Support for children aged 6–12, when something doesn’t feel right

Coming to therapy doesn’t mean you’ve done anything wrong or that there’s something wrong with you.

There are lots of reasons why children come to therapy. You might already know there’s something you’d like help with, or a parent, carer or another grown-up who cares about you might think talking to someone here could help.

Our job is to get to know you, understand what things are like for you and see how we might be able to help.

Your first visit is a chance to meet us, see what TMH is like and decide whether you’d feel comfortable coming back for therapy.

We’ll usually start with you and your parent or carer – whoever brings you – in the same room. We’ll talk a little, explain how things work and give you plenty of chances to ask us questions.

You don’t need to prepare anything or know what to say. We’re getting to know you, but you’re also getting to know us.

After your first appointment, your therapy sessions will usually be just you and your therapist.

If you feel nervous at first, your parent or carer can help you settle in and wait nearby while you have your session.

We’ll take things at a speed that works for you.

A therapist is someone who listens and helps you make sense of things that are happening in your life.

You can talk to them about thoughts, feelings, worries, relationships or anything else that matters to you.

They’re not there to tell you off, test you or decide whether you’re being good or bad.

They are trained to help you understand things that matter to you.

No. You might want talk while you draw, make something, play a game or use toys. Sometimes you might want to talk a lot. Other times you might not feel like talking much at all.

You and your therapist will find ways of spending the session that work for you.

That’s fine. You don’t need to arrive with something prepared.

You can talk about something important or something completely ordinary – school, friends, family, games, pets, something funny that happened or whatever comes into your head.

You can also draw, play, make things or have some quiet time. Your therapist will help you get started.

You don’t have to. Your therapist is here to help you start to understand your feelings. They can be difficult to work out, and sometimes you just know that something isn’t quite right without knowing what it is or why.

No. You can tell your therapist if you don’t want to talk about something or that you’re not ready yet.

They might sometimes ask about something or wonder about it with you, but therapy shouldn’t feel forced. You’re allowed to take your time.

Of course. You can ask about therapy, your therapist, the room, what happens in sessions or anything else you don’t understand.

If there’s something your therapist can’t answer, they’ll explain why.

That’s very normal when you’re meeting someone new. You don’t have to act comfortable before you actually are.

You can stay close to your parent or carer while you settle in, bring something familiar with you to help you feel comfortable, or simply take your time as you get used to us.

Tell us. What you think matters, even if a grown-up thinks therapy could help and you’re not sure.

Meeting us doesn’t mean you agreed to talk about things you don’t want to. We can listen to how you feel about being here and see whether there’s a way of helping that feels right for you.

Sometimes children and grown-ups see the same situation differently. We won’t assume the grown-up is right. We want to hear what things are like from your point of view too – therapy is a place where your thoughts and feelings matter.

No. What you talk about in therapy is usually private. Your therapist won’t give your parent or carer a list of everything you’ve said.

There are some situations where we may need to get extra help to keep you or someone else safe. If that happens, wherever possible we’ll talk to you about what needs to happen and why.

Yes. They might contact us if they’re worried or think there’s something it would be useful for us to know.

That doesn’t mean your therapist will agree with them or spend your session talking about what they’ve said. Your therapist wants to understand what things are like for you.

Yes. Being able to talk about private things is an important part of therapy. Everything you say is private, unless there’s something that makes us very worried that you or somebody else isn’t safe.

If we ever need to involve somebody else to help, we’ll try to explain what we’re doing and why rather than doing things without you knowing.

You can talk about it if and when you want to – and you don’t have to tell the whole story at once. Start whenever you feel comfortable, and your therapist can help you think about wat happened and how it affects you now.

Telling us about something from the past doesn’t automatically mean everybody else will be told. But if we think you or another child may still be unsafe, we may need to get some extra help.

You can tell us. You don’t have to deal with something frightening, unsafe or hurtful by yourself.

Your therapist will listen and help you. If we think you or another child isn’t safe, we may need to involve another adult who can help. But wherever possible, we’ll explain what’s happening.

Sometimes people have thoughts or pictures in their minds that feel frightening, strange or upsetting. Having a thought doesn’t automatically mean you want it to happen or that you’re bad.

You can tell your therapist about them. They’re here to help you understand what’s happening, not to be shocked or angry with you.

Please tell us. You won’t be in trouble for having those thoughts or for telling us that you’ve hurt yourself.

Your therapist will listen and talk with you about how you’re feeling and whether you’re safe. Sometimes we may need to involve another adult or service to help. But if we do, we’ll try to explain what needs to happen and why.

You can tell us. Everyone sometimes does things they regret, feel confused about or find difficult to say out loud. Your therapist isn’t there to decide whether you’re a good or bad person. They’ll help you think about what happened, how you feel about it and what might help now.

That’s okay. You might cry, laugh, feel angry, be quiet, move around, change the subject or not know how you feel at all.

There isn’t a special way you have to behave in therapy. Your therapist will try to understand what’s happening rather than expect you to act in a certain way.

You don’t have to use perfect words in therapy. You can have strong opinions, disagree with your therapist and sometimes you might swear.

Your therapist isn’t there to make you agree with them. We just ask everyone at TMH to treat other people with respect and not threaten or hurt anyone.

Tell us. It takes a little while to get used to someone new, but also sometimes people simply aren’t the right match.

If your therapist has said or done something that’s bothered you, please tell them if you feel able to – or tell your parent or carer. If things still don’t feel right, we can think with you about whether another therapist might suit you better.

Yes. If having something familiar helps you feel more comfortable, bring it with you. It might be a favourite toy, teddy, fidget, book, drawing kit or something else that matters to you.

If you’re not sure whether something’s okay to bring, you can always ask us first.

Yes. Talking isn’t the only way to communicate. Drawing, playing, making things, telling stories and playing games can all help you explore what you think and feel.

Your therapist is trained to work with all these different ways of communicating.

Tell us what helps. You might need more time, fewer words, more movement, a quieter room, clearer explanations, something to hold or another way of communicating.

We’re not here to change who you are. But we can change the therapy so it works better for you.

No. You might already have a diagnosis, be waiting for an assessment or not have one at all. We’re interested in getting to know you as a person, not just a label.

Not at TMH. We provide therapy rather than specialist assessments that diagnose things like autism and ADHD.

If we think another kind of assessment could be useful, we can talk about it with you and the adults looking after you.

Yes. You can talk about anything to do with school.

That might include lessons, teachers, friends, bullying, homework, exams, feeling under pressure, finding it difficult to concentrate or not wanting to go in.

Your therapist isn’t there simply to make you behave, get better marks or go to school. They’ll want to understand how you actually feel about school.

Yes.

Friendships can be brilliant, but they can also be confusing, upsetting and lonely.

You can talk about making friends, losing friends, arguments, fitting in, being left out, bullying or anything else that matters to you.

Yes. Things that happen online can affect you just as much as things that happen face-to-face.

You can talk about games, group chats, social media, online friends, messages, pictures, videos, bullying or anything you’ve seen or been sent.

Yes. You can talk about parents, carers, brothers and sisters, foster or adoptive families, people you miss, people you find difficult or changes happening at home.

It’s also okay to have lots of different feelings about the same person. Your therapist won’t take sides – or expect you to take sides.

Yes. Growing up can bring lots of questions about your body, relationships, feelings and who you’re becoming.

You can talk about whatever you’re wondering or worried about. Your therapist is there to listen and help you understand yourself, not tell you who you should be.

We don’t automatically tell your school that you come to therapy or what you talk about in your sessions.

Sometimes it can be helpful to speak to your school. But this would be thought about carefully and we would normally need permission from you or your parent or carer.

And even if we do speak to someone at school, it doesn’t mean they’re told everything you say in therapy.

Yes. You might get support from your GP, CAMHS, school, a social worker or another professional while you’re having therapy.

Different people can help with different things. And sometimes, with the right permission, the adults supporting you can also talk to one another so the support fits together.

You can still have therapy. Your therapist won’t prescribe medicine or tell you to stop or change it. Those decisions are made by a doctor or another person who looks after your medicine.

It’s helpful if you let us know what medicine you take and if anything changes.

Therapy usually happens once a week, often on the same day and at the same time. It helps to have a regular time and day, as it means you can talk about things while they’re still fresh in your mind.

We know there’ll be times when you can’t come to your session. You don’t need to worry about sorting that out yourself – your parent or carer can let us know.

Yes. Some people find online sessions helpful, and others prefer being in the same room as their therapist. If we feel online therapy is suitable for you, sessions can take place by video call. We always work with you to see what will help you most.

If something happens that you want your therapist to know about, you can ask a parent, carer or another adult you trust to contact us. Your therapist may not be able to reply straight away, but they can talk about it with you at your next session.

However, if you need help straight away because you or someone else isn’t safe, don’t wait to speak to your therapist: tell an adult you trust so they can help you get the support you need.

When it comes to knowing whether therapy is helping, you’ll find some changes are easy to notice, and others can be small.

You might realise you understand yourself better or find it easier to talk about something. Maybe you start to notice what happens when you feel worried or angry, or find new ways of dealing with things that are difficult.

Either way, you and your therapist will regularly talk about how things are going and whether therapy is helping.

Therapy can sometimes bring up difficult thoughts, feelings or memories. If a session feels too much, confusing or leaves you worried afterwards, your therapist needs to know.

You don’t have to pretend everything is fine – you and your therapist can talk about what’s happening and what might help.

Therapy doesn’t have to continue forever, but some people need it for longer than others. You and your therapist will keep thinking about how things are going and whether the sessions are still helping.

If you feel you’re not moving forward, tell your therapist. You can talk together about whether anything needs to change.

Yes. What you think about your therapy matters.

Where possible, having a final session gives you and your therapist a chance to think about the work you’ve done, say goodbye and talk about what you’ve taken from the sessions.

That’s fine. Finishing therapy doesn’t mean you can never ask for help again. If you need support again later, you or a grown-up caring for you can contact us.

It doesn’t have to be a huge problem. If something matters to you, keeps bothering you or you want some help understanding it, it’s okay to talk about it. Therapy isn’t only for emergencies.

Someone else having a difficult time doesn’t make what you’re going through any less important.

You don’t have to compare yourself with anyone else before asking for help – we want to understand what things are like for you.

Therapy isn’t about turning you into somebody else. We’re here to help you understand yourself, your feelings and your experiences, and find ways of handling things that are difficult.

That’s fine. Therapy isn’t about your therapist always being right. If you don’t agree with them on something, you should let them know.

Being able to disagree and talk something through can actually help you understand each other better.

You don’t need to know before you come. Your first appointment gives you a chance to meet us, see what TMH is like and ask whatever questions you have.

We’ll also think carefully about whether we’re the right people to help you, and if we think another kind of support would suit you better, we’ll explain why.

At your first appointment, we’ll ask what would help you feel comfortable with a therapist, and whether there’s anything that feels particularly important to you.

We’ll also think about what you might need help with, and which of our therapists have the right experience. Because we have a large team, there may be several people who could be a good fit.

We’ll talk through the options with you and the adults who support you, and we want you to tell us honestly what you think. Feeling comfortable with your therapist is an important part of therapy.