How Do I Know If My Child Needs to See a Therapist?


How do I know if my child needs to see a therapist? If you are asking yourself this question, you are not alone. The CDC reports that, based on a study done in 2009, an “estimated 13 –20 percent of children living in the United States (up to 1 out of 5 children) experience a mental disorder in a given year” (https://www.cdc.gov/childrensmentalhealth/features/kf-childrens-mental-health-report.html). As more recent data shows mental health awareness increasing, it is likely that this number may be increasing as well. So how do you know if what your child is
experiencing necessitates seeing a therapist?

The following are some reasons to seek therapy for your child or adolescent: (1) when your
child appears to be stuck in an unhealthy emotion such as depression, anxiety, or anger, (2)
when your child is struggling to regulate emotions appropriately for their age, (3) when your
child’s behaviors are unsafe for themselves or others, or (4) when your child’s emotions or
behaviors are causing distress at home, school, or socially. Keep reading for further descriptions
to help you determine if your child or adolescent is struggling in one or multiple of these areas.

Getting Stuck

Most of us have experienced times of anger, anxiety, and even deep sadness. These waves of
emotion are natural and even healthy at times. What can be unhealthy is landing on these
emotions for an extended amount of time. It’s important to pay attention to your children and
have conversations with them about their feelings to determine if they are stuck in these
emotions. Here are some ways that children may express these emotions differently than
adults (please note this is not an exhaustive explanation and a more individualized assessment
can be given by a therapist):
Anger: Anger is sometimes called a “secondary emotion.” This means that other emotions may
trigger anger on top of the primary emotion. Because children sometimes struggle to express
their primary emotions, anger may be a sign that other things are going on underneath. Anger
is sometimes a child’s main way of expressing anxiety and depression, difficulty in school,
boredom, or social distress. If your child is frequently angry or acting out, it may be helpful to
seek out a therapist to help uncover the primary cause for the anger.
Anxiety: Children sometimes exhibit physical signs of anxiety before they have the words to
explain what they are feeling. Frequent tummy issues without a medical explanation may be a
sign of anxiety. Children dealing with anxiety also tend to ask a lot of questions and need to
know what is happening. Teens, on the other hand, may express anxiety by saying they are
“stressed,” procrastinating, or isolating.
Depression: The way I sometimes explain sadness versus depression is that sadness sometimes
feels like you’re walking through a mud puddle; it feels heavy and slow, but you’re able to keep
moving. Depression sometimes feels more like sinking sand and you don’t always feel like
you’re able to move forward. Children and teens with depression will often have less interest in
things they used to enjoy (while not replacing these with new passions), isolate from friends
and family, sleep or stay in bed more than usual, or cry often.

Age Appropriate Emotion Regulation
The above descriptions of anger, anxiety, and depression are not complete without putting
them in the context of your child’s age. Please see resources below for a link to age appropriate
emotional development to determine if some of the “signs” your child is showing may be what
is appropriate for his/her developmental stage.

Safety Risks
If your child is having any thoughts about hurting or killing themselves or someone else, it is
important to seek out help immediately by calling 911 or going to your nearest emergency
room. The clinicians there will assess your child/teen’s safety and determine the most
appropriate treatment course. Taking your child to be assessed does not mean they will
definitely be hospitalized. The clinicians will determine if hospitalization is necessary. Upon
discharge (whether or not your child/teen was hospitalized), they should work with you on
developing a safety plan and referrals/recommendations for further treatment moving forward.
If you are unsure whether or not your child/teen needs to be assessed, you can call the national
suicide prevention lifeline at 1-800-273-TALK (8255) to ask questions.

Distress
Although your child may appear healthy and happy in one environment (home, school, social
settings), you may notice that your child seems upset in one or more of these environments.
Even if the distress is not happening across all environments, it may still be helpful to seek out a
therapist to help your child manage his or her distress in the environment that is upsetting.
Many of the above criteria will be best determined if you sit down and have a talk with your
child or adolescent. Use the above descriptions to explain what anxiety and depression feel like,
ask questions about their zeal for life, and talk to them about things that feel upsetting at home
and school. If you are still unsure whether or not therapy is right for your child, you can speak
to your pediatrician about your concerns or call us at SureHope to discuss your concerns.
I think my child needs therapy. Where do I start?

All of the staff here at SureHope would love to help direct you to a therapist who is a good fit
for your child. You can contact our North Charlotte/University Area office at (980)272-8180 or
our Matthews office at (704)443-8866. If neither of these locations are convenient for you,
we’d love to direct you to another therapist in your area. Another great place to start is talking
to your pediatrician.

Managing your own emotions about your child/adolescent’s mental health:
Sometimes it can feel very overwhelming to parent a child struggling with their mental health.
It’s important to not neglect your own self-care during this time. Many child and adolescent
therapists offer sessions with the parent to address helping the “parent part” of you and to give
parent coaching specific to your child. Additionally, it may be beneficial to seek out an
individual therapist for yourself. This will not only help with your own self-care emotionally and mentally, but will also model for your child that therapy can be a beneficial way to pursue
mental and emotional health.

Resources:
https://www.understood.org/en/learning-attention-issues/signs-symptoms/age-by-age-learning-skills/social-and-emotional-skills-what-to-expect-at-different-ages
https://surehopecounseling.com/
https://www.cdc.gov/childrensmentalhealth/features/kf-childrens-mental-health-report.html

~Jessica Winebarger