Why Talk Therapy Doesn’t Work for Children (and What Does)
Many parents seek out therapy with the expectation that their child will talk with a therapist about their problems and be taught coping skills to help manage those difficulties. When that doesn’t happen, it can feel confusing, or even concerning.
So, what gives?
The answer lies in brain development. Therapists are trained to understand human development because it guides how we support clients at different stages of life. Just as you have adjusted how you support your child as they’ve grown, child therapists also take development into careful consideration when working with children.
For example, when your child was an infant, you didn’t give them verbal instructions on how to hold their head up on their own. You instinctively knew they wouldn’t understand those instructions, and that they also needed time to build the physical strength required to do so. In the same way, children cannot be reasoned or rationalized into emotional regulation. This is what makes traditional “talk therapy” a developmentally mismatched approach for young children.
Our brains develop in a systematic way, and understanding that process can provide deeper insight into your child’s behavior and help you respond in ways that are developmentally appropriate and effective. Two key concepts that help explain this are emotional processing and cognitive processing.
Emotional Processing
Emotional processing is the dominant mode of processing in early childhood (ages 0–5) and remains the primary mode during much of middle childhood (ages 6–10). Emotional processing is how we feel, sense, and emotionally respond to experiences. It happens quickly, automatically, and often outside of conscious awareness.
What does this look like in everyday life? Imagine you are walking down the sidewalk and someone approaches you from the opposite direction. As you pass each other, you look up and notice they are smiling. You instinctively smile back, and you both continue on your way.
Now let’s slow that moment down. When you saw the person smile, you likely didn’t think, “Should I smile back? Yes, I think I will,” or “I don’t want them to feel uncomfortable, so I should smile.” Instead, the response happened automatically. You smiled without conscious thought or deliberation. That is emotional processing at work.
Cognitive Processing
Cognitive processing begins to emerge during middle childhood (ages 6–10) and continues to develop rapidly through late childhood and adolescence (ages 11–18), though emotional processing still tends to lead. Cognitive processing involves how we think, reason, analyze, and reflect. It is slower, more deliberate, and conscious. It is language-based and relies on skills such as working memory, attention, and abstract thinking.
Cognitive processing supports executive functioning skills like planning, impulse control, and perspective-taking. It allows us to ask and answer questions such as “Why did this happen?” or “What should I do next?” These skills continue developing well into young adulthood, and cognitive processing does not become fully reliable until approximately ages 18–25.
A helpful way to think about these two systems is this: emotional processing drives behavior, while cognitive processing explains it. We feel first, and then, if we are regulated enough, we think.
To effectively engage in traditional talk therapy, a client must have sufficient abstract thinking, the ability to gain insight through language, and the capacity for internal reflection. These are cognitive processing skills. Children, however, primarily communicate through play, movement, symbols, and relationships, all of which are guided by emotional processing.
From this developmental perspective, talk therapy is asking children to do something they are not yet developmentally equipped to do. It’s like asking a child to drive a car before they can reach the pedals. They may understand what driving is in theory, but they physically cannot do what is required. It’s also like asking a child to read aloud before they know the alphabet.
So, if children cannot talk through their problems in the same way adults do, how does therapy support them?
Child therapists meet children where they are developmentally. Rather than relying on verbal discussion, we enter the child’s world and use their natural language, which is play. Through play, therapists help children build emotional awareness, develop a sense of self, make meaning of their experiences, strengthen self-esteem, and learn coping skills in ways their developing brains can truly integrate.
We don’t skip steps in development, we build them.
