Therapy is not always the answer. Yup, that’s how I’m choosing to lead an article promoting therapy. Over the past few years there has been a welcome erosion of the stigma surrounding therapy. This is undeniably a good thing. Parents are now more open than ever to find their child help for a variety of psychosocial concerns. While this is a great thing to see, I have also witnessed a burgeoning trend of children being sent to therapy in the absence of a clear clinical need. I get it – we want our children to flourish and get out ahead of any psychological issue that could manifest in the future. My concern with this trend is that children who are sent to therapy unwillingly with no clear clinical reason may develop an enduring negative bias against therapy. So that begs the question – when is it appropriate to seek therapy for your child? Below I outline five primary signs that suggest it may be time for your child to get some help.
A Significant Impact on a Major Life Area
It is not uncommon for childhood to have its fair share of stress, rife with ups and downs. In fact, I would argue that some stress throughout childhood is not only normal, but critical for children to thrive as adults. Stress helps children develop the necessary tools to solve problems, work through distress and live their best lives as they grow older. However, when the stress of life starts to negatively impair one or more major life area, therapy may be indicated. Is your child staying home from school because of anxiety? Is your child losing friends because their increased irritability is pushing people away? Was your teenager fired from their job because they had trouble showing up on time and keeping track of their schedule? When deciding whether a problem warrants therapy, I encourage parents to ask two questions: 1.) What are my child’s major roles in life, and 2.) Is the problem negatively impacting at least one of these roles?
Prolonged Duration
There are key differences between developmental appropriate stress and clinically significant distress for a child. One such distinction lies within the duration of the distress. It is fairly normal for older children and adolescents to experience discrete periods of feeling lonely and sad. Most of the time, these emotional states do not persist more than a couple of days. Parents are right to be concerned, however, when the duration of these states becomes prolonged, lasting more than a few days.
Significant Distress
It is entirely possible that many children with a mental health concern in need of treatment are finding a way to get by. Their issues may not be negatively impacting any major areas of their life. However, that does not always mean help is not warranted. Another question to ask is whether the concerns are causing my child distress? Do they report wishing every day that they could just stop worrying so darn much? Do they endorse feeling helpless to solve whatever issue they are working through? Is your teen sick and tired of feeling anxious any time they try something new? On the outside they may appear to be crushing it in all areas of life, but if they feel distressed about their issue, therapy may be warranted. Oftentimes a child may report that their problems cause them no such distress. Family members, on the other hand, may feel great distress regarding their child’s issue. Therefore, a second key question to ask is whether the concerns are causing family level distress? Do you feel like you and your co-parent have to walk on eggshells all day to avoid upsetting your child? Are you tired of providing your teen excessive reassurance to assuage their worries? If the answer is yes, it may suggest that it’s time for therapy.
The Subtle Behavioral Signs
It is not uncommon for a teen to skip a shower here and there and stink up the whole house (sound familiar?). However, when a child is struggling emotionally, their daily routine and activities of daily living are often a subtle indicator of their inner state. A child who formerly had no problem falling asleep, eating regularly, and possessing good hygiene habits may start to skip more than a few showers, brush their teeth less, show irregular sleep patterns, and experience a suppressed appetite. Children, especially the younger ones, may have a difficult time articulating their emotional state. Therefore, the subtle behavioral signs described above provide a good compass for a parent wondering if outside help is needed.
They Ask for It
This may come as a shock to you, but not every child wants to be in my office. Even more shocking, it is usually not the child’s choice to be in my office. Sarcasm aside, it is rare for a child to specifically ask for therapy (although it certainly does happen!). The stigma for therapy has decreased over the years, yet it is still alive in well in the social world that children inhabit. So when a child asks for therapy, or even if they willingly agree to go to therapy at your suggestion, that may be sign that your child is stuck in some way. Furthermore, one of the biggest predictors of treatment success is the child’s openness to receiving help. So when a child asks for help, it not only may indicate they need help, but also that they may be more likely to benefit from such help.
