Mighty Oaks From Little Acorns Grow
4100 West 15th Street #220, Plano, Texas 75093
Conveniently accessed by 121, George Bush, 75, and the Dallas North Tollway
Dr. Sarah Carlson, LPC-S, RPT-S, E-RYT 200, YACEP, EMDR Trained
Owner & Director
Frequently Asked Questions About Child, Family, Adult, and Play Therapy
How do I know if my child needs therapy?
You don't have to wait until your child's struggles become a crisis to consider therapy. Sometimes parents simply notice that something has changed or that their usual strategies aren't working anymore.
You might consider therapy if your child is experiencing frequent or intense emotions, anxiety, anger, changes in behavior, difficulty at school, challenges with friendships, sleep difficulties, grief, trauma, or significant changes at home. You may also notice that your child seems overwhelmed, withdrawn, unusually worried, or is having a hard time managing everyday transitions.
Sometimes the signs are less obvious. A child may be doing well at school but having big meltdowns at home, becoming increasingly perfectionistic, or complaining of frequent stomachaches or headaches.
You know your child best. If something doesn't feel quite right, you don't need to know exactly what's wrong before reaching out. A consultation can help you determine whether therapy may be helpful and what type of support would be the best fit.
What age is appropriate for play therapy?
Play therapy can be helpful for young children, school-age children, and some adolescents. Because play is a natural way children communicate and make sense of their experiences, it can be especially helpful for children who don't yet have the words—or don't feel comfortable using words—to explain what they are experiencing.
There isn't one "right" age for play therapy. The approach is adapted to each child's developmental level, personality, needs, and concerns.
For younger children, therapy may be primarily play-based. For older children and adolescents, play therapy may be combined with conversation, creative activities, games, expressive arts, coping skills, and other therapeutic approaches.
The goal is not simply to have a child play. The goal is to use play intentionally to help children understand themselves, express emotions, develop skills, and work through challenges.
What if my child won't talk to a therapist?
That's okay. Your child doesn't have to know how to talk about their feelings for therapy to begin.
Children often communicate through play, art, movement, stories, games, and other forms of expression. A skilled child therapist doesn't expect a child to sit down and immediately explain everything that is bothering them.
We begin by building a relationship and creating a sense of safety. Over time, children often become more comfortable expressing themselves in ways that feel natural to them.
Sometimes the most important first step isn't getting a child to talk. It's helping them feel safe enough to eventually want to.
Does my child have to know why they're coming?
No. Children don't need to fully understand why they are coming to therapy before their first appointment.
In fact, many children simply know that their parents are worried, that something has been difficult lately, or that they are going to meet someone who works with kids.
We encourage parents to be honest while keeping the explanation simple and age-appropriate. You might say:
"You're going to meet someone whose job is to help kids with big feelings, big problems, or things that are hard to figure out. You don't have to know exactly what to say, and you don't have to talk about anything before you're ready."
We want children to understand that therapy is a safe place to be themselves—not a place where they are going to be judged, tested, or punished.
What happens during the first appointment?
The first appointment is primarily about getting to know your family, understanding what brings you to therapy, and beginning to build a relationship with your child.
Depending on your child's age and needs, the first session may include time with the parent, time with the child, or a combination of both. We will talk with you about your concerns, your child's strengths, their developmental and family history, and what you hope will be different with therapy.
Your child will also have an opportunity to meet their therapist and become familiar with the space. We don't expect a child to immediately open up or share everything during the first visit.
The first appointment is about beginning a relationship and creating a plan together—not having all the answers on day one.
Does a parent stay during play therapy?
Typically, parents do not remain in the play therapy room during the child's individual play therapy session. Having a private therapeutic space allows children to develop their own relationship with their therapist and gives them the freedom to express themselves in ways that may be different from how they communicate with their parents.
Parent involvement is still an important part of child therapy. Depending on your child's needs, we may meet with parents separately, provide updates and recommendations, practice strategies to use at home, or collaborate with parents throughout treatment.
For younger children or children who are having significant difficulty separating, we may adjust the approach and work gradually toward greater independence.
Our goal is to find the approach that helps your child feel safe while also supporting you as their parent.
How does play therapy help with anxiety?
Children don't always experience or express anxiety as adults do. Anxiety may look like worries and fears, but it can also show up as irritability, perfectionism, avoidance, difficulty separating from parents, physical complaints, sleep difficulties, or frequent reassurance-seeking.
Play therapy gives children a developmentally appropriate way to explore those feelings and experiences.
Through play, children can practice coping skills, work through fears, develop a greater sense of control, learn to identify emotions, and experience situations that feel overwhelming in a safe and manageable way.
Therapy can also help parents understand what may be contributing to their child's anxiety and learn ways to support emotional regulation and confidence at home.
Can play therapy help ADHD?
Yes. Play therapy can be one part of a comprehensive approach to supporting children with ADHD.
Children with ADHD may experience challenges that go beyond attention and organization. They may struggle with frustration tolerance, emotional regulation, impulsivity, friendships, self-esteem, or the experience of repeatedly feeling like they are "in trouble."
Play therapy provides opportunities for children to practice skills such as waiting, problem-solving, managing frustration, recognizing emotions, communicating needs, and navigating social situations in developmentally appropriate ways.
We also work with parents to better understand the child's needs and develop practical strategies that support regulation and success at home and at school.
The goal isn't to make a child fit a particular mold. It's to help children understand how their brains work, build skills, and develop confidence in themselves.
Can play therapy help after divorce?
Yes. Divorce and separation can bring significant changes to a child's world. Even when parents are doing their best to make the transition as healthy as possible, children may experience sadness, anger, worry, confusion, loyalty conflicts, or changes in behavior.
Children don't always have the words to explain how those changes are affecting them.
Play therapy gives children a safe place to express and process their feelings without having to choose sides or worry about protecting a parent.
Therapy can also help children develop coping skills, adjust to changes in routines and family structure, and communicate their needs in healthy ways.
When appropriate, we also work with parents to help them understand their child's experience and support their child through the transition.
Can play therapy help with grief?
Yes. Children grieve too, but they don't always grieve in the same way adults do.
A child may cry and talk about a loss one moment and then return to playing the next. They may ask the same questions repeatedly, become more clingy, have changes in behavior or sleep, or seem unaffected for a period of time.
These responses can all be part of how children process grief.
Play therapy provides a safe space for children to express feelings, remember and make meaning of their relationships, ask questions, and work through experiences of loss at their own developmental pace.
We don't expect children to "move on" from grief. Instead, we help them find ways to carry their loss while continuing to grow, connect, play, and experience moments of joy.
Parents are also an important part of this process. We help caregivers understand children's grief and learn how to support them while allowing them space to grieve in their own way.
Do you accept insurance?
At Mighty Oaks, we provide self-pay services only to allow for increased autonomy and confidentiality of services. Some insurance companies will reimburse for services with a receipt of services rendered, which your clinician can provide for you. We are happy to discuss with you the potential and appropriateness for utilizing your out-of-network benefits. We can also work with a sliding fee scale based on your income and number of family members in the home.
Dr. Sarah Carlson's sessions begin at $225. She offers a sliding scale based on individual/family need.
Jessica Gustafson, Keith Bryant, and Devyn Hagan's sessions begin at $175, but they can offer a sliding scale.
Kacey Szabo and Xiadani Mendoza Juarez can provide a sliding scale. Their sessions begin at $135.
Yoga classes are $23 per class, or students can purchase a 5 class pass for $100. Workshops and individual yoga session rates vary.
Read about the recent passage of the No Surprises Act here.
How long do sessions last?
Play therapy sessions last 45 minutes. The play therapy room is one where children do not clean up, so your clinical requires time between sessions to make the room the same, consistent environment for the next child.
Adult and family sessions last 50 minutes. Supervision and mindfulness training/yoga last the full hour.
How long will my child be in play therapy?
There is no set time a child will be in play therapy. Many studies have cited that anywhere from 14-20 sessions is average. Your clinician will meet with parents and teachers on a regular basis to discuss progress and communicate what techniques to implement at home and school.
Can I leave my child and run errands while he/she is in therapy?
We require parents stay in the waiting room for the duration of the session. In the therapy process, going with an adult that you do not know can be scary and anxiety inducing. It is important that parents are there when the session is over to help calm these feelings. During the assessment, children may need more breaks than expected and parents need to be there if this occurs.
Do you work with schools?
Our team finds it extremely important to work with schools and teachers, whether it be giving teachers support, helping implement modifications and accommodations in the classroom, or participating in Admission, Review, Dismissal (ARD) meetings in public schools.
What if I need to cancel?
We require a 24-hour notice for cancellation. While we understand that emergencies happen and cannot be helped, a fee will be charged if the cancellation does not occur 24 hours beforehand.