Does My Child Need Therapy? / Does My Teen Need Therapy?

Childhood and adolescence are full of emotional ups and downs.  How do you know whether your child is showing signs of anxiety or depression? Or just experiencing the usual growing pains.

The good news is that most therapists (including us) offer free consultations. We are happy to help determine whether therapy might be helpful for your child.  Here are some of the questions we ask.

Assessment Questions from a Child Therapist in Maryland*

*When we say “child” we are referring to anyone young enough to be in your care. Teens included! Where the answers are different for different ages, we’ll let you know.

1.What behaviors are you noticing?

Your parental instincts are strong. And there’s something that prompted you to ask whether therapy might be helpful.   What concerning behaviors or emotions are you seeing in your child? 

2. What do you fear could happen if they aren’t addressed?

This question helps determine how urgent or serious the issue is. If you are concerned that your child might put himself in a dangerous situation or injure someone else. Request a child therapy or teen therapy consult immediately.

3. What impact are the behaviors or emotions having?

Is his school performance changing as a result?  Are her friendships or relationships with family members affected?   In order to be considered a clinical issue, the behavior has to affect performance in school, work, or relationships.

4. Where and when do you see this emotion or behavior?

Clinical issues such as depression, anxiety, or ADHD are evident in more than one context (school, home, mom’s house, dad’s house, soccer practice).   If you have seen changes in your child’s behavior across multiple contexts. Or negative behaviors that don’t change in response to parenting. Consult a therapist.

If the behavior seems to occur in only one context, check for problems in that environment. Try to resolve the issue.  For example, misbehavior at math time likely signals some frustration with the class content. 

Angry outbursts directed at a particular sibling may reflect resentment about a past conflict.  If your family can talk it through and solve the problem, the behavior may resolve.  If it doesn’t, try family therapy to find the deeper root of the issue.

5. Have you noticed a change?

How is this behavior or emotion different from what you usually see your child doing?  How long has it been going on?  What was your child like before this behavior appeared? 

Abrupt changes in behavior can be signs of a change in your child’s mental health.   It’s a good idea to ask your child what’s happening at school and in friendships, and to help her problem solve.  If emotional reactions persist after the problem has been solved, seem out of proportion to the problem, or seem not to have been prompted by anything, it’s time to ask a professional.

6. Are your child’s classmates showing similar behavior?

Changes in behavior can indicate a mental health need, but can also simply signal a new stage of development.   For example, puberty often prompts an increase in emotional reactivity in adolescents.  Looking at what is happening with peers can help determine whether your child’s behaviors or emotions are more intense or otherwise different than what’s expected at this stage.  If they are, consult a therapist.

7. Is your child getting enough rest, unstructured playtime, and quality time with you?

Children show stress and overwhelm through their behavior.   Try giving more downtime between activities, going to bed a little earlier, or adding 15 minutes of one on one time with you each day. You may see the behavior resolve on its own.   

If these needs are met. And you’re still seeing problem behaviors at home. A therapist can help your child build the skills to handle everyday stress more effectively.

8.  Is it getting worse rather than better?

If the behavior seems to be increasing in frequency or intensity, consult a therapist to figure out how to reverse the trend.  A therapist can help you add new tools to your parenting toolbox. Or consider strategies you haven’t yet tried.

9. Are you seeing any of the following behaviors?

If your child is showing any of these behaviors, contact a licensed therapist right away.

  • Physically harming himself or someone else (including animals).

  • Withdrawing from all friendships or relationships.

  • Using drugs, alcohol, or sexual behavior to cope with stress.

  • Telling you he/she was sexually abused or assaulted.

  • Threatening to harm him/herself or others.

  • Telling you s/he wishes s/he were dead or you’d be better off without him/her.

child-psychologist

If the danger is imminent, call 911 or the Montgomery County Crisis Center at 240-777-4000 for help keeping your child and family safe.

If you aren’t sure, if your child or teen needs help request a consult.  We’re happy to talk it through with you.

Finding the right child therapist in Maryland

If you do decide to see a therapist, choose one who focuses on children and/or teens. A therapist who works consistently with children will have plenty of play based tools. So your child can learn and grow in the ways that come most naturally to them.

Adolescents are often being dragged to therapy by a parent. A therapist that is working frequently with teens and takes the time to understand what matters most to them is a must. A therapy space (even a virtual one) that is designed for them helps your teen connect and engage.

You’ll find that in our practice, even when we are online. Different therapists work with different age groups, and each has a virtual therapy room built for children or teens. Those who serve tweens have both!

For more detail on selecting the right child therapist in Maryland, see our post on this topic. Guidance is state specific because therapist licensing differs state to state. Our office is most convenient to those in Bethesda, Chevy Chase, Kensington, Rockville, and Silver Spring.

Once you’ve decided that you do want your child or teen to see a therapist. Getting them on board is tricky. Especially in the teen years.

How to get your teen to go to therapy: advice from our teen therapist in Maryland

It matters how you talk about therapy. Your teen may be embarrassed, which is common. And it may be hard for them to admit they might need help. So let’s talk about therapy in a way that leaves no room for shame.

Share how you think therapy is helpful and could benefit them. Pause and listen to their opinions on the matter. Then make them a part of the decision process.

Can they have a say in who they see? Can they help decide what day or time? Most of the time it will take a few sessions to know if it’s the right fit.

Give them the freedom to talk about what they want to talk about in session. ( After the goals have been stated and agreed to.) And let them share with you what they want.

And if they still refuse? Getting parenting support can be just as helpful. Read our article on this topic for more detailed advice.

Did you enjoy this article? Sign up for our newsletter to get a monthly summary in your inbox. Or meet with a neurodiversity affirming therapist for more personalized advice.

Robin Brannan

Robin Brannan is a Licensed Clinical Marriage and Family Therapist in Maryland, where she has been treating children, couples, parents, and families since 2001.

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