Reasons why child-led therapy can feel hard

Child-led therapy is all about following a child's interests and allowing them to lead. Rather than coming in with an adult-directed agenda, we enter the child’s world of play. This makes sessions intrinsically motivating and meaningful for the child. It also allows us to establish ourselves as true play partners and form authentic relationships built on trust and connection. Trust is foundational for our language models to be accepted by children.

Child-led therapy is also very different from what many therapists, parents, and children are used to. Because of this, it can make some clinicians and children feel uneasy—and that’s okay. Start slow and consider the following information.

Common Reasons Why Child-Led Therapy Can Be Hard for Parents or Professionals (and What to Do)

1. You were taught that successful sessions are highly planned, structured, and adult-directed.

For many, therapy has always meant sitting at a table, using printed materials, and following a predetermined plan. Compliance-based or adult-directed therapy may be all you’ve ever known, so when sessions don’t look like that, it may feel like you’re not “doing your job.”

First, you’ve got this! Trying something new—especially something that challenges your training—can be uncomfortable. Sometimes we have to unlearn before we can learn. Start to listen to your intuition and reflect on what you are doing in therapy (or at home) and why.

2. It involves a lot of thinking on your feet.

When you’re used to adult-directed therapy, the idea of going into a session without a rigid plan can feel overwhelming.

What to do:
Start small. Try it with one or two clients at first. Build your comfort with following their lead and thinking on your feet while still intentionally incorporating their goals. With practice, the unknown becomes much less intimidating.

3. You’re worried about what parents or other professionals might think.

This is one of the most common challenges. Our #1 tip is to focus on education from the start. Be very clear with families and other professionals about what your sessions will look like and why you use child-led therapy. When others understand the purpose and approach, the pressure to make sessions look more adult-directed decreases.

A Helpful Analogy to Understand Expectation Mismatches

Many people struggle with child-led therapy not because it is ineffective, but because it does not match what they expected.

Imagine your family goes on a tropical vacation every single year. You know exactly what to pack: bathing suits, sandals, sunscreen, lightweight clothes. One year, you show up at the airport with your perfectly packed tropical suitcase, only to find out the trip is actually to Alaska.

Suddenly, everything in your suitcase is not right for this new destination. But you were not wrong for packing it. You prepared based on the information and experiences you had. You simply did not know the destination had changed.

You might feel surprised, unprepared, or even disappointed, not because Alaska is bad, but because it wasn’t what you were expecting.

This is exactly how child-led therapy can feel to parents or professionals who are used to compliance-based, structured, adult-directed therapy. Their expectations were shaped by past experience, so when they watch child-led sessions, they may think:

“This doesn’t look like therapy.”
“Are we just playing?”
“Is this effective?”

Their discomfort often comes from misaligned expectations, not from any flaw in child-led therapy.

This is why education from the start is essential. When people understand what to expect and why child-led therapy looks the way it does they are far more open, supportive, and confident in the process.

4. Your work environment or parenting partner is not supportive of these methods.

If child-led therapy is new to them, skepticism is normal. Share or seek resources that help deepen understanding of language modeling and child-led therapy. We recommend sharing the link to enroll in our free Masterclass on Child-Led Therapy & Echolalia as a starting point. From there, consider exploring books or our full courses to learn more in-depth information. You can also find a helpful script for educating others here.

5. You feel overwhelmed by the number of items out during child-led therapy.

Our #1 tip is to minimize. Less is more. Too many items can be visually overwhelming and dysregulating for both you and the child.

Use what we call our "rule of three". Have no more than three toys or activities out at a time:

• Two preferred toys/activities/sensory supports

• One new or novel item

There are no expectations for how the child will use any of them .They are simply available for the child to choose from.

Common reasons why a child may not respond to child-led therapy and what to do

• It’s not actually child-led, the adult is controlling most of the play and play decisions and/or the child is being offered materials/toys that they have no interest in. Follow the child’s lead. Bubbles? You got it. Balls? Here you go! Don’t force your ideas. Bring in those items of interest and a new item but always look to the child for direction.
• The child has never been given the chance to independently or free play and much like prompt dependence, is waiting to be told what to do. Some children have had a history of compliance based or “traditional” therapies and aren’t sure what to do. Give it time and be an encouraging, gentle and present listener. 
• The child is dysregulated and overwhelmed due to the environment or internal or situational reasons. If a child is crying, refusing, crashing, pushing, hitting and/or you are worried about safety… consider regulation. We always recommend consulting with an occupational therapist well-versed in sensory processing  if possible. We need to address regulation before we address communication. Children cannot pick up our language models with a dysregulated nervous system. 
• The child is not ready for toy play. Not all children are ready for or interested in toy play and that’s okay! Not all play has to be with toys. Think about people play, sensory motor play and/or media for the kids you work with (or parent) that aren’t ready for toy play. Also, we shouldn't let the arbitrary idea of “age-appropriate interests” keep our clients from interacting with toys or engaging in activities that are of interest and meaningful to them. 

Want to learn more in-depth information about how to support gestalt language processors?

1. There are many free podcasts, webinars and articles to get you started. A comprehensive list of resources can also be found on our website. We just released a new FREE masterclass on echolalia and child-led therapy that is perfect for anyone starting their learning journey or on the fence about purchasing our courses! 
2. Consider taking the Meaningful Speech course to learn more about how your child or client processes language, how you can help support them from echolalia to self-generated (original flexible) language, child-led therapy, and neurodiversity-affirming practices. Looking for something shorter? We have a 1-hour introductory course perfect for extended family, daycare or school staff.
3. Consider taking our AAC + Gestalt Language Processing course. It will teach you how to identify, evaluate and support gestalt language processors who use AAC or who you think might benefit from AAC.
4. Look for a speech-language pathologist (SLP) who "gets it" and can help you in supporting your child's language development. Check out our registry for SLPs who understand gestalt language processing and child-led therapy.
5. Are you a school-based or private practice clinician looking for intake forms for new clients/students or creative visual reminder posters for your space? Check out the Meaningful Speech Marketplace.