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Now that your child is starting psychotherapy, you may be concerned about the process and about how you will be involved. Therapy varies depending on the child and the therapist, but some elements are likely to be similar for all. 

ASSESSMENT: Therapy begins with some kind of assessment process. The therapist gathers most of the information from interviews with you and your child. These may be done together or separately, but you always should be included in some way. A therapist occasionally may use a formal psychological test, but this does not mean you should expect one. Interviews, observations, and sometimes questionnaires usually provide enough information. Although the questions a therapist chooses to ask vary depending on his or her theoretical orientation, some are standard. You should expect to discuss your child's developmental history, specific descriptions of the problem you came to solve and its influential factors, and what you've tried before and what has or hasn't worked.  

WHAT TO EXPECT: Some practitioners involve parents more than others, and styles of therapy change depending on the therapist's theoretical orientation. Whatever the orientation, however, the therapist should tell you something specific about your child's problem and what caused it, what concerns will be addressed and how, what channels of communication exist between the therapist and you, what your involvement will be, and if your involvement is minimal, why you won't be included in the therapy. You should expect your child to improve over time. If her or she doesn't, talk to the therapist to make sure you understand what the problems are and why therapy does not seem to be helping. Remember, you and the therapist are in a partnership for your child's best interests. You deserve to know if there are complications.  

CONFIDENTIALITY LAWS: Confidentiality laws protect children as well as adults. There are limitations on these laws, which vary from state to state, but in general the therapist can break this confidence only when he or she suspects your child is in danger, might endanger others, or might destroy property. Professionals involved in the child's care, such as teachers or pediatricians, have no right to know what the child tells the therapist. Between your child and you, however, confidentiality is more of a judgment call. Although the law in this case does not protect children from parents, a trusting relationship with the therapist often depends on some understanding of confidentiality. Therapists take different approaches in this situation. Some will tell you almost nothing, while some will tell you everything. Many take a middle path, letting you know your child's general thoughts and emotions but none of the specifics. Before you begin therapy, you should make sure that both you and your child understand how confidentiality applies in your child's therapy. If you and your child's other parent are both custodial parents but divorced or never married, you have equal rights to speak to the therapist about your child. In the case of single custody, however, the noncustodial parent must receive permission from the custodial parent to be involved in the therapeutic process in any way. 

MEDICATION: In general, providers are cautious about prescribing medication to children. Drugs can affect children differently from adults and in some cases can cause side effects that adults don't experience.