Sometimes kids, like adults, can benefit from therapy. Therapy
can help kids develop problem-solving skills and also teach them
the value of seeking help. Therapists can help kids and families
cope with stress and a variety of emotional and behavioral
issues.
Many kids need help dealing with school stress, such as
homework, test anxiety, bullying, or peer pressure. Others need
help to discuss their feelings about family issues, particularly if
there's a major transition, such as a divorce, move, or serious
illness.
Should My Child See a Therapist?
Significant life events - such as the death of a family member,
friend, or pet; divorce or a move; abuse; trauma; a parent leaving
on military deployment; or a major illness in the family - can
cause stress that might lead to problems with behavior, mood,
sleep, appetite, and academic or social functioning.
In some cases, it's not as clear what's caused a child
to suddenly seem withdrawn, worried, stress, sulky, or tearful. But
if you feel your child might have an emotional or behavioral
problem or needs help coping with a difficult life event, trust
your instincts.
Signs that your child may benefit from seeing a psychologist or
licensed therapist include:
- developmental delay in speech, language, or toilet
training
- learning or attention problems (such as ADHD)
- behavioral problems (such as excessive anger, acting out,
bedwetting or eating disorders)
- a significant drop in grades, particularly if your child
normally maintains high grades
- episodes of sadness, tearfulness, or depression
- social withdrawal or isolation
- being the victim of bullying or bullying other children
- decreased interest in previously enjoyed activities
- overly aggressive behavior (such as biting, kicking, or
hitting)
- sudden changes in appetite (particularly in adolescents)
- insomnia or increased sleepiness
- excessive school absenteeism or tardiness
- mood swings (e.g., happy one minute, upset the next)
- development of or an increase in physical complaints (such as
headache, stomachache, or not feeling well) despite a normal
physical exam by your doctor
- management of a serious, acute, or chronic illness
- signs of alcohol, drug, or other substance use (such as
solvents or prescription drug abuse)
- problems in transitions (following separation, divorce, or
relocation)
- bereavement issues
- custody evaluations
- therapy following sexual, physical, or emotional abuse or
other traumatic events
Kids who aren't yet school-age could benefit from seeing a
developmental or clinical psychologist if there's a significant
delay in achieving developmental milestones such as walking,
talking, and potty training, and if there are concerns regarding
autism or other developmental disorders.
Talk to Caregivers, Teachers, and the Doctor
It's also helpful to speak to caregivers and teachers who
interact regularly with your child. Is your child paying attention
in class and turning in assignments on time? What's his or her
behavior like at recess and with peers? Gather as much information
as possible to determine the best course of action.
Discuss your concerns with your child's doctor, who can
offer perspective and evaluate your child to rule out any medical
conditions that could be having an effect. The doctor also may be
able to refer you to a qualified therapist for the help your child
needs.
Finding the Right Therapist
How do you find a qualified clinician who has experience working
with kids and teens? While experience and education are important,
it's also important to find a counselor your child feels
comfortable talking to. Look for one who not only has the right
experience, but also the best approach to help your child in the
current circumstances.
Your doctor can be a good source of a referral. Most doctors
have working relationships with mental health specialists such as
child psychologists or clinical social workers. Friends,
colleagues, or family members might also be able to recommend
someone.
Consider a number of factors when searching for the right
therapist for your child. A good first step is to ask if the
therapist is willing to meet with you for a brief consultation or
to talk with you during a phone interview before you commit to
regular visits. Not all therapists are able to do this, given their
busy schedules. Most therapists charge a fee for this type of
service; others consider it a complimentary visit.
Factors to Consider
Consider the following factors when evaluating a potential
therapist:
- Is the therapist licensed to practice in your state? (You can
check with the state board for that profession or check to see if
the license is displayed in the office.)
- Is the therapist covered by your health insurance plan's
mental health benefits? If so, how many sessions are covered by
your plan? What will your co-pay be?
- What are his or her credentials?
- What type of experience does the therapist have?
- How long has the therapist worked with children and
adolescents?
- Would your child find the therapist friendly?
- What is the cancellation policy if you're unable to keep
an appointment?
- Is the therapist available by phone during an emergency?
- Who will be available to your child during the
therapist's vacation or illness or during off-hours?
- What types of therapy does the therapist specialize in?
- Is the therapist willing to meet with you in addition to
working with your child?
The right therapist-client match is critical, so you might need
to meet with a few before you find one who clicks with both you and
your child.
As with other medical professionals, therapists may have a
variety of credentials and specific degrees. As a general rule,
your child's therapist should hold a professional degree in the
field of mental health (psychology, social work, or psychiatry) and
be licensed by your state. Psychologists, social workers, and
psychiatrists all diagnose and treat mental health disorders.
It's also a good idea to know what those letters that follow
a therapist's name mean:
Psychiatrists
Psychiatrists (MDs or DOs) are medical doctors who have advanced
training and experience in psychotherapy and pharmacology. They can
also prescribe medications.
Clinical Psychologists
Clinical psychologists (PhDs, PsyDs, or EdDs) are therapists who
have a doctorate degree that includes advanced training in the
practice of psychology, and many specialize in treating children
and teens and their families. Psychologists may help clients manage
medications but do not prescribe medication.
Clinical Social Workers
A licensed clinical social worker (LCSW) has a master's
degree, specializes in clinical social work, and is licensed in the
state in which he or she practices. An LICSW is also a licensed
clinical social worker. A CSW is a certified social worker. Many
social workers are trained in psychotherapy, but the credentials
vary from state to state. Likewise, the designations (i.e., LCSW,
LICSW, CSW) can vary from state to state.
Different Types of Therapy
There are many types of therapy. Therapists choose the
strategies that are most appropriate for a particular problem and
for the individual child and family. Therapists will often spend a
portion of each session with the parents alone, with the child
alone, and with the family together.
Any one therapist may use a variety of strategies,
including:
Cognitive Behavioral Therapy (CBT)
This type of therapy is often helpful with kids and teens who
are depressed, anxious, or having problems coping with stress.
Cognitive behavioral therapy restructures negative thoughts into
more positive, effective ways of thinking. It can include work on
stress management strategies, relaxation training, practicing
coping skills, and other forms of treatment.
Psychoanalytic therapy is less commonly used with children but
can be used with older kids and teens who may benefit from more
in-depth analysis of their problems. This is the quintessential
"talk therapy" and does not focus on short-term
problem-solving in the same way as CBT and behavioral
therapies.
In some cases, kids benefit from
individual therapy
, one-on-one work with the therapist on issues they need guidance
on, such as depression, social difficulties, or worry. In other
cases, the right option is
group therapy
, where kids meet in groups of 6 to 12 to solve problems and learn
new skills (such as social skills or anger management).
Family therapy
can be helpful in many cases, such as when family members
aren't getting along; disagree or argue often; or when a child
or teen is having behavior problems. Family therapy involves
counseling sessions with some, or all, family members, helping to
improve communication skills among them. Treatment focuses on
problem-solving techniques and can help parents re-establish their
role as authority figures.
Preparing for the First Visit
You may be concerned that your child will become upset when told
of an upcoming visit with a therapist. Although this is sometimes
the case, it's essential to be honest about the session and why
your child (or family) will be going. The issue will come up during
the session, but it's important for you to prepare your child
for it.
Explain to young kids that this type of visit to the doctor
doesn't involve a physical exam or shots. You may also want to
stress that this type of doctor talks and plays with kids and
families to help them solve problems and feel better. Kids might
feel reassured to learn that the therapist will be helping the
parents and other family members too.
Older kids and teens may be reassured to hear that anything they
say to the therapist is confidential and cannot be shared with
anyone else, including parents or other doctors, without their
permission - the exception is if they indicate that they're
having thoughts of suicide or otherwise hurting themselves or
others.
Giving kids this kind of information before the first
appointment can help set the tone, prevent your child from feeling
singled out or isolated, and provide reassurance that the family
will be working together on the problem.
Providing Additional Support
While your child copes with emotional issues, be there to listen
and care, and offer support without judgment. Patience is critical,
too, as many young children are unable to verbalize their fears and
emotions.
Try to set aside some time to discuss your child's worries
or concerns. To minimize distractions, turn off the TV and let
voice mail answer your phone calls. This will let your child know
that he or she is your first priority.
Other ways to communicate openly and problem-solve include:
- Talk openly and as frequently with your child as you
can.
- Show love and affection to your child, especially during
troubled times.
- Set a good example by taking care of your own physical and
emotional needs.
- Enlist the support of your partner, immediate family members,
your child's doctor, and teachers.
- Improve communication at home by having family meetings that
end with a fun activity (e.g., playing a game, making ice-cream
sundaes).
- No matter how hard it is, set limits on inappropriate or
problematic behaviors. Ask the therapist for some strategies to
encourage your child's cooperation.
- Communicate frequently with the therapist.
- Be open to all types of feedback from your child and from the
therapist.
- Respect the relationship between your child and the
therapist. If you feel threatened by it, discuss this with the
therapist (it's nothing to be embarrassed about).
- Enjoy favorite activities or hobbies with your child.
By recognizing problems and seeking help early on, you can help
your child - and your entire family - move through the tough times
toward happier, healthier times ahead.
Reviewed by:
Michelle New, PhD
Date reviewed: August 2007
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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