What Therapy Really Looks Like for Kids & Teens

When you hear “therapy,” you might picture someone lying on a couch, diving deep into their feelings while a therapist nods thoughtfully. But when it comes to therapy for kids and teens? It looks a lot more like coloring, building with Legos, storytelling, and sometimes even laughter.

So what actually happens in therapy with young people? Let’s take a look inside the therapy room and break it down.

First Things First: Every Child is Unique

Therapy is always personalized to fit the child or teen’s developmental level, personality, and needs. Some kids need lots of movement and play, others need quiet space to reflect and create. Some teens thrive with talk therapy, while others feel safer easing in through activities or expressive arts.

No two sessions are exactly the same—but here’s what you might see:

1. Art Therapy & Expressive Arts

For many kids and teens, it’s hard to put big feelings into words. That’s where creative therapy comes in. We might:

• Draw or paint what sadness, anger, or anxiety looks like

• Create “feeling masks” or identity collages

• Use storytelling or comics to work through difficult experiences

• Write poems, songs, or journal entries to express inner thoughts

Creative expression helps externalize emotion—it’s not just about talking about the feeling, but showing it, moving through it, and making sense of it.

2. Play Therapy

Play is a child’s natural language—and therapy taps into that. In sessions, I might bring out:

• Miniature figures, sand trays, or dollhouses to act out stories

• Therapeutic board games or emotion card games

• Puppets or stuffed animals for role-play and social learning

• Building materials like Legos or blocks for metaphor-based work

Through play, children can express what’s going on internally without pressure. It also helps build emotional regulation, problem-solving skills, and confidence.

3. For Teens: Creative Tools + Real Talk

Teens often benefit from a mix of approaches. In addition to talk therapy, sessions may include:

• Vision boards to explore identity and goals

• Music-based activities (analyzing lyrics, creating playlists)

• Role-play for practicing communication or setting boundaries

• Mindfulness or body-based practices for emotional grounding

I meet teens where they are—sometimes it’s lighthearted, sometimes it’s deep. The important thing is that they feel respected, understood, and empowered.

4. Skill-Building and Coping Tools

Throughout all sessions, I weave in tools for emotional regulation and real-life challenges, such as:

• Identifying and naming emotions

• Coping strategies for anxiety, anger, or overwhelm

• Social skills and boundary setting

• Executive functioning tools for kids with ADHD

We’ll often practice these skills through games, activities, or real-life scenarios so they become second nature.

5. Parent/Caregiver Involvement

You’re part of the healing process, too. Depending on the child’s age and needs, I often include:

• Check-ins before or after sessions

• Parent coaching around behavior, communication, or emotional support

• Family sessions to improve connection and teamwork

• Tools and resources to support therapy goals at home

The goal is to create consistency between what happens in the therapy room and what happens in daily life.

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A Typical Session Might Look Like…

Let’s say a 9-year-old comes in dealing with anxiety and meltdowns at school:

• We start by checking in with a mood meter or emotion cards

• Move into a game or art activity to explore the week’s challenge

• Practice a coping skill like deep breathing or progressive muscle relaxation

• Wrap up with a short parent check-in to share wins or homework

Or a teen struggling with self-esteem might:

• Start with journaling prompts or a grounding activity

• Explore recent experiences through art or open conversation

• Learn a DBT or CBT skill (like challenging negative thoughts)

• End with a strengths-based reflection or goal-setting

Final Thoughts

Therapy with kids and teens isn’t just about “fixing” problems—it’s about helping them feel seen, heard, and supported as they grow into their most authentic selves.

It’s creative, compassionate, and deeply personalized. And often, it’s the one space where kids get to show up just as they are—messy feelings and all—and know they’re still worthy, capable, and not alone.

If you’re curious about how therapy might support your child or teen, I’m always here to help.