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When to Have Your Child See A Therapist


By: Tzudek Stern LMHC, SpEdJuly 3rd, 2014

Children do not come with instruction manuals, but there is a time in every parents’ experience when they wish they did. Most parents can truthfully state that there was something about parenting that was surprising, confusing, befuddling, or all of the above. One of those times can be when children exhibit emotional or behavioral problems. When is a problem behavior so extreme that parents should seek help? When are a child’s tantrums or negative emotions real problems that warrant getting help from a professional? What if children experience a traumatic event or crisis? What should parents do? Common wisdom tells parents that children are resilient and they will bounce back from traumatic events. But parents naturally worry, what if my child is different? What if my child has repressed the experience and it will come back to haunt them in 20 years? This article is intended to clarify some of the signs that a child truly does need therapy and what types of therapy might be best for children.

Trauma or Crisis

When children experience or witness a traumatic experience or crisis, some children seem to return to life as usual fairly quickly while others exhibit problem emotions and behaviors that make it clear that something is wrong. It might surprise parents to learn that in both cases children need to see a therapist. Children are resilient, but they are sometimes resilient because they are adapting to their new circumstances and are learning to view the trauma or crisis circumstance as normal. For instance, if a small child witnesses violence in the home, the child is most likely learning that violence is normal. As another example, if a child’s parents divorce the child may seem to adjust well but they are likely internalizing misconceptions about their own role in the divorce and how family life should be. Because of the effect that trauma and crisis have on any human being and because children are at a time in their lives when all of their experiences become part of their developmental process, it is important that parents seek appropriate therapy for their children.

Parents might also ask what qualifies as a trauma or crisis. To answer this question, parents can first think about what would be traumatic or critical to them or what would have scared them as children. In addition, parents should ask early education experts, teachers, doctors, professionals experienced in trauma and crisis response to seek their opinions. If there is any question in the parents’ mind whether an event was traumatic or critical for the child, then the parent should assume that counseling is necessary.

Life Changes, Emotional Problems, and Family Issues

Therapy might also be needed when a life change occurs over which the child exhibits stress. This life change could be something external such as a move to a new town or bullying or it could be internal like the onset of adolescence. If a child exhibits ongoing, unrelenting stress that either lasts for more than a month or is particularly intense then the parents should seek therapy for their child. This is true even if the family doctor prescribes medication for the child. Psychoactive drugs are not a good substitute for therapy for children or adults. For instance, anytime a child exhibits behaviors of severe and persistent anxiety, depression, or makes comments about suicide or dying, parents should seek help right away. They should seek this help right away regardless of whether or not the child persists in talking about or exhibiting extreme emotions. The intensity of extreme anxiety, depression or talk about suicide or dying warrants an immediate response.

Finally, when a child’s behaviors are interfering with family functioning or parenting effectiveness, family counseling can be an excellent option. The child may not appear to you or others to be particularly extreme, but if the child’s behaviors are perceived as a problem for the family or for some other family members, family counseling can help the entire family function better. Sometimes, problems in family functioning that seem to be the fault of one member are actually family-wide problems in functioning. In these cases, counseling can help everyone.

Types of Counseling

Another relevant question for parents is what type of counseling would be best for their children? Depending on the age and ability of the child, the traditional psychotherapeutic talk therapy might not be the best option. Very small children, for instance, do not articulate their thoughts and feelings very well in words. However, they often express themselves through play, stories, or any other type of make-believe. Play therapy can be a good option for very young children because it allows children to express themselves through play while the therapist directs some of the subject matter to those related to the problem. Board games have also been recommended by some psychotherapists because they can be a positive way for children up through school-age to relax with the therapist and also tackle difficult subjects in a way that is not as direct and personal as talk therapy. That being said, an older and particularly articulate child might benefit from traditional talk therapy. The important thing here is that the therapy helps the child feel free and empowered to express his or her problems, thoughts and feelings.

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