbally
• Those who've experienced trauma or significant life changes
• Children with behavioral difficulties
• Those dealing with family transitions (divorce, new siblings, moving)
• Children with autism or developmental differences
• Those experiencing anxiety or fears

Different Types of Play Therapy

Non-directive play therapy: The child leads the session, choosing activities and topics while the therapist provides a safe, accepting environment.

Directive play therapy: The therapist guides activities more specifically to address particular issues or teach specific skills.

Sandplay therapy: Uses miniature figures and sand trays to create worlds, allowing children to express unconscious material safely.

Filial therapy: Teaches parents play therapy skills to use at home, strengthening the parent-child relationship.

Cognitive Behavioral Therapy (CBT): Thoughts, Feelings, and Actions

CBT is a structured, goal-oriented approach that helps young people understand the connections between their thoughts, feelings, and behaviors. It's particularly effective for specific symptoms like anxiety, depression, and behavioral problems.

How CBT Works with Young People

CBT teaches young people to identify unhelpful thought patterns and develop more balanced, realistic thinking. It also provides practical tools for managing difficult emotions and changing problematic behaviors.

For example, a teenager with social anxiety might learn to recognize thoughts like "Everyone will think I'm stupid" and challenge them with more balanced alternatives like "Some people might not be interested in what I say, but others might, and that's normal."

Age-Appropriate CBT Adaptations

For children (8-12): CBT uses more visual aids, games, and concrete examples. Concepts are simplified, and homework assignments might involve drawing or simple behavioral tracking.

For teenagers (13-18): CBT can be more sophisticated, incorporating abstract thinking and complex emotional concepts. Teenagers can engage with worksheets, thought records, and behavioral experiments.

For young adults (18-25): CBT closely resembles adult approaches but may focus more on life transitions, identity formation, and independence-related challenges.

What CBT Looks Like in Practice

Common CBT techniques include:

• Thought records to track and challenge negative thinking
• Behavioral experiments to test feared situations gradually
• Relaxation and mindfulness techniques for anxiety management
• Problem-solving skills training
• Social skills practice and role-playing
• Homework assignments to practice new skills

When CBT is Most Effective

CBT works particularly well for:

• Anxiety disorders (social anxiety, separation anxiety, phobias)
• Depression with clear negative thinking patterns
• Behavioral problems with identifiable triggers
• OCD and repetitive behaviors
• Eating disorders (as part of comprehensive treatment)
• Sleep difficulties
• Anger management issues

Limitations of CBT

While CBT is highly effective for many issues, it may be less suitable for:

• Very young children who can't engage with cognitive concepts
• Complex trauma requiring deeper processing
• Family systems issues that need broader intervention
• Young people who resist structured approaches

Psychodynamic Therapy: Understanding the Deeper Patterns

Psychodynamic therapy, which is my primary approach, focuses on understanding unconscious patterns, early relationships, and how past experiences influence current behavior and emotions. Rather than just addressing symptoms, it seeks to understand the underlying causes of difficulties.

How Psychodynamic Therapy Works

This approach recognizes that many of our emotional patterns are formed in early relationships and experiences. By understanding these patterns, young people can develop insight into their behavior and make conscious choices about how they want to be in relationships.

For example, a teenager who becomes very angry when feeling rejected might explore how early experiences of abandonment or inconsistent caregiving created a hypersensitive rejection response. Understanding this pattern can help them respond differently in current relationships.

What Psychodynamic Therapy Looks Like

Key elements include:

• Exploring the therapeutic relationship as a window into other relationships
• Understanding defense mechanisms and coping strategies
• Examining family patterns and dynamics
• Processing unconscious conflicts and emotions
• Connecting past experiences to current difficulties
• Developing insight into repetitive patterns

Psychodynamic Therapy Across Ages

For children: Often combined with play therapy, using play to explore unconscious material and relationship patterns.

For teenagers: Focuses on identity formation, family relationships, and emerging independence while exploring underlying emotional patterns.

For young adults: Examines how childhood experiences influence current relationships, career choices, and life direction.

When Psychodynamic Therapy is Most Effective

This approach works particularly well for:

• Complex emotional difficulties without clear triggers
• Relationship patterns that repeat across different contexts
• Identity and self-esteem issues
• Family dynamics and attachment difficulties
• Processing difficult early experiences
• Young people seeking deeper self-understanding

The Time Factor

Psychodynamic therapy typically takes longer than other approaches because it addresses underlying patterns rather than just symptoms. However, the changes tend to be more comprehensive and lasting.

Family Therapy: Addressing the System

Sometimes, a young person's difficulties are best understood within the context of family relationships and dynamics. Family therapy works with the entire family system to create positive change.

How Family Therapy Works

This approach recognizes that families are interconnected systems where changes in one person affect everyone else. Rather than focusing on the "identified patient" (usually the young person), family therapy examines how family patterns contribute to difficulties and how changes in these patterns can support healing.

Types of Family Therapy

Structural family therapy: Focuses on family hierarchy, boundaries, and organization.

Strategic family therapy: Addresses specific problems through targeted interventions and behavioral changes.

Systemic family therapy: Examines communication patterns and belief systems within the family.

Narrative family therapy: Helps families rewrite problematic stories about themselves and their relationships.

When Family Therapy is Most Effective

Family therapy works particularly well for:

• Behavioral problems that occur primarily at home
• Family conflict and communication difficulties
• Eating disorders and self-harm (as part of comprehensive treatment)
• Substance use issues
• School refusal and anxiety
• Major family transitions or crises

Integrative and Specialized Approaches

Many therapists, including myself, use integrative approaches that combine elements from different therapeutic models based on the young person's specific needs.

Common Combinations

Play therapy with psychodynamic principles: Using play to explore unconscious material and relationship patterns.

CBT with mindfulness: Adding mindfulness techniques to traditional CBT for enhanced emotional regulation.

Family therapy with individual work: Alternating between family sessions and individual therapy with the young person.

Specialized Therapeutic Approaches

EMDR (Eye Movement Desensitization and Reprocessing): Specifically for trauma processing, can be adapted for children and teenagers.

Dialectical Behavior Therapy (DBT): Originally designed for borderline personality disorder, now used for emotion regulation difficulties in adolescents.

Acceptance and Commitment Therapy (ACT): Focuses on psychological flexibility and values-based living, particularly useful for anxiety and depression.

Art and Creative Therapies: Use artistic expression as the primary means of communication and healing.

Choosing the Right Approach: Key Considerations

Age and Developmental Stage

Ages 3-8: Usually benefit most from play-based approaches with some family involvement.

Ages 9-12: May engage with more structured approaches like CBT while still benefiting from creative elements.

Ages 13-18: Can engage with most therapeutic approaches, though individual preferences and personality matter significantly.

Ages 18-25: Can participate in any approach, with choice often depending on specific issues and personal preferences.

Type of Difficulties

Specific symptoms (anxiety, depression, phobias): Often respond well to CBT or other structured approaches.

Complex trauma or attachment issues: Usually benefit from longer-term psychodynamic or trauma-focused approaches.

Family or relationship difficulties: May require family therapy or approaches that include family members.

Behavioral problems: Often respond to combination approaches including behavioral strategies and family work.

Personality and Learning Style

Highly verbal young people: May engage well with talking therapies like CBT or psychodynamic approaches.

Creative or artistic young people: Might prefer art therapy, music therapy, or other creative approaches.

Concrete thinkers: Often benefit from structured, practical approaches like CBT.

Intuitive or emotional young people: May prefer exploratory approaches like psychodynamic therapy.

Cultural and Family Factors

Different families have varying comfort levels with different therapeutic approaches. Some prefer structured, symptom-focused approaches, while others are more comfortable with exploratory, relationship-focused work.

It's important that the therapeutic approach aligns with family values and cultural beliefs while still being effective for the young person's specific needs.

The Therapeutic Relationship: The Foundation of All Approaches

Regardless of the specific therapeutic approach, the relationship between the therapist and young person is the foundation of effective therapy. Research consistently shows that the quality of this relationship is one of the strongest predictors of therapy success.

What Makes a Good Therapeutic Relationship

For children: Feeling safe, understood, and accepted without judgment. The therapist becomes a trusted adult who provides consistency and emotional attunement.

For teenagers: Having their autonomy respected while feeling genuinely cared for. The therapist provides a non-judgmental space for exploring identity and independence.

For young adults: Feeling understood and supported without being patronized. The therapist serves as a collaborative partner in exploring life challenges and decisions.

Building Trust Across Ages

Trust develops differently at different developmental stages:

• Young children build trust through consistent, predictable interactions and feeling emotionally understood
• Teenagers need to feel respected and not judged, with their confidentiality clearly maintained
• Young adults want to be treated as capable individuals while receiving support for areas where they're still developing

Making Therapy Work: Practical Considerations

Frequency and Duration

Play therapy: Usually weekly sessions, with duration depending on the complexity of issues (3 months to 2+ years).

CBT: Often weekly for 12-20 sessions for specific symptoms, though complex issues may require longer.

Psychodynamic therapy: Typically weekly or bi-weekly for 6 months to several years, depending on goals and complexity.

Family therapy: Usually weekly or bi-weekly, often shorter-term (3-6 months) but may be longer for complex family issues.

Involving Parents and Carers

Young children (under 12): Parents are usually heavily involved with regular updates and sometimes joint sessions.

Teenagers (13-18): Balance between individual confidentiality and keeping parents informed about general progress.

Young adults (18+): Usually individual therapy with family involvement only if specifically requested by the young person.

Measuring Progress

Progress in therapy with young people might include:

• Improved emotional regulation and coping skills
• Better relationships with family and peers
• Increased confidence and self-esteem
• Reduced symptoms (anxiety, depression, behavioral problems)
• Better functioning at school or work
• Greater self-understanding and insight

What to Expect: The Therapy Process

Initial Assessment

The therapy process typically begins with an assessment to understand:

• The young person's current difficulties and strengths
• Family history and dynamics
• Previous experiences with therapy or other interventions
• Goals and expectations for therapy
• Cultural and practical considerations

Early Sessions

Early sessions focus on:

• Building rapport and trust
• Understanding the young person's perspective on their difficulties
• Establishing therapeutic goals collaboratively
• Beginning to address immediate safety or crisis issues

Middle Phase

The middle phase involves:

• Working on core issues using the chosen therapeutic approach
• Developing new skills and insights
• Processing difficult emotions or experiences
• Practicing new behaviors and ways of relating

Ending Therapy

Therapy typically ends when:

• Goals have been achieved or significantly progressed
• The young person has developed sufficient coping skills
• Family dynamics have improved sufficiently
• The young person feels ready to manage independently

When Things Aren't Working: Adjusting the Approach

Sometimes, despite best intentions, the chosen therapeutic approach isn't the right fit. Signs that an adjustment might be needed include:

• Lack of progress after several months
• Young person consistently resisting or disengaging from sessions
• Family feeling that the approach doesn't match their values or needs
• New issues emerging that require different therapeutic skills

Good therapists regularly review progress and are willing to adjust their approach or refer to colleagues with different specializations when needed.

Finding the Right Therapist

Questions to Ask Potential Therapists

• What therapeutic approaches do you use with young people?
• How do you adapt your approach for different ages?
• How do you involve families in the therapeutic process?
• What's your experience with [specific issue]?
• How do you measure progress in therapy?
• What happens if the initial approach isn't working?

Red Flags to Watch For

• Therapists who are inflexible about their approach
• Those who don't explain their methods or reasoning
• Therapists who don't seem to connect well with your young person
• Those who make unrealistic promises about quick fixes
• Therapists who don't involve parents appropriately for the young person's age

The Evidence Base: What Research Tells Us

Different therapeutic approaches have varying levels of research support for different issues:

Strong research support:

• CBT for anxiety disorders, depression, and behavioral problems
• Family therapy for eating disorders and behavioral issues
• Play therapy for trauma and emotional difficulties in children
• EMDR for trauma processing

Emerging research support:

• Mindfulness-based approaches for anxiety and depression
• DBT for emotion regulation difficulties in adolescents
• Psychodynamic therapy for complex emotional difficulties

However, it's important to remember that research findings represent averages across groups. What matters most is what works for your specific young person in your specific circumstances.

The Role of Medication

While this article focuses on therapy approaches, it's worth noting that medication sometimes plays a role in treating young people's mental health difficulties. The decision about medication should always involve:

• Thorough assessment by qualified medical professionals
• Consideration of therapy as first-line treatment for many conditions
• Careful weighing of benefits and risks
• Regular monitoring and review
• Integration with therapeutic approaches rather than replacement of them

Supporting Therapy at Home

Regardless of the therapeutic approach, families can support the process by:

• Maintaining consistent routines and boundaries
• Practicing skills learned in therapy
• Communicating openly about the therapy process
• Being patient with the pace of change
• Taking care of their own emotional needs
• Following through with therapist recommendations

Hope and Healing: The Power of Appropriate Support

Understanding different therapeutic approaches empowers families to make informed decisions about their young person's mental health support. While the variety of options can seem overwhelming, this diversity means there's likely an approach that will work well for your family's specific situation.

Remember that therapy is not a sign of failure or weakness—it's an investment in your young person's emotional wellbeing and future relationships. The skills and insights gained through therapy often serve young people throughout their lives, improving not just their current difficulties but their overall resilience and capacity for healthy relationships.

Every young person deserves to feel understood, supported, and hopeful about their future. With the right therapeutic approach and a strong therapeutic relationship, positive change is not just possible—it's expected.

If you're considering therapy for a young person in your life, explore our specialized services for child therapy, teenage therapy, and young adult therapy. For additional support navigating this process, our parent support services provide guidance for families throughout the therapeutic journey.