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Should we stay or should we go? (to therapy with my kid)

Parenting is a remarkable journey filled with joy, love, and a deep sense of responsibility. Alongside these positive emotions, parents often experience worry and concern for their children's well-being. From their physical health to their emotional and social development, parental worries are ever-present.


Children's mental health is a priority at every stage of their development. As parents and caregivers, it's crucial to recognize when our children may benefit from therapy and understand the differences in approaching therapy at various ages. Each developmental stage presents unique challenges and opportunities for growth. In this blog post, we will explore the importance of therapy for children at different ages and discuss the distinctive considerations for each stage.


Recognizing Behavioral or Emotional Changes


The first step in considering therapy for a child is recognizing significant behavioral or emotional changes. Pay attention to signs such as:


· Persistent sadness, anxiety, or mood swings.

· Difficulty concentrating or declining academic performance.

· Social withdrawal or sudden changes in friendships.

· Frequent and unexplained physical complaints (headaches, stomachaches, etc.).

· Extreme changes in appetite or sleep patterns.

· Self-harm behaviors or expressions of hopelessness.

· If you notice these signs lasting for an extended period or affecting your child's daily functioning, it may be an indication that therapy could be beneficial.


Impact on Daily Functioning

Consider how your child's difficulties are impacting their daily life. Are their challenges interfering with their relationships, school performance, or overall well-being? If the issues persist or worsen over time and begin to affect their functioning and quality of life, seeking therapy can provide them with the support and tools they need to overcome these challenges.


Trust Your Intuition as a Parent

As a parent or caregiver, you have a deep understanding of your child's needs and behavior. Trust your instincts if you have concerns about your child's emotional well-being. Your intuition can be a valuable guide when making decisions about seeking therapy. If you feel that therapy could help your child, it's worth exploring further.


Communication with Professionals

Engage in open and honest communication with professionals involved in your child's life, such as pediatricians, teachers, or school counselors. They can provide insights into your child's behavior and offer recommendations for further evaluation or therapy. Collaborating with professionals who have expertise in child development and mental health can help validate your concerns and guide you toward the appropriate course of action.


Seeking Professional Evaluation

If you're unsure whether therapy is necessary, consider seeking a professional evaluation. Mental health professionals, such as psychologists or child therapists, can conduct assessments to better understand your child's emotional well-being, identify any underlying concerns, and recommend appropriate interventions. A professional evaluation can provide clarity and guide your decision-making process.


Normalizing therapy and reducing stigma

Explaining to your child that therapy is a safe and supportive space to talk about their feelings and challenges can help alleviate any apprehensions. Emphasize that therapy is a tool to help them navigate difficult emotions, learn coping skills, and develop a positive mindset.

Calvin and Hobbes by Bill Watterson for July 09, 1993


Early Childhood (Ages 3-6)


Therapy during early childhood can provide a solid foundation for emotional well-being. Here are some key considerations when getting kids in therapy during this stage:


· Play-based therapy: Young children often communicate and process their emotions through play. Play therapy allows them to express themselves freely, explore their feelings, and develop essential social and emotional skills in a safe and supportive environment.

· Parental involvement: Parents play a crucial role in early childhood therapy. Therapists may work closely with parents, offering guidance on parenting strategies, emotional regulation techniques, and fostering a secure attachment between parent and child.

· Addressing developmental milestones: Therapy can help identify any developmental delays or challenges in early childhood. Early intervention can support children in reaching their developmental milestones, ensuring a strong foundation for future growth.


Middle Childhood (Ages 7-12)


As children enter middle childhood, their experiences become more complex, and therapy can help navigate these challenges. Here are some considerations when seeking therapy for children in this age range:


· Cognitive development: Middle childhood is marked by significant cognitive development. Therapists may utilize cognitive-behavioral therapy (CBT) techniques to help children understand and reframe their thoughts and behaviors. CBT can assist in managing anxiety, building resilience, and promoting healthy coping mechanisms.

· Peer relationships and social skills: This stage is characterized by increased peer interactions and the development of social skills. Therapy can support children in navigating friendships, resolving conflicts, and enhancing their communication and empathy skills.

· Building self-esteem: Middle childhood is a critical period for building self-esteem.


Therapy can help children develop a positive self-image, embrace their strengths, and navigate challenges such as academic pressure, body image concerns, and bullying.


Adolescence (Ages 13-18)


Adolescence brings about significant physical, emotional, and social changes. Therapy can be instrumental in supporting teenagers during this transformative stage. Here are some considerations when getting teens in therapy:


· Identity exploration: Adolescence is a time of self-discovery and identity formation. Therapy can help teenagers explore their values, interests, and aspirations, as well as navigate issues related to self-identity, peer pressure, and societal expectations.

· Emotional regulation and mental health: Teenagers often experience increased emotional intensity and may struggle with mental health issues such as anxiety, depression, or eating disorders. Therapy can provide a safe space for expression, teach coping strategies, and offer tools for emotional regulation.

· Future planning and transition: Adolescence involves significant transitions, such as preparing for college, entering the workforce, or navigating independence. Therapy can help teenagers set goals, develop decision-making skills, and cope with the stress associated with these transitions.


The level of parental involvement in a child's therapy depends on the child's age and developmental stage. If younger children may require more parental involvement, older children and adolescents often desire more autonomy and privacy. Therapists use their clinical judgment to determine the appropriate balance between respecting the child's confidentiality and involving parents in the therapeutic process.


Sharing Information with Parents:

Therapists generally encourage open communication and collaboration with parents to ensure the child's holistic well-being. While the specifics of what is shared with parents may vary depending on the child's age, therapists typically discuss the general progress, treatment goals, and strategies being utilized in therapy. This information helps parents provide support and reinforce therapeutic techniques outside the therapy session.


Limits and Exceptions:

There are circumstances when therapists may need to breach confidentiality and share information with parents. These include situations where there is a risk of harm to the child or others, such as abuse, neglect, or potential danger. Therapists are mandated by law to report such cases to ensure the child's safety. In these exceptional cases, therapists carefully balance the child's right to privacy with their duty to protect and ensure their well-being.


Building Trust and Collaboration:

Effective communication and collaboration between therapists, children, and parents are vital to navigate the boundaries of confidentiality. It is important for therapists to establish clear expectations and guidelines with parents and children at the beginning of therapy. Regular discussions with parents can provide updates on progress and address any concerns, fostering trust and a shared understanding of the therapeutic process.


Discussing mental health symptoms with children can be challenging, especially when they lack the language to articulate their experiences. However, open and compassionate communication about these issues is crucial for children to understand and engage in treatment effectively.


Create a Safe and Supportive Environment:

Establishing a safe and supportive environment is key to starting conversations about mental health symptoms. Ensure that your child feels comfortable, loved, and accepted. Cultivate an open atmosphere where they know they can trust you and share their thoughts and feelings without judgment.


Simplify and Use Age-Appropriate Language:

When discussing mental health symptoms, it's important to use language that is appropriate for your child's age and developmental stage. Simplify complex concepts and explain things in a way they can grasp. Use relatable examples or metaphors to help them understand difficult emotions or experiences.


Focus on Feelings and Behaviors:

While children may not have the vocabulary to describe specific mental health conditions, they can often express their feelings and behaviors. Encourage your child to talk about how they are feeling, both emotionally and physically. Help them recognize any changes in their thoughts, behaviors, or moods that they may be experiencing.


Use Visual Aids and Storytelling:

Visual aids, such as books, illustrations, or videos, can be powerful tools to help children understand and relate to mental health symptoms. Look for age-appropriate resources that explain emotions, anxiety, depression, or other common mental health challenges. Storytelling can also be effective, as it allows children to engage with characters who share similar experiences. These movies have a great potential to start and aid a discussion about such topics as grief and loss – “Up”, inner life and our emotions – “Inside Out”, grief and anxiety – “Finding Nemo”, mental health stigma (don’t feel, conceal, don’t let them know) – “Frozen”, mental health archetypes with sad Eeyore, worried Piglet, hyper Tiger in the “Christopher Robin” movie.


Validate and Normalize:

It's essential to validate your child's feelings and experiences. Let them know that it is okay to feel the way they do and that they are not alone. Normalize the fact that many people, including children, may experience mental health challenges and that seeking help is a positive step towards feeling better.


Encourage Questions and Active Listening:

Encourage your child to ask questions and express any concerns they may have. Practice active listening by giving them your full attention, validating their feelings, and responding with empathy. This helps them feel heard and understood, fostering a sense of trust and openness.


Involve Them in the Treatment Process:

Engaging children in the treatment process can increase their investment and willingness to participate. Discuss the different treatment options available and involve them in decision-making to the extent appropriate for their age. Encourage their input and make them feel like an active participant in their own healing journey.


Highlight the Benefits of Treatment:

Emphasize the positive impact that treatment can have on their well-being. Explain how therapy or other interventions can provide support, teach them coping skills, and help them feel better. For adolescents it can be helpful to frame treatment as an opportunity for growth, self-discovery, and improved overall quality of life.


Getting kids in therapy at various ages is essential for their overall well-being and development. By recognizing the unique needs and challenges presented by each developmental stage, parents and caregivers can make informed decisions about seeking therapy. Whether it's play-based therapy in early childhood, cognitive-behavioral techniques in middle childhood, or identity exploration support in adolescence, therapy can provide invaluable guidance and support to children as they navigate the complexities of life. Prioritizing their mental health at every stage sets the stage for a happier and healthier future.


By Elena Lewis, MSW Intern

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