Should Parents Be in the Therapy Room?

The answer is…sometimes.

You’ve booked the appointment. You’ve attended the intake and had a chance to speak privately with the therapist about your concerns. Now you’ve arrived for your child’s first therapy session.

The therapist greets your child and leads them into the therapy room.

And you stay behind.

Sitting in the waiting room, perhaps with a coffee and your phone, you might find yourself wondering: Wait. Why am I not in there? Shouldn’t I be part of my child’s therapy? Is my child going to tell them what’s actually going on? What are they talking about in there? And am I allowed to ask?

You absolutely are. In fact, whether parents should be in the therapy room is something those of us working in pediatric mental health talk about a lot. We discuss it, research it, compare approaches, attend trainings about it…and then discuss it some more.

And after all of that, there still isn’t one answer.

That’s because it depends on the child, their age, why they are coming to therapy, and what we are trying to accomplish.

Why Wouldn't I Be In the Room with My Child?

Sometimes, we need to see your child without you. There are times when having some space from a parent can be really valuable, particularly in play-based therapy.

Children communicate through much more than words. Through play, conversation, art and interaction, we begin to understand how they experience their world: their family, school, friendships, worries, and relationships.

When a parent is in the room, children will naturally look to them. "Is it okay to say this? Did I get that right? Is Mom upset? Does Dad agree?"

And parents—being human—respond. A raised eyebrow, a quick smile, a surprised expression or even a tiny shift in posture can communicate a great deal to a child without anyone saying a word.

None of this means a parent is doing anything wrong. It simply means that sometimes we want the opportunity to get to know the version of your child who isn't checking the room for reassurance or approval.

We want to understand how your child sees their world. But that doesn't mean you're sitting on the sidelines.

This is the important part.

Parents should be involved in their child's treatment.

Generally, the younger the child, the more important it is that parents understand what we are working on, receive feedback, and learn strategies they can use outside the therapy room. After all, we may see your child for an hour. You are raising them the other 167 hours of the week.

Once we have had an opportunity to assess and understand your child's needs, we may bring you into sessions. Your child might practise sharing something with you. We might teach coping or regulation strategies together. Or we may spend time helping everyone understand how to respond differently at home.

Sometimes, the most important work we do with a child happens through the adults who care for them. And sometimes, parents are part of therapy from the very beginning.

It also depends entirely on why you're coming to see us. If your family is participating in Parent-Child Interaction Therapy (PCIT), for example, parents are an essential part of treatment. You're not waiting outside—you're learning and practising right alongside your child. Family therapy may include a combination of individual child sessions, parent sessions, and sessions with everyone together. 

And as children move into middle school and adolescence, things change again. Teenagers need increasing opportunities to develop independence and something therapists call differentiation—the very normal developmental process of discovering:  I can have thoughts, feelings, and opinions that are different from my parents' thoughts, feelings, and opinions.

Having a private therapeutic space can be an important part of that development, while parents continue to play an important supportive role.

So, Should You Be in the Room?

The wonderfully frustrating therapist answer is: it depends. But you should understand why.

If you aren't sure why you're in the waiting room, ask us. If you don't understand how you're supposed to be involved, ask us. If you want to know how the work happening in therapy connects to what you can do at home, definitely ask us.

Good pediatric therapy shouldn't just support a child. It should help support the people raising them, too.