When Parents Disagree on Therapy: Mediation for Mental Health Decisions About a Child
- Ivan Veenemans
- 2 days ago
- 17 min read
When making important decisions about a child's mental health, disagreements can arise even in the best of families. In any South African city – whether consulting a psychologist in Pretoria, a psychologist in Bloemfontein, or a psychologist in Nelspruit – parents seek professional help when their child faces challenges. But what happens when the parents themselves disagree on therapy? Many families turn to social workers in Johannesburg or social workers in Pretoria for guidance. Likewise, social workers in Durban, social workers in Port Elizabeth, and social workers in Bloemfontein often assist families through mediation when conflicts arise. In communities across the country – from social workers in Soweto to Benoni social workers and social workers in East London – professionals echo the same message: the child's best interests must come first. When parents clash over counseling or treatment plans, mediation for mental health decisions is often the best path forward to find common ground and support the child.
Why Do Parents Disagree on a Child’s Therapy?
It’s not uncommon for parents to have differing opinions about a child’s therapy. One parent might firmly believe the child needs counseling, while the other is skeptical or concerned about the idea. In divorced or separated families, disagreements can be even more pronounced: legal custody arrangements often require both parents’ consent for major medical or psychological care. (In South Africa, both parents generally share responsibility for healthcare decisions under the Children’s Act 38 of 2005, meaning neither should act unilaterally on major therapy choices (Acting alone can create conflict or even legal trouble). Here are some common reasons parents may disagree about therapy for their child:
Different Beliefs About Therapy: Sometimes one parent thinks therapy is unnecessary (perhaps believing the child will “grow out of” a phase or fearing stigma), while the other parent strongly feels that professional help is needed. These differing personal beliefs or cultural views about mental health can lead to a stalemate.
Disagreements on the Type of Treatment: Even if both agree the child should get help, they might disagree on what kind. For example, one parent may trust a particular approach recommended by a psychologist, while the other prefers a different therapist or treatment method. They might argue over which psychologist or counselor to see (e.g., a parent may want a specific psychologist in Nelspruit who was recommended, while the other parent is not comfortable with that choice).
Concerns About Influence or Content: Parents might worry about what happens in therapy sessions. One parent could fear that the therapist might take sides or that the other parent will use the therapy to influence the child’s feelings. Such trust issues can make a parent hesitant to agree.
Practical Issues – Timing and Cost: Therapy can be a commitment in terms of time and money. One parent might be worried about the cost of regular sessions or the logistics of taking the child to appointments (missing school or extracurriculars). If parents share expenses, there may be disputes about payment.
Communication Breakdowns: Underlying all these reasons is often a breakdown in communication. Emotions run high when it comes to a child’s well-being. In high-conflict situations (especially post-divorce), a parent might oppose a decision simply because it comes from the other parent, rather than focusing on the idea itself. Past relationship issues can spill over into co-parenting discussions.
Disagreeing on therapy can leave a child in limbo – possibly needing help but not receiving it due to parental conflict. This conflict can also create stress for the child. Parental tension and arguing, especially about the child’s health, often makes children feel caught in the middle.
That’s why mental health professionals emphasize that whenever possible, both parents should be on the same page about therapy. In fact, it is usually in the child’s best interest for both parents to agree on treatment: the child then gets a consistent, positive message and support from both sides, and is less likely to feel torn between. Even when one parent has the legal right to decide, involving the other parent and reaching a joint agreement can greatly benefit the child’s experience in therapy.
How Can Mediation Help When Parents Clash Over Therapy?
When parents reach a deadlock over a child’s therapy, mediation can be a game-changer. Mediation is a structured process where a neutral third party (the mediator) helps the parents communicate and resolve their disagreement. Unlike a courtroom battle, mediation is cooperative rather than adversarial – it’s about finding a solution, not declaring a “winner” or “loser.” Here’s how mediation can specifically help in therapy disputes:
Focused on the Child’s Needs: A good mediator will keep both parents focused on what the child needs, rather than on the parents’ personal grievances. In a mediation session, parents are encouraged to discuss their concerns about therapy openly. For example, if one parent fears therapy isn’t necessary, they can voice why; if the other is worried about the child’s emotional health, they can share observations. The mediator makes sure each parent truly hears the other. By keeping the discussion child-centered, mediation steers the conversation toward solutions that will benefit the child.
Clearing Up Misunderstandings: Often, disagreements persist because of misconceptions or lack of information. A mediator might suggest that both parents speak with the child’s doctor or a psychologist together to understand the situation better. Sometimes, bringing in a neutral expert opinion during mediation (for instance, a report or letter from a child’s psychologist or school counselor) can provide facts that ease one parent’s concerns. Mediation provides a safe space to clarify what therapy would involve, address fears (e.g., about confidentiality or influence), and correct any false assumptions.
Creating a Plan Both Can Accept: Through calm discussion, mediation looks for common ground. The mediator can help brainstorm compromise solutions – perhaps the parents agree to a trial period of therapy and then re-evaluate, or agree on choosing a therapist together. For example, if cost is a concern, the mediator might guide the parents to agree on splitting costs in a fair way or using a counseling service covered by insurance. If scheduling is an issue, the mediator can help outline who will take the child to sessions or how to adjust visitation schedules to accommodate therapy. The goal is a clear plan that both parents can support.
Reducing Conflict and Stress: Mediation sessions are confidential and informal, typically much less intimidating than court. This environment can defuse hostility. With a mediator managing the discussion, parents are less likely to talk over or blame each other. By the end of the process, even if they started far apart, parents often feel they have worked as a team to solve a problem. This reduction in conflict benefits the child immediately – children pick up on tension, and seeing their parents cooperate, even grudgingly, can be reassuring. Research shows that when parents resolve their disputes through mediation, they tend to have a better co-parenting relationship going forward, with less hostility.
Importantly, mediation is voluntary and the mediator does not impose a decision. The power remains with the parents to decide what to do, which can be empowering. Instead of a judge or third party deciding what’s “best,” the parents create an agreement that they both can live with. This often leads to more commitment to the plan – in this case, commitment to supporting the child’s therapy plan – because both parents had a hand in shaping it.
If the idea of sitting down with your co-parent seems daunting, remember that mediators are trained to handle high-conflict emotions. They will set ground rules (for example, no interrupting or name-calling) and keep the discussion productive. In South Africa, the Children’s Act actively encourages parents to use mediation and even parenting coordination to resolve disputes without litigation. The very act of coming to the table in mediation sends a powerful message to your child: that their parents are willing to work together for their sake.
Practical Tips for Parents (Keeping Conflict Low)
While mediation is a great step, there are also day-to-day strategies parents can use to prevent or reduce conflict over decisions like therapy:
Communicate Early and Calmly: Don’t spring a major decision on the other parent without warning. If you think your child might need therapy, raise the topic privately in a calm moment – not in the heat of an argument. Explain your concerns and be ready to listen to the other parent’s perspective. Early, respectful communication can sometimes resolve misgivings before they escalate.
Keep the Focus on the Child, Not the Past: It’s easy for discussions to dredge up old marital issues or blame. Try to separate those personal grievances from the current issue of the child’s therapy. Center the conversation on your child’s behaviors, feelings, and needs, rather than on what your ex or co-parent may have done wrong in the past. This isn’t about “winning” against the other parent; it’s about helping your child.
Educate and Involve Both Parents: If one of you is unsure about therapy, consider talking together to the proposed therapist or a psychologist in Bloemfontein (or whichever area is convenient) to ask questions. Attend an initial informational session or do a joint call with the therapist so both parents hear the same information about how therapy could help. When both parents understand the process and goals of therapy, it can alleviate fear and build mutual support.
Consider a Temporary or Compromise Solution: If you can’t agree outright, see if a compromise is possible. For instance, you might agree to try therapy for a set number of sessions and then discuss how it’s going. Or agree to involve the child’s pediatrician or school psychologist in evaluating the need for therapy, so you both have additional professional input. Writing down a short-term plan can give each parent some comfort (e.g., “We’ll have our child attend four sessions with a counselor, then both parents will meet with the counselor to discuss progress and next steps”).
Use Neutral Help Before It Gets Heated: If you sense that a conversation about therapy is turning into a fight, it’s okay to pause and suggest getting help. This could be as informal as asking a mutually trusted relative to sit in and moderate, or as formal as hiring a mediator. Sometimes bringing in a social worker or counselor as a neutral party for a family meeting can keep things civil. The sooner you bring in a neutral third party, the less entrenched each side may become.
Following these steps can prevent a lot of heartache. Parents ultimately have a common goal – they both want their child to be healthy and happy. Reminding yourselves of that shared goal, and using tools like mediation and clear communication, can turn a potential tug-of-war into a collaborative effort.
Can a Social Worker or Psychologist Act as a Mediator in These Cases?
Yes. Mediation doesn’t have to be done by a lawyer or formal mediator only. In many cases, professionals like social workers or psychologists (who have training in mediation or family counseling) can serve as the neutral facilitator to help parents resolve disputes about therapy. The key is that the person is neutral (not taking either parent’s side) and skilled in conflict resolution.
Social Workers as Mediators: Social workers, especially those who specialise in family services or child welfare, often have experience in helping families navigate conflicts. In South Africa, for example, the Office of the Family Advocate uses trained social workers in Johannesburg and other areas as family mediators in custody and care disputes. A social worker-mediator will understand family dynamics and keep the focus on the child’s well-being. If you’re already working with a social worker in Pretoria or social worker in Durban through a school or community organization, they might be able to act as a mediator or refer you to a mediation service. These professionals bring a caring, empathetic approach that can help de-escalate emotional situations.
Psychologists as Mediators or Evaluators: Psychologists (and educational psychologists) are also sometimes involved in resolving parenting disputes. While a psychologist’s primary role might be to assess or provide therapy, some are also trained in mediation or parenting coordination. For instance, a psychologist in Pretoria who works with families might offer mediation sessions as part of their practice, or at least facilitate discussions about the child’s needs. Even if a psychologist isn’t a formal mediator, parents might jointly consult a child psychologist for an independent assessment: the psychologist can evaluate the child and advise whether therapy is recommended. Having that neutral expert opinion can mediate the disagreement by providing an objective viewpoint that both parents trust.
Professional Mediators with Legal or Counseling Backgrounds: There are also professional family mediators who may have a background as attorneys, retired judges, or counselors. The advantage of a mediator with a legal background is that they know how a court might view the dispute (for example, a lawyer-mediator can inform parents that a court would likely prioritise the child’s best psychological interests and could order therapy if deemed necessary). On the other hand, a mediator with a counseling background might be better at handling emotional discussions and getting to the heart of personal issues. Both types aim for the same result: an agreement that avoids the need for a court decision.
When choosing a mediator, parents should agree on someone both feel comfortable with. Many mediation centers have co-mediators – one lawyer and one mental health professional – working together, which can be very effective in complex cases. The mediator could be based in your area (so they understand local resources, like knowing reputable psychologists in Bloemfontein or experienced social workers in Port Elizabeth who could be involved if needed).
The important thing is to engage a person who is neutral and trained in dispute resolution. Check credentials: in South Africa, mediators can be accredited through organizations like SAAM (South African Association of Mediators) or NABFAM, and many social workers in East London, Pretoria, etc., have such accreditation for family mediation. Psychologists may be registered counseling mediators as well. Don’t hesitate to ask about a mediator’s background in family or child-related cases.
Mediation is a flexible process. It can even be done virtually (online mediation became common during COVID-19 and continues to be an option), meaning you aren’t limited to mediators only in your town if, say, one parent lives far away. Whether it’s a social worker, psychologist, or specialised mediator facilitating the sessions, having that skilled third party involved often makes all the difference when parents are at an impasse.
What If We Still Can’t Agree on Therapy (Even After Mediation)?
Mediation is very often successful, but of course it doesn’t guarantee an agreement. If you and the other parent truly cannot reach a consensus – even after multiple mediation sessions – you may need to explore legal remedies. Here’s what typically happens next:
Consult Your Attorneys: If you haven’t already involved lawyers, this would be the time. Especially in a divorce or separation scenario, inform your family law attorney about the impasse. They can advise on your options based on your custody agreement and local law. Sometimes just a formal letter from an attorney to the other parent, outlining the importance of the therapy and potential legal consequences of withholding consent, can prompt a change of heart (though this can also escalate tensions, so use carefully).
Court-Mandated Mediation or Family Services: In some jurisdictions, before a court hears a dispute like this, they may mandate further mediation or an evaluation. For example, the court could refer you to the Family Advocate’s office (in South Africa) or a similar family court service. The Family Advocate (which includes family counselors who are often social workers or psychologists) will assess the situation and make a recommendation about what is in the child’s best interests. This assessment could involve interviewing both parents, the child, and perhaps gathering opinions from teachers or doctors. It’s essentially a mediated investigation.
Court Hearing (Last Resort): If all else fails, a judge will have to decide. This is truly the last resort. A parent can file a motion requesting the court to allow (or block) a certain treatment for the child. In court, each parent would present their case – why they believe therapy is or isn’t necessary (often with evidence like doctor’s reports, teacher letters, or expert testimony). The judge’s job is to weigh this and make a decision based on the child’s best interests. Judges tend to give substantial weight to recommendations from mental health professionals. For instance, if a pediatrician or child psychologist strongly recommends therapy, it’s likely the court will side with that recommendation unless the other parent has very compelling reasons against it.
If you do end up in court, be aware that litigation can be adversarial and stressful. It may also be time-consuming (delays in the court system can mean your child goes without help longer) and costly. Moreover, a court battle can further strain the co-parenting relationship, which isn’t good for the child in the long run. Courts themselves recognize this; that’s why judges and family law statutes often urge mediation first. Litigation should be viewed as a last measure when one parent is genuinely acting against the child’s interests or absolutely refusing to compromise.
Should a court ruling become necessary, try to mentally prepare to respect the outcome. If the court orders therapy over one parent’s objection, that parent will need to comply (and ideally, try to emotionally support the child in the process, despite personal reservations). On the other hand, if the court decides therapy isn’t warranted at this time, the pro-therapy parent must accept that decision or potentially seek to modify custody arrangements if they strongly disagree.
Remember: even after a court decision, co-parents can still return to mediation later if circumstances change. For example, if therapy was denied but the child’s condition worsens, you both could mediate a new agreement rather than immediately filing another court case. Conversely, if therapy was ordered and after some time one parent has concerns about how it’s going, you can discuss those concerns in mediation. The door to cooperative decision-making is never truly closed, and it’s always better to walk back through it than to stay in conflict.
What Does Research Say About Parental Conflict and Mediation?
Research consistently shows that resolving parental disagreements through mediation is far better for a child’s wellbeing than prolonged conflict. It is not the separation or divorce itself that causes long-term harm, but the level of conflict between parents. According to insights from The Aurit Center for Mediation, children exposed to ongoing hostility are at a much greater risk of anxiety, depression, and behavioural difficulties. In contrast, when parents communicate effectively and resolve disagreements quickly, even about therapy, children tend to show greater emotional stability.
Mediation plays a vital role in this process. A research summary by Palo Alto University explains that mediation improves co-parenting communication and satisfaction with agreements, especially when those agreements reflect the needs of the child. Child-inclusive mediation, where feedback from the child is sensitively shared with both parents, has been shown to reduce parental conflict and help parents focus on supporting the child’s mental health.
Further supporting this, Birt Law reports that over 70% of families who engage in mediation reach sustainable agreements. These outcomes are directly linked to improved parenting cooperation and better emotional development in children, especially when decisions around therapy are made collaboratively.
Mediation does not just resolve one-time disputes. It builds long-term patterns of healthier communication. A review in Psychology Today explains that therapy is most effective when both parents understand and support the process. Mediation helps parents reach that level of shared understanding without court conflict.
Does Mediation Really Work? (A Real-Life Example)
Yes, and many families have experienced its benefits. To illustrate, here’s a real-life example (based on a true story shared by a Mediation Center) of how mediation helped a high-conflict parenting situation:
Scenario: “Sarah and Mark” were divorced parents who couldn’t agree on anything when it came to their two young children – whether it was scheduling, schooling, or activities. Every conversation turned into a shouting match. The kids were feeling the tension: one child developed anxiety and had trouble sleeping, and the other became withdrawn and started misbehaving at school. In one instance, Sarah wanted their son to see a counselor about his anxiety, but Mark was opposed, saying it was unnecessary. This led to weeks of arguments and no action, while their son’s troubles continued.
Mediation Intervention: Exhausted by conflict, Sarah and Mark agreed to try mediation before taking the matter to court. The mediator set ground rules and helped them discuss their concerns without yelling. Both parents finally got a chance to explain their fears: Mark admitted he feared therapy would paint him as the “bad guy” to the child; Sarah shared that their son had been crying at night and asking to talk to someone. The mediator guided them to focus on the child’s perspective. They even consulted with a child psychologist (during the mediation process) who answered Mark’s questions about therapy confidentiality and assured him the goal was to support the child, not to assign blame. Armed with this information and a calmer mindset, Mark’s resistance to therapy decreased.
Outcome: Through a series of guided discussions, Sarah and Mark were able to craft a detailed plan. They agreed to let their son start therapy for a three-month period and then reassess together. They chose the therapist jointly from a list provided by the psychologist. They also worked out a parenting communication plan: weekly check-ins to calmly discuss how the kids were doing, and ground rules about not criticizing each other in front of the children. The conflict between them dropped dramatically – they learned how to talk without exploding. Over the next weeks, their children no longer witnessed constant arguments; exchanges at handovers became civil. The son started seeing the therapist and soon felt more secure, knowing both parents supported it. The children’s anxiety and tension levels went down, and they began to thrive again. Sarah and Mark were astonished that they could finally cooperate on something. This success through mediation built trust – it became easier for them to tackle the next parenting issue together, without returning to open warfare.
This example shows that even when parents are deeply divided, mediation can lead to a positive breakthrough. The key elements here were open communication facilitated by a neutral party, focusing on the child’s needs, and being willing to compromise. It turned what could have been a protracted court fight (with both sides slinging accusations) into a workable solution that benefited the kids.
Every family’s story will be different, but many who have used mediation report similar outcomes: reduced stress, more effective co-parenting, and children who are happier because the adults in their lives are cooperating. As one parent in a successful mediation put it, “The process made me feel like I was in control of the outcome… and it took away the stress. I didn’t have to appear in court, and I’m at peace and happy.” (auritmediation.com). While it’s not always easy to sit down with someone you’re at odds with, stories like these show that doing so with professional help can transform a tough situation into one that’s manageable – and even bring a sense of relief and closure to both parents.
Putting Your Child First
Disagreements over a child’s therapy can be challenging, but they don’t have to turn into damaging battles. The core principle for resolving these conflicts is simple: put the child’s well-being first. When both parents keep that goal in mind, tools like mediation become much more effective. Mediation provides a path for parents to move from opposition to collaboration, ensuring that important mental health decisions are made calmly and thoughtfully, not in the haze of anger or stress.
In the end, whether you are a lawyer advising clients, a psychologist or social worker assisting a family, or a parent yourself, the message is the same – the child should not be caught in the crossfire of adult disputes. By seeking common ground (with professional help when needed), parents can come to agreements that allow the child to get the support they need. Remember that conflict is costly – not just in terms of legal fees or time, but in terms of the emotional toll on a child. By contrast, cooperation and compromise are investments in your child’s healthy future.
If you find yourself at odds with your co-parent about therapy or any major decision, consider using the approaches outlined in this blog. Talk openly, listen to each other, involve a neutral third party, and focus on what truly matters: your child’s health and happiness. In many cases, you’ll discover that you both ultimately want the same thing for your child. Mediation and collaboration are simply ways to help you get back on the same team.
Taking that first step might be hard – perhaps it’s suggesting mediation to a skeptical co-parent, or reaching out to a family therapist or social worker in Pretoria who can guide the conversation. But doing so is a step toward reducing conflict and protecting your child’s emotional well-being. Parents in conflict don’t have to stay in conflict. With the right support and mindset, you can turn a “Me versus You” situation into an “Us for our Child” solution.
Frequenntly Asked Questions (FAQs)
What if one parent disagrees with starting therapy?
Disagreement is common. Involving a psychologist in Pretoria or a neutral mediator early helps both parents hear expert advice and reduce conflict.
Can social workers assist when parents clash about therapy?
Yes, social workers in Johannesburg, social workers in Durban, and Benoni social workers can act as neutral facilitators or refer families to mediation.
Is a psychologist in Bloemfontein allowed to treat a child with one parent's consent?
This depends on legal custody. It's best to get both parents to agree, often through mediation or involving social workers in Pretoria for guidance.
What if therapy was recommended by a school or GP but the other parent refuses?
A family mediator or social worker in Port Elizabeth can help align views before the situation escalates to court.
Can therapy decisions be included in a parenting plan?
Yes. A parenting plan drafted with the help of social workers in Soweto or social workers in East London can set out how therapy decisions are made.
If you’re currently struggling with a similar situation, don’t hesitate to seek help. Visit our website for everything mediation.
In the delicate matter of a child’s mental health, working together is the best gift you can give your child – and yourselves.
Date Published: 02 December 2025
Publisher: Mediation Academy SA
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