Know if Your Child Needs Therapy

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As a parent, it can be difficult to distinguish “growing pains” in your child from more serious issues that require professional help. Sure, most kids have trouble in some areas of life that they eventually grow out of. However, if your child is persistently dealing with issues in their behavioral, emotional, and social functioning, it may be time to see a therapist. You might be reluctant to involve someone outside the family, but therapy may help. If you spot these common signs, know how to get your child the professional assistance they need.

Steps

Watching for Behavioral Signs

  1. Look for signs or threats of self-harm. Cutting or other acts of self-harm (i.e. burning, scratching, picking at skin, etc.) are red flags that your child needs professional help. However, even if your child hasn’t actually hurt themself, stay alert for threats of them harming themself. This may be clearly spelled out, such as “I want to die” or more subtle like, “I need to punish myself.”[1]
  2. Listen to their verbal remarks. Statements your child makes can help clue you in that something isn't going right in their inner world. Children can't express their thoughts and feelings in the same way adults do. But, they may offer hints that they are having problems.[2]
    • Listen to comments that hint at anxiety or other problems, like "I'm scared to go to sleep at night because images of the accident come into my head." Or, "I don't want to go to school because the other kids don't like me."
  3. Check for acting out behaviors. Common behavioral signs that your child may benefit from therapy include acting out behaviors, such as angry outbursts, uncontrollable tantrums, aggressive behaviors, or extreme crying episodes. Your child may also exhibit hitting, biting, or kicking behaviors towards you or others.[3]
  4. Notice a marked change in their functioning. Any major, yet unexplained, shift in your child’s behavior or functioning should be considered when making your decision. There are various ways underlying problems may manifest. Bedwetting, sleeping problems, sudden clinginess, eating changes, and bullying incidents may all point to a bigger issue.[4]
  5. Ask other adults for their opinion. Before deciding to go to therapy, you may determine the extent of the problem by reaching out to others. Oftentimes, problem behaviors are not unique to the home. Your child may have declining academic or athletic performance, too. Others may also note changes in their attitude or self-esteem.[5]
    • You might talk to your partner or co-parent to see if they have spotted any alarming behaviors. You might also ask your child’s teachers, coaches, school counselors, or childcare professional for their honest assessment.

Investigating Social and Emotional Issues

  1. Decide if your child isn’t coping after a major life change or loss. Sudden life changes may disrupt your child’s mental or emotional health. Loss of a loved one, a recent move, episodes of bullying, or a parent’s divorce can negatively impact a child’s functioning. Think back to determine if any recent life changes are affecting them.[6]
    • Any of these experiences take some adjusting, but if your child doesn't seem to be eating, sleeping or functioning as normal after several weeks, they may not be coping well.
  2. Notice unusual sadness, fatigue or tearfulness. If your child is generally happy and energetic and recently seems down in the dumps, overly tired or blue, they may benefit from talking to a therapist. Take note whether a shift in mood or energy happens suddenly or as a result of certain stimuli. Closely monitoring these changes can help a therapist better understand how to help your child.[7]
  3. Evaluate their social life. Children who are struggling may pull away from friends and family. If you’re your child seems to no longer want to play with or hang out with friends or siblings, pay close attention. Social isolation or withdrawal may signal an underlying problem.[8]
    • You might ask your child about this change by saying, “Honey, I noticed you never go outside to play with your friends anymore. Do you want to talk about that?”
  4. Take note of unexplained physical complaints. If your generally healthy child constantly whines about stomach aches, headaches, or other physical symptoms, keep track of their complaints. Unless they have an undiagnosed medical condition, these issues should be resolved by a visit to the doctor, rest, or over-the-counter meds. If nothing seems to ease these problems, the root of these physical complaints may lie in your child’s emotional functioning.[9]
  5. Notice strain on your marriage or family. You may not want to admit it, but your child’s current functioning may be taking a toll on your household. If you and your spouse are disagreeing about how to parent, or if siblings often complain that everything revolves around one child, you may need to seek professional help. Letting the problem go unaddressed may lead to irreparable damage in your home life.[10]

Going to Therapy

  1. Document your concerns. You can better inform your child’s doctor and therapist by collecting information. Even after you book the appointment, continue to monitor your child and document your findings. This information can help steer their healthcare team in the right direction.[11]
  2. Request a referral from their pediatrician. Often, you will need the go-ahead from your child’s pediatrician in order to see a mental health therapist. Your child’s doctor will likely perform a routine examination and ask questions about their symptoms. Thorough monitoring and documenting on your part can help your child’s doctor send you to the right professional.
  3. Find a therapist who aligns with your values and needs. Even if you are being connected to a therapist through a referral, you still have a say in who your child sees. It may help to do some cursory research about different kinds of therapy and the types of therapists in your area.[12]
    • Look for a therapist who has special training working with children and adolescents. You may want to make sure their experience acknowledges any unique concerns regarding your child, like disabilities, culture, religion, or language barriers.
    • Keep in mind that not every therapist will suit your child. Give it time for them to build rapport, but be open to seeing someone else if your child doesn’t seem to connect with the new therapist.
  4. Explain therapy to your child. Once it’s been determined that your child will be seeing a therapist, you will need to break the news to them in a way they can understand. It’s helpful to acknowledge that you’ve noticed your child struggling and letting them know you want to help. Then, explain that a therapist can help address their needs.[13]
    • You might say, “Your dad and I have noticed that your grades have dropped a lot. You’re also skipping band and not hanging with your friends. We think it may help for you to see someone who works with kids who are struggling.”

Sources and Citations