Good mental health is important for children because it is linked to healthy childhood development and achieving important developmental milestones. Sometimes, a child may begin to struggle with concerning behaviors, speech, or thoughts. Oftentimes, that behavior can be linked to social or emotional challenges. If this happens, it is important to consider therapy. Therapy helps by changing thoughts which can result in improved behavior and healthier outcomes.
Why might a child need therapy?
There are a variety of signs that show children may need therapy. Some of these are linked to falling short of developmental milestones, a major family or life change, anxiety, or bullying. Here are some typical reasons.
Anxiety
“We tend to see children with intense anxiety that gets in the way of their daily functioning like doing regular tasks, going to school, feeling comfortable at school, or being able to separate from their parents,” explains Leah Fellenstein, counselor at Abundant Life Counseling.
Anxiety is not just limited to major trauma like a major family change or death of a loved one. According to Fellenstein, sometimes it can occur after exposure to something that was scary such as a movie or something they heard in a story.
“The scared response is developmentally normal if it lasts a night or two but, if it continues and they are not sleeping, then they need some tools to figure out how to handle the anxiety,” she says.
Difficulty in School
Difficulty in school may be linked to a mental health concern. A child who has trouble focusing, difficulty getting motivated, or problems taking action at home or school may need therapy.
Major Family Changes
Children who experienced a significant family transition such as a move, divorce, or death may benefit from therapy. However, a big family change does not always mean the child will need therapy. Therapy can be helpful if the child is struggling to accept those changes.
Bullying
Bullying impacts self-esteem and often causes increases in anxiety and depression.
“Often the work with kids who are being bullied and kids engaging in bullying behaviors, looks really similar,” Fellenstein says. “Both groups usually need to work on reducing negative self-talk/low self-esteem and benefit from learning assertive and healthy communication skills.”
Are there signs that a child needs therapy based on age?
Therapy is helpful for children who cannot meet typical tasks for school or tasks that are expected for their age.
Elementary School Aged Children
Separation anxiety in children age 2 or in preschool is normal developmental behavior. Therapy may be appropriate if your child is elementary school age or older and gets really upset and can’t calm themselves down when it’s time to separate.
In younger children, parents typically will see a change in the child’s behavior or mood. They may have more meltdowns and express defiance.
Adolescents
It is common for adolescents ages 9-14 to have shifts in their mood and changes in their behavior because of puberty. However, Fellenstein suggests therapy “when they are just really not acting like themselves for an extended period of time — like a couple of weeks. Also, therapy can help if something seems off, they are withdrawn, or keeping to themselves.”
Teenagers
Teens tend to be more verbal. Fellenstein says, “Irritability is actually the most common sign of depression in teenagers. Many people think signs of depression are sad and mopey, but it is not. They snap at you, then they feel really bad, and then they withdraw.”
Also, be aware of teens behaving in a way that has not been typical of them in the past. She advises, “Regardless of age, your child should be assessed immediately if they are experiencing suicidal thoughts or self-harming behaviors. However, we see that most often with teenagers.”
Who should parents speak with if they believe their child needs therapy?
A pediatrician or school counselor can help you determine if your child’s behavior is developmentally appropriate or if the child needs therapy.
Fellenstein recommends speaking with a pediatrician “if you notice that your child is not themselves, unable to recover from the up and down, or gets stuck in the down for more than two weeks.”
She adds that your child’s pediatrician can also help equip you with tools that may help your children before trying therapy.
If you are really concerned, consider asking a therapist for an evaluation. A therapist can assess your child and then provide a recommendation. It is also possible the child does not need therapy. The most important thing is, parents trust their parental instincts and seek therapy if they are concerned.
What questions should parents ask before placing their child in therapy?
If therapy is recommended, you should meet with the therapist first without your child to see if it may be a good fit.
“This will help parents understand how the therapist might mesh with their kid and how they approach therapy. I recommend this up to age 16,” Fellenstein says.
Before selecting the therapist, ask about certifications, educational background, and training. This information is on the therapist’s website or their “Psychology Today” profile. This will help you know whether the therapist has a strong background in understanding children and their approach to therapy.
“It is not sufficient training for someone to go to school for therapy and only takes a couple of classes about working with kids,” Fellenstein says. “They either need to have been supervised and taught as they gained experience, or they need a background in children, or both.”
Parents should also consider their own need for counseling so they can learn how to better respond to, support, and equip their child.
If you decide that your child needs therapy, then ask if the therapist accepts your health insurance and if your insurance policy covers mental health services. If not, explore whether free or reduced cost programs exist. If these do not exist, you may need to pay out-of-pocket for sessions.
Does this make me a bad parent?
Sometimes parents are afraid to seek mental health treatment for their children because of stigma and embarrassment. If your child needs therapy, this does not make you a bad parent.
“We deliberately teach kids math, science, and how to read and write. We’re starting to be more deliberate in teaching them feelings and healthy coping skills. So the expectation that we should just know how to deal with our feelings isn’t fair,” Fellenstein says. “Therapy is providing you and your child with the tools necessary to help connect the pieces and have better self-awareness and understanding.”
