Does your child need therapy?

Kids can’t always express when they need an extra level of emotional support. Here are the signs to look out for and advice about how to talk to your child about them. 

Ask any parent and they’ll tell you: Every child goes through rough patches. 

Sometimes the strong emotions or acting out lasts for just a few days or weeks. And you can usually clearly link it to something, such as a recent move or starting a new school year. Being bullied or the loss of a pet or loved one are also on the list. When the tough days pass, you breathe a sigh of relief and move on. You might even forget it ever happened.  

Other times, though, those difficult emotions drag on. And your efforts to fix things don’t go anywhere. You may feel helpless. You might worry that you don’t have all of the resources your child needs to feel better. That’s when you may start to wonder: Could my child need therapy? 

Answering that question can be tough. Many kids have trouble explaining their feelings. “Young kids often don’t have the vocabulary to express that something is wrong psychologically,” says Carol Landau, PhD. Landau is a clinical professor of psychiatry and human behavior and medicine at the Alpert Medical School at Brown University.

That’s why it’s important to stay tuned in to major shifts in their behavior or mood that last for 2 weeks or longer.

“If there are significant and persistent changes in a child’s sleep, appetite, energy, mood, behavior, or school performance, get it checked out,” says David Fassler, MD. Dr. Fassler is a child and adolescent psychiatrist in Burlington, Vermont. “Most child mental health issues are quite treatable. But intervention is most effective when the signs and symptoms are recognized as early as possible.”

Here are worrisome signs to be on the lookout for id you think your child could need therapy:

  • Changes in school performance (such as dropping grades) or behavior (trouble focusing). 
  • Frequent temper tantrums or angry outbursts. Especially if those outbursts are becoming more common or intense. 
  • Major changes in temperament. For example, becoming withdrawn, anxious, sad, or irritable when they’re usually sociable and easygoing.  
  • Regressions in behavior. They might become clingy or talk like a baby. This is more likely to happen with younger children. 
  • Frequent unexplained physical complaints. Common ones are stomachaches and headaches. 
  • Sleeping or eating more than usual. Or having trouble sleeping or frequent nightmares. 
  • Unexplained absences from school. (This is usually with teens.) 
  • Problems with impulse control. For example, lashing out at others verbally or physically. 
  • Suddenly not wanting to be with friends or family members. 
  • Self-injury or self-destructive behavior. 
  • Intense fear of weight gain with no relationship to actual body weight. Also, excessive dieting, throwing up, or using laxatives to lose weight.
  • Outbursts of aggression. Think: fighting, kicking, or biting. 
  • Repeated threats about running away from home or harming themselves.

If you see any of these signs, talk to your child about what’s going on. “Talk about the behavior. Say something like, ‘I’ve noticed you don’t want to go to school.’ Or ‘You’ve been really hard on your younger brother lately,’” Landau suggests. She is also the author of Mood Prep 101: A Parent’s Guide to Preventing Depression and Anxiety in College-Bound Teens.

“Then you could say, ‘I know that’s not you. So I’m wondering if there’s something else going on,’says Landau. The goal is to get them talking. Then you can confirm their feelings and understand what’s upsetting them. 

If this doesn’t go anywhere? It may be that your child doesn’t know what’s going on, says Michele Borba, EdD. Borba is an educational psychologist based in Palm Springs, California. Or perhaps they don’t want to disappoint you. That’s when it can help to bring in a third party.

During a calm moment — not in the heat of a meltdown — you might suggest the idea. “Say something like, ‘Let’s go to the doctor and get some help so you can feel better.’ You don’t need to call it a therapist,” Borba says. Borba is also the author of Thrivers: The Surprising Reasons Why Some Kids Struggle and Others Shine.

Meanwhile, ask your pediatrician or a school counselor to suggest a therapist. They can help you find someone who’s right for your child’s age and the issue(s) you seem to be dealing with. Then call the therapist and talk to them on the phone. You might want to call a couple of different ones. You just want to get a sense of what they’re like and whether they’re likely to be a good fit for your child.

Need more help finding therapists in your network? A digital health management app such as Wellframe is a great tool. It can connect you with your care advocate, who can help you find providers and schedule appointments. To find out if you have the Wellframe app, contact your health plan.

“Parents need to be careful not to feed into a child’s ambivalence about seeing a therapist,” Landau warns. “If your child says no to going, suggest going once and seeing how it goes. Or suggest remote therapy.” Talking to someone from the comfort of home might feel better at first. Above all, Landau adds, “normalize it. Tell your child that a lot of people find it really helpful to have someone else to talk to.” 

There are many ways you can help prepare your child for therapy. This may be one of your more difficult parenting experiences. But know that you’re not alone. You and your child can get through this with the right support and guidance.

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