Does My Child Need Therapy?

Psychological problems are common for kids. How to know when it's time for help.

Posted Sep 28, 2020

"When I was a kid, no one needed therapy — I just don't understand what's wrong with kids these days."

Most therapists who've worked with parents have heard some variation of the above statement. While evidence does suggest that the prevalence of mental health problems for children and adolescents is increasing over time [5] particularly for adolescent girls with internalizing problems {according to [1]), researchers are largely unsure of a causal explanation.

It could be due to increased academic and social expectations on children in the 21st century, or due to technology, socio-cultural change over time, or simply increased diagnostic accuracy and awareness of mental health. Regardless, what's most important for parents is the safety and health of their child(ren). So the question remains: How can parents tell when their child needs to see a mental health professional?

Curious about the rate of children who feel a need to see a mental health professional and decide not to inform their parents due to fear of various repercussions, I conducted an anonymous survey of 70 young adults (18-29) and asked the following question:

"True or False? Before I was 18 years old, I could have benefited from mental/behavioral health services but did not ask my parents because I was scared of what they would think/say/do."

43 percent of respondents indicated "True" — meaning that they did not receive mental health services that could have benefitted them because of their fear about their parents' reaction(s). Granted, this is informal research and I think further inquiry should be made. Notably, well-regarded resources like the Child Mind Institute have already released a how-to article targeted at teens who are searching for "how to talk to my parents about mental health problems." If you are a teen, I highly recommend you consider reading their article.

In the academic literature, a nationally representative sample of over 10,000 adolescents (read: your average teenager) [4] found that one-third of respondents qualified for an anxiety disorder, one-fifth for a behavior disorder, and one-eighth for a mood disorder. Notably, there is frequent overlap — one person may qualify for multiple diagnoses. Perhaps most shockingly, the average age of onset for these disorders was 6 years old for anxiety, 11 for behavior, and 13 for mood disorders. In other words, a significant minority of children and adolescents qualify for a mental/behavioral health diagnosis and could benefit from treatment, but many of these are likely not approaching their parents for help — possibly due to fear of their parents' reaction(s).

Now that I've sufficiently worried you, what is a concerned parent to do? If you notice these signs in your child, it may be time to have a candid, non-judgmental conversation about their mental health.

  1. Social withdrawal/exclusion
  2. Skin- or hair-picking or other self-harm activities
  3. Non-normative (think sudden or severe) changes in mood or personality
  4. Extreme changes in activities of daily living like eating, sleeping, and exercising (e.g. teens like to sleep, but they should not be staying in bed all day)
  5. Headaches, stomachaches, dizziness, shortness of breath, and racing heartbeat that seems all-too-suspiciously correlated with activities like sports practice, leaving for school in the morning, or social events
  6. Death of a close loved one or friend — especially death by suicide [3]

I will credit Jill Ceder, LMSW, JD who wrote an excellent article called "Why Your Child May Need to See a Therapist" [2] which makes similar points. I would encourage you to consult her article for additional information if you're interested.

Joanna Malinowsha / Pixabay
Source: Joanna Malinowsha / Pixabay

If you've read this far, you're probably a parent. And if you're a parent, it's your job to protect your child(ren). Just as you wouldn't put them in harm's way of some physical danger, you should take responsibility to protect them from psychological danger. Most importantly, remember that connecting your child with mental health services is not "giving up" or admitting fault — it's a decision made by strong parents who want the best for their kid(s). You'll likely find that your child's therapist commends you for it!

To find a therapist, please visit the Psychology Today Therapy Directory

References

Bor, W., Dean, A. J., Najman, J., & Hayatbakhsh, R. (2014). Are child and adolescent mental health problems increasing in the 21st century? A systematic review. Australian and New Zealand Journal of Psychiatry, 48(7), 606-616. doi:10.1177/0004867414533834

Ceder, J., LMSW, JD. (2020, March 02). Should You Take Your Child to Therapy? Retrieved September 25, 2020, from https://www.verywellfamily.com/signs-your-child-may-need-a-therapist-4130486

Melhem, N. M., Day, N., Shear, M. K., Day, R., Reynolds, C. F., & Brent, D. (2004). Traumatic grief among adolescents exposed to a peer's suicide. American Journal of Psychiatry, 161(8), 1411-1416. doi:10.1176/appi.ajp.161.8.1411

Merikangas, K. R., He, J., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., . . . Swendsen, J. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: Results from the national comorbidity survey Replication–Adolescent supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49(10), 980-989. doi:10.1016/j.jaac.2010.05.017

Twenge, J. M., Cooper, A. B., Joiner, T. E., Duffy, M. E., & Binau, S. G. (2019). Age, period, and cohort trends in mood disorder indicators and suicide-related outcomes in a nationally representative dataset, 2005–2017. Journal of Abnormal Psychology (1965), 128(3), 185-199. doi:10.1037/abn0000410