All kids have emotional ups and downs: periods of moodiness, trouble with friends, dips in academic performance.
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But how do you know if your child is struggling with something more serious? And when should you seek professional help?
- How to Tell if a Kid Actually Needs to See a Therapist
- Signs Your Child May Benefit from Seeing a Therapist
- Finding Low-Cost Mental Health Care
- Counselling Services for Children and Young People
- Taking Your Child to a Therapist
- Behaviour problems
- How can you help your child
- Provide Feedback
- Behavior Therapy
- What is Behavior Therapy?
- Types of Behavioral Therapies
- Does My Child Need Pediatric Counseling?
- Stigmatization in Pediatric Counseling
- Treatment in Pediatric Counseling
- Ways to Help Your Child When They Are Struggling
- Make Time to Talk
- Healthy Sleeping Habits
- Daily Exercise
- Counselor Reviews
- Your Child Depends On You
- Does Your Child Need Behavioral Therapy? How to Tell and What to Do
Some struggles are normal
“Some moodiness, anxiety, and social and school difficulties are expected as kids grow up,” says psychologist Kristen Eastman, PsyD. “I call them bumps in the road.”
These normal developmental challenges may require your child to change perspectives or learn new skills. In most cases, if you offer support, sensitivity and patience, your child can figure it out.
“When these things pop up, I encourage parents to try to listen first and validate their child’s experience,” Dr. Eastman says.
It’s natural to want to quickly jump in and try to problem-solve, but children just need to know they’re heard and understood. She suggests using phrases like, “I see this is really hard for you,” or “I notice you’ve been struggling lately.”
“You’ll be surprised how far validating your child‘s experience can go in helping them feel heard,” she says. “Then they’re more receptive to talking about how to get through it.”
When to seek help
Yet what seems like a normal childhood difficulty can sometimes turn into something more serious. Dr. Eastman says you should be concerned if your child:
- Has problems in multiple areas of life, such as family relationships, academic performance, leisure activities and friendships.
- Starts feeling bad about himself or herself, less confident or less effective.
- Shows excessive worry about the future.
- Expresses hopelessness.
- Withdraws from family, friends or activities he or she used to enjoy.
- Has a significant change in sleep habits or appetite.
- Engages in negative behavior more frequently.
- Has repetitive, self-destructive behaviors such as hair-pulling or skin-picking.
- Talks about or engages in any kind of self-harm.
- Makes comments like “I wish I weren’t here,” or “Nobody would care if I ran away.”
- Talks explicitly about suicide.
Dr. Eastman also recommends that parents trust their gut. “You know your child best. If something just doesn’t feel right, trust that instinct. It’s better to go and get something checked out if you’re not sure.”
How to reach out
Don’t be afraid to broach the topic with your child, says Dr. Eastman. “Often if you just say to your child, ‘Does this feel like something we need to get some help with?’ they’ll say, ‘Yeah, it does,’ ” she notes.
Parents are often surprised by how willing their children are to get extra help.
That help is as close as your pediatrician. “Pediatricians are often very good at helping parents differentiate what is and isn’t normal, and can offer reassurance,” Dr. Eastman says. If necessary, your pediatrician can refer you to a therapist who is a good match for your child and recommend other resources.
Parents sometimes assume that mental health treatment will mean medication or hospitalization for their child.
“But even when problems aren’t severe, therapy can help the child and family learn new coping skills and different strategies for handling problems,” Dr. Eastman says. “We need to destigmatize the idea of mental health treatment.”
Whether your child needs help navigating normal developmental challenges or is dealing with something more serious, seeking help can make life easier and happier for all of you.
How to Tell if a Kid Actually Needs to See a Therapist
As we’ve reported before, therapy can guide grown-ups through the stresses of adulting. The same holds true for the turbulent teen and childhood years. An assist from a mental health professional often makes the challenges of youth—from recess to relocation to relationships—more surmountable.
But dragging a reluctant child to therapy just because someone died, you’ve moved, or you’re splitting from your spouse can backfire, and it’s just not always necessary. “Every child is going to react differently to these situations,” says Shana Schnaue, an elementary school counselor in Fairfax County, Virginia, and a spokesperson for the American Counseling Association. “Some kids have the skills they need to cope. Other kids don’t. It’s when you start to see warning signs that it’s really beneficial for parents to reach out for outside support.”
So how do you know when your child’s crying for help—and what can you do to answer? Watch for these red flags, then raise your concerns in a calm, low-key manner. Point out what you’ve seen, and gently suggest the benefits of involving an outside expert for everyone involved, suggests Bethany Raab, a Denver-based therapist who’s treated teens and college students for a decade.
Sign 1: They’re struggling at school.
Mental health and academic difficulties are intimately intertwined, says Anil Chacko, associate professor of counseling psychology at New York University. As early as preschool or kindergarten, kids who lag on learning the alphabet, putting sounds together, and other language-related tasks might benefit from early interventions to improve learning. That, in turn, can protect their social, emotional, and behavioral health for years to come.
As toddlers become elementary-, middle-, and high-schoolers, poor grades—especially if they drop suddenly—can signal a wide range of problems. “Whether they are struggling with depression, anxiety, a bully or even a learning difference, bringing a mental health professional on board can be a huge support to both the child and the family as a whole,” Raab says.
Keeping in close touch with your child’s teachers, counselors, and other school staff can help you spot issues you might not see outside classroom walls. “Teachers have a broader comparison base to identify kids where there may be some kind of concern,” Chacko says. They also can help shed light on the root causes—for instance, whether your student’s performance is suffering because of a learning disability or because anxiety or peer conflict is keeping him or her in the counselor’s office for hours, Schnaue points out.
Sign 2: They’ve grown detached.
Being introverted doesn’t count as a psychiatric disorder, Chacko points out, and quiet activities like reading shouldn’t be stigmatized. However, even kids and teens who tend to be loners typically have at least one or two friends they spend time with. If your child never discusses friendships or activities with peers, something may be amiss, he notes.
That’s especially true if a normally gregarious child turns silent or if kids who normally enjoy activities like soccer refuse to take the field, Schnaue says. A loss of enjoyment can serve as a warning sign of depression, or a bully on the team could be kicking your kid to the bench—both situations in which intervention might be appropriate.
Of course, behaviors and family relationships naturally shift over time, but extremes should raise suspicions. “If your child is unusually aggressive verbally or physically, or is withdrawn and refusing to talk with you about it, you might want to consider having a professional help determine what is going on,” Raab says.
More From Tonic: Raised and Confused: Screen Babies
Sign 3: Their appearance suffers.
Messy hair might just be a fashion choice, but severe slips in hygiene—wearing the same soiled clothes over and over, skipping showers, not using a toothbrush—might signal depression, bullying, or other big problems with friendships or peer relationships, Schnaue says.
“Often, when you comment on it, you’ll get this gruff response—like, ‘leave me alone, it’s none of your business,'” she says. At that point, it’s worth following up with teachers, coaches, daycare providers, or anyone else who regularly interacts with your child if they have relevant observations, she notes. Putting together those pieces can help you, as a parent, determine what you might be able to help change—and when it’s time to call for reinforcement.
Sign 4: You get intel from other places.
As a parent, you’re an expert on your child’s behavior. But since you’re not with him or her 24/7, there can easily be things you miss. Sometimes, your kids’ friends—or those kids’ parents—might be privvy to information you don’t have, Raab says. This could range from the relatively banal—say, an overheard conversation about two teens ditching school—to more serious issues, like abusive relationships and substance use.
Though it might be difficult or frightening to hear the news from another source, take these communications seriously, Raab says. And try not to take it personally that your child hasn’t come directly to you. Some problems might feel safer to express to a friend or a non-parent.
Sign 5: You spot physical symptoms.
Of course, psychological health isn’t all in your child’s head. Some behaviors have manifestations and consequences for the rest of his or her body, too. Take substance abuse—you might notice telltale signs like booze on your teen’s breath or red eyes and dilated pupils from smoking pot.
Other red flags include visible cuts that might be the result of self-harming, Raab says. Or, you might notice unexplained weight loss or physical evidence of bingeing and purging, which could indicate your child has an eating disorder.
Even if these behaviors aren’t disrupting your child’s relationships or academic performance, “it’s affecting their body and how they’re choosing to take care of their body,” Raab says. Intervening might protect your child’s mental and physical health.
Read This Next: What Therapists Think About Their Worst Patients
Signs Your Child May Benefit from Seeing a Therapist
Knowing when a child needs to see a therapist can be tricky. Naturally, young kids don’t have the emotional or communication skills to verbalize what they need and how they’re feeling.
Therapy can be incredibly helpful for kids. It teaches children healthy coping skills. It teaches them how to understand, articulate and express their feelings instead of acting out behaviorally, said Clair Mellenthin, LCSW, a child and family therapist.
Therapy also provides additional support for the whole family, especially during a divorce or death, she said.
During tough times, kids may think they need to protect their parents and don’t want to add to their pain. Therapy provides a safe space for kids to grieve, “without feeling like they need to take care of anyone else.”
How do you know if your child needs to see a therapist? Below, Mellenthin, also clinical director at Wasatch Family Therapy, shared the various signs along with tips for finding a good therapist.
According to Mellenthin, significant changes in your child’s behavior or emotionality may be signs they would benefit from therapy. These might include:
- Crying uncontrollably
- Social isolation
- Bedwetting after being potty-trained for a while
“Typically young children do not have the language or emotional intelligence to tell a parent what is wrong; they just feel really big emotions and because they don’t have words, they will use their behaviors to tell you instead.”
Mellenthin suggested parents seek out a play therapist. This is a child therapist who’s specifically trained to work with young kids.
“A Registered Play Therapist (RPT/RPT-S) is most appropriate for children 2-11 years old because they use play therapy to access the child’s world.” She noted that kids open up and work through their issues more quickly when play therapy is used.
Parents can find therapists at The Association for Play Therapy website, she said.
Also, when looking for a therapist, find a practitioner who not only works well with your child, but also “is willing to work with you as a parent and be part of a team instead of the expert.”
Mellenthin tells parents that therapy isn’t a punishment. Therapy “should never be used as a consequence to an undesired behavior,” such as “Cut that out or you will have to see a shrink!”
Instead, she suggested saying that “they are going to see a special grownup who they can talk about their worries with and find new ways to feel happy or better inside.” Parents also refer to a therapist as a “’feelings doctor, who will help you feel happier again,” she added.
Most of Mellethin’s young clients call their therapy sessions a “play date,” because she uses play therapy.
In fact, she stressed that therapy doesn’t have to be scary or even serious. “It can be playful and enjoyable, even when working through difficult issues including trauma, anxiety, and abuse.”
- This piece from The New York Times parenting blog “Motherlode” has insights from parents who sought therapy for their kids.
- This Psych Central piece focuses on teens and therapy.
Signs Your Child May Benefit from Seeing a Therapist
Finding Low-Cost Mental Health Care
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What should you do if you’re under a lot of stress or dealing with a mental health issue and you don’t have the money for treatment?
You’re not alone if you’re concerned about paying for mental health care. Lots of people need help and worry that they can’t afford it. Even though health insurance covers mental health issues, it can still be challenging. Some insurance companies don’t cover mental health services very much, and they often have expensive copays and deductibles.
Still, it is possible to find affordable — sometimes even free — mental health care or support.
Free or Low-Cost Counseling
When it comes to finding a counselor, start at school. School counselors and school psychologists can provide a good listening ear — for free! They can help you size up the situation you’re dealing with and, if needed, refer you to more support in your county or community.
If your school counselor can’t help, you’ll need to do a little more research to figure out how to get help. Some of the free or low-cost mental health care possibilities to explore include:
- Local mental health centers and clinics. These groups are funded by federal and state governments so they charge less than you might pay a private therapist. Search online for “mental health services” and the name of the county or city where you live. Or, go to the website for the National Association of Free & Charitable Clinics. The U.S. Department of Health and Human Services’ Health Resources and Services Administration also provides a list of federally funded clinics by state.
(Note: By clicking either of these links, you will be leaving the TeensHealth site.)
One thing to keep in mind: Not every mental health clinic will fit your needs. Some might not work with people your age (for example, a clinic might specialize in veterans or kids with developmental disabilities). It’s still worth a call, though. Even if a clinic can’t help you, the people who work there might recommend someone who can.
- Hospitals. Call your local hospitals and ask what kinds of mental health services they offer — and at what price. Teaching hospitals, where doctors are trained, often provide low- or no-cost services.
- Colleges and universities. If a college in your area offers graduate degrees in psychology or social work, the students might run free or low-cost clinics as part of their training.
- On-campus health services. If you’re in college or about to start, find out what kind of counseling and therapy your school offers and at what cost. Ask if they offer financial assistance for students.
- Employee Assistance Programs (EAPs). These free programs provide professional therapists to evaluate people for mental health conditions and offer short-term counseling. Not everyone has access to this benefit: EAPs are run through workplaces, so you (or your parents) need to work for an employer that offers this type of program.
- Private therapists. Ask trusted friends and adults for recommendations, then call to see if they offer a “sliding fee scale” (this means they charge based on how much you can afford to pay). Some psychologists even offer certain services for free, if necessary. To find a therapist in your area, check the websites of your state’s mental health association or the American Psychological Association (APA).
(Note: By clicking either of these links, you will be leaving the TeensHealth site.)
To qualify for low-cost services, you may need to prove financial need. If you still live at home, that could mean getting parents or guardians involved in filling out paperwork. But your therapist will keep everything confidential.
If you’re under 26, your mental health care should still be covered under your parent’s insurance policy. It’s worth a call to the insurance company to find out what services the policy covers and how much of those services it pays for.
Programs like Medicaid or the State Children’s Health Insurance Program (SCHIP) offer free or reduced-fee medical insurance to teens who are not covered. To find out if you qualify for mental health assistance through these programs, call your doctor’s office or hospital and ask to speak to a financial counselor. Your school counselor also might be able to help you figure out what kind of public medical assistance you could qualify for and guide you through the process of applying.
People under age 18 who live at home will need a parent or guardian to sign off on the paperwork for these programs. After that, though, your care will be confidential. A therapist won’t tell parents what you’ve talked about — unless he or she thinks you may harm yourself or another person.
Getting Help in a Crisis
If you’re feeling suicidal, very hopeless or depressed, or like you might harm yourself or others in any way, call a suicide or crisis hotline. These offer free help right away.
- Suicide hotlines. Toll-free confidential lines like 1-800-SUICIDE or 1-800-999-9999 are staffed 24 hours a day, 7 days a week by trained professionals who can help you without ever knowing your name or seeing your face. They can often give you a referral to a mental health professional you can follow up with in your area.
- Crisis hotlines. These help survivors of rape, violence, and other traumas, Some may also provide short-term counseling. To find one, do an online search for your state and “crisis hotline.”
Other cost-effective ways to help you work through crisis situations are:
- Emergency rooms. Emergency rooms are required to evaluate and care for people who have emotional emergencies as well as physical ones. If you think you might hurt yourself or someone else, you can also call 911.
- Local crisis centers. Some states have walk-in crisis centers for people coping with mental health problems, abuse, or sexual assault. They’re a bit like ERs for people who are having an emotional crisis.
Each county and state does things differently. A few might not have crisis centers. Others may have mobile units that come to you in an emergency. Some crisis centers operate in hospitals, others are run by non-profits or county mental health services. To see if there’s a crisis center near you, search online for your city, county, or state and terms like “crisis center,” “crisis counseling center,” “psychiatric emergency services,” or “crisis intervention.”
If you need help finding any kind of services, contact your state’s mental health association or the APA to find out where you can get therapy and treatment near you. (Note: By clicking either of these links, you will be leaving the TeensHealth site.)
Paying for prescriptions can really drain your wallet. Here are some ways to be smart about the money you spend on medicines:
- Find out if you can take generic or non-brand medicines. Ask your doctor or pharmacist if there are over-the-counter versions of the same kinds of prescription medications.
- Find out about prescription assistance programs (also called “patient assistance programs”). The Partnership for Prescription Association gives free or low-cost prescriptions to people who qualify based on income. (Note: By clicking on this link, you will be leaving the TeensHealth site.)
- Compare prices at local pharmacies. Call each to ask what they’re charging for your prescriptions.
- Contact the pharmaceutical company that makes the medication. All the big pharmaceutical companies have prescription assistance numbers you can call for help.
- Beware of free prescription samples (or coupons and rebates). They sound appealing, but they are often for expensive, name-brand medications. That’s fine while the samples last. But since doctors don’t like to change a medication if it’s working, you could get stuck paying full price after the samples run out.
Before accepting a free sample, talk to your doctor about whether you can afford that medication in the long term. If it’s something you’ll only need for as long as the samples last, take advantage of the freebie!
If you’re already taking medication, there are two things to know:
- Never stop taking a prescribed medication or reduce your dosage because you can’t afford to fill the prescription. Some medications can cause side effects if they’re adjusted or stopped without a doctor’s advice.
- Never use someone else’s medicine. Even if the person has the same health condition you do, medications work differently for different people.
If you can’t afford to refill a prescription, call the prescribing doctor. Say you’re having a hard time affording your meds and need some advice. It’s not unusual these days for people to ask for this kind of help, and doctor’s offices often know how to get it or put you in touch with someone who can.
Parents and Other Adults
Navigating your way through the health care system can be confusing (even for adults). That’s why it’s a good idea to have a parent, relative, doctor, school counselor, or social worker help you connect with a mental health professional.
But what if you want to get counseling without a parent (or guardian) knowing? In many states, teens can be given mental health treatment without parental consent. When you call a clinic, hospital, or therapist, ask about your state’s rules on parental consent for mental health services. And, when you see a counselor, find out about the rules when it comes to filling a prescription. Even if you can get confidential care, your parents may need to give the OK to fill prescriptions.
Whatever happens, don’t let money hold you back from getting help. Affordable mental health care options are out there — it may just take some time and effort to find them. But don’t give up. Stress and mental health problems don’t usually get better on their own.
Reviewed by: Steven Dowshen, MD Date reviewed: January 2015
Counselling Services for Children and Young People
Many young people are struggling with how they feel. They are having problems with friends, family or school, they are anxious, depressed, angry or scared and need to talk to someone, but find it difficult to talk to people they know. Counselling and other advice services can help them talk things through, support them without making them feel judged, and in confidence (unless they disclose that their personal safety is at risk). Advice services can make a positive difference to their lives.
The range of advice services for children and young people includes face-to-face counselling, one-to-one phone calls, webchat, email, forums and face-to-face sessions.
How counselling can help young people
Counselling is the most common form of talking therapy and is sometimes available on the NHS through the GP surgery, or through school-based counselling. It can help young people deal with issues and events and the effects they are having on their mental wellbeing. Counselling could be recommended for young people who are basically healthy but who are struggling with a mental health disorder such as depression or eating disorders; it can address problems with anxiety, bereavement; bullying, anger, relationships, low self-esteem, and self-harm. The counsellor will help explore the problem, the symptoms and strategies for coping.
Different types of counselling
There are different types of counselling, but the most common ones recommended for young people are:
Cognitive Behavioural Therapy (CBT): The approach of CBT is about thinking more positively about life, looking at how you can get stuck in patterns of behaviour and ways of changing these rather than dwelling on past events. There are typically six or 12 weekly sessions and the therapist sets goals with the young person, often with ‘homework’ to do in between.
Mindfulness: Mindfulness is often combined with CBT and helps a young person to focus on difficult thoughts and feeling, rather than avoiding them, so that the fear of them gradually lessens. Therapists can also include meditation, yoga and breathing exercises.
Psychotherapy: This is a more long-term therapy and involves talking about the effects of past events and can be more helpful with long-term problems such as depression or eating disorders. NHS psychotherapists work in clinics or hospitals; some private psychotherapists work from home.
Family Therapy: The whole family works with the family therapist to try and understand the problems they are all having. It can help improve communications between family members and issues such as children’s behavioural problems, disability, family breakdown, addiction and domestic violence.
Taking Your Child to a Therapist
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What Is Therapy?
Many children and teens have problems that affect how they feel, act, or learn. Therapy is a type of treatment for these problems. It is a way to get help for your child.
In therapy, kids talk and learn how to work out their problems. Going to therapy helps them cope better, communicate better, and do better.
What Problems Do Therapists Help With?
Therapists are trained to help with all kinds of problems. For example, they help kids and teens going through tough times like:
- family problems
- school problems
- health problems
They help with feelings like:
- stress and worry
- low self-esteem
They help kids and teens with conditions like:
- OCD and anxiety
- eating disorders
- disruptive behavior disorders
- trauma-related disorders
Why Do Kids and Teens Need Therapy?
Kids and teens need therapy when they have problems they can’t cope with alone. Or they need help when problems affect how well they do, feel, or act. If things don’t get better on their own, kids may need therapy so things can improve. Sometimes, entire families need support while trying to communicate, learn, and create boundaries.
How Does Therapy Work?
In therapy, kids learn by doing. With younger kids, this means working with the whole family, drawing, playing, and talking. For older kids and teens, therapists share activities and ideas that focus on learning the skills they need. They talk through feelings and solve problems.
Therapists give praise and support as kids learn. They help kids believe in themselves and find their strengths. Therapy builds helpful thinking patterns and healthy behavioral habits.
A therapist might meet with the child and parent together or meet with the child alone. It depends on the child’s age. A therapist might also meet with a parent to give tips and ideas for how to help their child at home.
What Happens in Therapy?
At first, the therapist will meet with you and your child to talk. They will ask questions and listen. This helps them learn more about your child and about the problem. The therapist will tell you how they can help.
After that, your child will go to more therapy visits. At these visits, your child might:
- Talk. Talking is a healthy way to express feelings. When kids put feelings into words instead of actions, they can act their best. When someone listens and knows how they feel, kids are more ready to learn.
- Do activities. Therapists use activities to teach about feelings and coping skills. They may have kids draw or play as a way to learn. They may teach mindfulness and calm breathing as a way to lower stress.
- Practice new skills. Therapists help kids practice what they learn. They might play games where kids need to wait their turn, use self-control, be patient, follow directions, listen, share, try again, or deal with losing.
- Solve problems. With older kids and teens, therapists ask how problems affect them at home, at school. They talk over how to solve these problems.
How Long Do Kids Do Therapy?
How long therapy lasts depends on the goals you and your child’s therapist have. Most of the time, a therapist will want to meet with your child once a week for a few months.
How Can Parents Help?
You can do things to help your child get the most from therapy. Here are some of them:
- Find a therapist you and your child feel comfortable with. Your child’s health care team can help you find someone.
- Take your child to all the appointments. Change takes time. It takes many therapy visits for your child to learn new skills and keep them up.
- Meet with your child’s therapist. Ask what to do when your child shows problems at home. Ask how to help your child do well.
- Spend time with your child. Play, cook, read, or laugh together. Do this every day, even if it’s only for a few minutes.
- Parent with patience and warmth. Use kind words, even when you need to correct your child. Show love. Give praise when your child is doing well or trying hard.
Reviewed by: Colleen C. Cullinan, PhD Date reviewed: March 2018
Counselling can give you and your child the space you need to talk about what’s going on, without fear of judgement. Treatment methods may include talking therapy and behavioural therapy, which help your child express how they’re feeling and learn how to cope with their emotions in a safe, effective way.
How can you help your child
Sometimes, problem behaviour can be managed at home, without the need for professional support. As a parent, there are a number of things you can do to address the behaviour.
Don’t give up – Seek support from your friends, family or another parent. Talking about the situation can not only help you feel less alone but also see things in a new light.
Be consistent – Be consistent in how you react to their behaviour. If you react in one way, then the next day in another, you will confuse your child and they won’t understand why it’s wrong.
Stay calm and try not to overreact – It’s easy to let your frustration build up and when overwhelmed, you’re less likely to deal with the situation in the best way. If you’re particularly frustrated, find other ways to cope, like talking to a friend.
Talk to your child – They may have something going on that they’re too scared to talk to you about. Consider what’s going on in their life – bullying, new schools and family changes can make a difference. Ask them why they’re angry or behaving a certain way, and work together to overcome the problem.
Focus on the positives – It’s easy to only focus on the bad behaviour, but forgetting to praise your child for their achievements can have a detrimental effect on their confidence. Tell them why you’re proud of them and remind them that you love them, no matter what.
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Created on August 5, 2017. Last updated on August 3rd, 2017 at 11:21 am
What is Behavior Therapy?
Behavioral therapies for children and adolescents vary widely, but they all focus primarily on how some problematic thoughts or negative behaviors may unknowingly or unintentionally get “rewarded” within a young person’s environment. These rewards or reinforcements often contribute to an increase in the frequency of these undesirable thoughts and behaviors. Behavior therapies can be applied to a wide range of psychological symptoms among adolescents and children.
Although behavioral therapies can vary substantially from disorder to disorder, a common thread is that behavioral therapists encourage children and adolescents to try new behaviors, reward desired behaviors, and to allow unwanted behaviors to “extinguish” (that is, ignore unwanted behaviors).
For instance, imagine a teenager who has difficulty completing homework. To encourage desired behaviors (e.g., homework completion), the parents institute a reward plan that includes earning points each day that homework is completed that can be traded in for a desired reward at the end of the week (e.g., using the car to go to the movies with friends). The reward must be something the youth wants and it must be specifically tied to a specific goal (homework completion). At first the youth works for the external reward, but over time, the task itself becomes easier and the reward can be faded out. Then, new goals can be generated.
In behavior therapy, parents and children learn to promote desirable behaviors and reduce unwanted behaviors.
One common trap that families fall into is unintentionally rewarding the wrong behavior. For example, take the teen who has not finished his homework, but really wants to take the car. Despite initial objections, the teen persists, and becomes angry, irritable, and disobedient towards his parents. Following a tantrum, the parents decide they cannot take the hassle anymore and allow him to borrow the car. In this way, the parents unintentionally reward, or reinforce, the teen’s oppositional behavior. The best way to handle these situations is to planfully ignore acting out behavior and to reinforce wanted behavior (homework attempts) as much as possible. Behavioral therapists seek to understand such links between behaviors, rewards, and learning, and to help youth and parents shape their own behaviors to meet individual and family goals.
Types of Behavioral Therapies
Behavioral Classroom Management
Behavioral classroom management is a type of evidence-based therapy designed to support students’ positive behaviors in the classroom, while preventing negative behaviors, and increasing student academic engagement. In this type of therapy, the child’s teacher participates in delivering the treatment. Behavioral classroom management has received substantial empirical support as an effective therapy in the treatment of attention-deficit/hyperactivity disorder (ADHD).
Behavioral Peer Interventions
Behavioral peer interventions involve one or more of a student’s peers providing assistance to the child with behavioral problems. A teacher will train a child’s peers to reinforce the child’s positive behaviors and academic performance with social and academic support strategies. This kind of therapy is often used in the school setting and has been shown to provide many benefits to academic, social, and interpersonal development.
Participation has also shown to be a positive influence for the peer assistant as well, because it reinforces a sense of responsibility and constructive behavioral changes. Behavioral peer interventions have been proven by science to be effective in treating ADHD.
There are a variety of peer-based behavioral interventions, including:
- Peer modeling
- Peer initiation training
- Classroom-wide tutoring
Behavioral Parent Training
Behavioral parent training was developed to teach parents how to reinforce desirable behaviors in their children, discourage unwanted behaviors, and improve parent-child interactions. In this form of therapy, the parents play a significant role in treating their children’s behavior problems. During the therapy sessions, parents learn how to carefully observe their children’s behaviors at home and are taught skills to reward their children’s positive behaviors by using praise, positive attention, and rewards. They are also taught to use rule-setting, time-out, and ignoring to discourage bad behaviors.
Behavioral parent therapy has received substantial empirical support to be effective in reducing behavior problems – especially for children with ADHD.
Combined Behavioral Management Interventions
Research has found that combining forms of behavioral classroom management, behavioral parent training, and/or behavioral peer interventions are well-established and effective for treating ADHD.
Modeling is a form of therapy in which a therapist demonstrates a non-fearful response to a negative situation in order to promote imitation in the child or adolescent. It has been proven to be effective in treating anxiety in children and adolescents.
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Children face many obstacles as they grow up, and they all experience things like stress, grief, and bullying in their own ways. It can be difficult to know when your child can work through something independently and when she might need the help of an expert. In my practice, parents often wait as long as they possibly can before seeking therapy for their child. If your child breaks her wrist, it’s clear that you need to get her to the hospital right away. What to do if your child is showing symptoms of anxiety and depression, however, is often much less straightforward.
The good news: There’s plenty of help out there for children who need it. Kids as young as age 4 can benefit from therapy, especially if you notice any of these red flags:
1. He’s having difficulties at home, in school, and beyond. When a child is struggling with his emotions, he tends to behave badly across the board — say, by talking back to his teacher at school, hitting his siblings, and not listening to his coach.
2. She’s suddenly isolating herself from friends. Friendships change over time and some kids enjoy larger peer groups than others, but if she’s avoiding friends it’s a red flag. Be on the lookout for statements such as, “Everyone hates me” or “I’m a loser” or “I have no friends.”
3. He’s regressing. Here’s the thing: Kids tend to regress when there’s a major change in their lives, such as the birth of a new sibling, a move, or a divorce between their parents. But, things like bedwetting, clingy behavior, whining, excessive fearfulness, and tantrums that aren’t related to a change (or these behaviors are happening for more than a month after a big change) signal a problem.
4. She’s incredibly sad and worried. All kids have worries at times and all kids cry. That’s part of childhood. But, worrying isn’t normal if it’s interfering with her ability to go to school or take care of herself.
5. His sleep habits and/or appetite has changed. Worrisome symptoms include trouble falling or staying asleep, nightmares, eating too much or too little, and excessive headaches and stomachaches.
6. She’s developed self-destructive behaviors. This can be a difficult one, because sometimes kids do bang their heads against things without intent to harm themselves. Repeated self-destructive behavior, however, is an issue–like, if she’s digging her nails into skin to try to cause pain, or cutting or hitting herself.
7. He talks about death, or thinks about it repeatedly. It’s normal if he talks about dying and how he might die as he explores the concept of death, but repeated talk about death and dying is a red flag. Watch out for statements about suicide (in kid language, of course) or killing others. Any talk about suicide or killing another person requires the help of an expert…immediately.
At the end of the day, you know your child the best. You have to trust your gut. If you feel like something isn’t right and your child is struggling, you’re probably right. Also? Many children play out their feelings and/or express their feelings through art. Pay close attention to art and play for a glimpse into your child’s emotions.
Never be afraid to make that first phone call to find a child psychotherapist in your area. Your child, and your whole family, will be better for it. Check Good Therapy to find a counselor in your area.
Does My Child Need Pediatric Counseling?
Stigmatization in Pediatric Counseling
Are you concerned that diagnosing your child will stigmatize them? Your assigned mental health counselor can use diagnostic tools such as the Preschool Age Psychiatric Assessment (PAPA), which is designed to give a DSM diagnosis for preschool-aged children. However, there are many debates as to whether it is appropriate to give children so young a mental health diagnosis. Utilizing assessment tools such as the PAPA can help recognize your young child’s struggles now so that they have a good chance of overcoming their symptoms and developing into a healthier child and teenager.
Your child’s disorder is not their personality type. We need to be able to separate their symptoms from a child’s character and give them the help they need. Assessment tools such as the PAPA help to isolate and focus on the symptoms that your child is presenting. This provides an objective and separate look at your child from their illness.
Assessment Tools are also valuable in recording, monitoring, and treating their mental health issues. Such tools used throughout the therapeutic process assess whether your child will benefit from seeking mental health treatment, provide information for diagnosing the issues presented, and increase your understanding, and influence the development of measurable goals to be used during your child’s progress.
Wondering If Your Child Needs Pediatric Counseling? Ask A Child Psychology Expert. Schedule An Appointment Online Now.
If your child is given a DSM-V diagnosis, please remember that your child’s psychiatric disorder is not because of bad parenting. Certainly, a home environment and parental relationship can affect a psychiatric disorder, but that doesn’t mean they cause the disorder. Disorders such as anxiety, depression, and autism have biological roots, as well.
A mental health disorder does not signify that you or your child are weak, and they are not based on willpower to manage these conditions. ADHD, anxiety, depression, and other disorders cause serious dysfunctions and can affect all areas of your child’s life. Managing their psychiatric disorder greatly benefits from the right clinician, an appropriate treatment plan which includes your input as a parent to have their health and wellness restored. You, as a parent, are not to blame and in fact, play a pivotal role and giving support and care such as mental health care that is critical to your child’s recovery.
Treatment in Pediatric Counseling
These first few years in your child’s life are so important when you start to see symptoms. Treatment interventions, even when children are very young, can be successful. Pediatric counselors will utilize different forms of counseling to help treat different types of mental health issues. One type of treatment that is evidenced based is called cognitive-behavioral therapy or CBT.
Although children younger than 7 years old do not have the level of cognitive skills for reasoning, verbal expression, autobiographical memory, or self-reflection. However, cognitive-behavioral therapy treatment has been shown and tested for its effectiveness in children as young as 3-6 years old. Cognitive-Behavioral Therapy focuses on changing beliefs that contribute to mental health. A skilled therapist who is working with a young child who has never been asked by an adult to do therapy work will be able to engage the young child in cognitive therapy tasks. They will be able to focus on changing the child’s thoughts, feelings, and behaviors that are causing serious issues.
There are many concerns regarding the use of medications and pediatric treatment of childhood mental health disorders. It is important to note that a good psychiatrist will take care of deciding how and when to start a child on medication. Psychiatric illnesses and medication should be taken just as seriously as a child with diabetes or any other chronic health condition.
For instance, a child struggling with a psychiatric disorder may never receive clinical care because their issues may be deemed less obvious than a child who has lost their hair due to chemotherapy. Kids rely on their parents to help give them access to services such as counseling. The potential to make changes in their way of thinking may be higher now than any other age.
Ways to Help Your Child When They Are Struggling
It’s never easy to watch your child struggle, especially when it’s something that you can’t fix. If you have considered pediatric counseling and are still not sure if that is the help your child needs, there are some simple things you can do at home to help them cope with their problems. These suggestions won’t solve the issue at hand, but they can help make life a bit easier for your child.
Make Time to Talk
Take the time to sit down to talk with your child and really be present an understanding of the struggles they are currently facing. This can help your child feel heard and can also help them sort through their own thoughts and figure out a solution to their problem.
Healthy Sleeping Habits
Numerous studies have linked sleep issues with mental health issues in children. Make sure that you are encouraging your child to have healthy sleeping habits such as a bedtime routine, getting enough sleep, etc.
Experts have found that regular exercise can help children cope with anxiety, depression, self-esteem, and other mental health issues. Encourage your child to exercise daily, whether it is through organized sports or simply taking a family walk.
BetterHelp Can Help You Take A Proactive Approach
If your child is struggling, taking a proactive approach is often the best option, rather than hoping their struggles go away. One way to do this is to get them the help that they need. This is where counseling comes into play. At this juncture, it may be beneficial for both you as a parent and your child to get counseling. Getting counseling as a parent can help you help with the various issues that affect the family when your child is struggling. BetterHelp is an online counseling platform that can give you the help you need. They can be a great resource for learning more about how to help your child and finding a pediatric counselor. Online counseling is both convenient and confidential. With BetterHelp, you can talk with your licensed counselor via messaging, chat, phone, or video – whatever is easiest for you.
If your child is in their teens, they can also get help with BetterHelp’s Teen Counseling. This is an online counseling platform designed specifically for children ages 13 to 19. The counselors are licensed and can help your child work through anxiety, stress, self-esteem, bullying, anger, and other mental challenges. This method of counseling is comfortable for teens, given its online nature. They can communicate with their counselor by exchanging messages, chatting live, speaking on the phone, or even by video. Check out what other parents have to say about their experience with BetterHelp counselors below.
“Dr. Torres is amazing with the things she is doing with my 13-year-old daughter. My daughter has recently been bullied, which caused her to be angry, and lack of motivation skills was 0. No confidence in herself. She would not go anywhere or do anything. When my daughter spoke with Dr. Torres for the first time, a few days later, she picked up herself and started to go out and wanted to do things with me and by herself, she also wants to sign up for dance. I was completely amazed, everyone I spoke to was amazed. I’d also like to add that Dr. Torres is kind, patient, calm, and very warm and friendly to me and my daughter. Every time I tell my daughter Dr. Torres is calling, a big smile comes on her face, it’s so wonderful to see that. I know we still have a long journey to go, and I can’t wait to see what happens next. I am so glad I signed my daughter up for this. Please keep up the excellent work.”
“I am THRILLED with Rachel and with BetterHelp! It is affordable, I am a single mom with 4 kids on a tight budget and a LOT of stress, and this format makes it easy to get help. I LOVE that I can write my feelings to her whenever I am having them, not have to wait a week for the next session. She is very insightful, and I am thankful!”
Your Child Depends On You
As a parent, helping your child learn the coping mechanisms and skills that they needed to overcome the mental challenges that life presents to them should be a top priority. However, you don’t have to do it alone. Start working with a BetterHelp counselor today who can give you the tools to help them through their challenges, give you the necessary resources to work together with a pediatric counselor, or even help you get your teen help with the licensed counselors at Teen Counseling directly. No matter what you’re experiencing, there are tools available to help both you and your child be the healthiest you can be.
Does Your Child Need Behavioral Therapy? How to Tell and What to Do
Determining whether or not your child is experiencing depression or anxiety can be tough. How do you know when your child’s behaviors warrant therapy and what type of therapy they need?
Determining whether or not your child is experiencing depression or anxiety can be tough. Trying to understand if their tantrums are typical or unusual is also a difficult task. So, how do you know when your child’s behaviors warrant therapy and what type of therapy they need?
Depression can appear in many forms, such as regular irritability, loss of interest in activities, changes in eating and sleep patterns and thoughts of death and/or suicide. Anxiety is considered excessive when it gets in the way and causes problems in daily life. And, if your child struggles with intense emotional reactions, disruptions in mood or behavior, or is easily set off by minor triggers, then they may need assistance.
“Warning signs include any sudden change in mood or behavior, or if you notice that your child or teen is struggling in day to day tasks,” explains Dr. Melissa A. Butler, psychiatrist at Indiana University Health. “If safety towards oneself or others is an issue, or if the emotional or behavioral problems are impacting their functioning, it’s time to seek professional help.”
These problems are best treated with behavioral therapy, such as Cognitive Behavioral Therapy (CBT) or Dialectal Behavioral Therapy (DBT).
CBT focuses on problem solving. “CBT looks at the relationship between thoughts, behaviors or feelings,” explains Dr. Butler. “When someone has depression, anxiety, or ADHD there may be negative or irrational thoughts that lead to certain feelings or behaviors. With CBT, the patient tracks and identifies these thoughts, tests whether they are realistic and is then challenged to replace those thoughts with more positive ones.”
For example, if a child is reprimanded at school for not doing his work and is required to miss recess, he may kick his desk, talk back to the teacher and believe that it’s not fair because people always pick on him. He will document his thoughts in a journal. When he meets with his therapist, they will discuss his thoughts and behaviors, determine if they were rational based on both current and past experiences and, if not, they will work to replace those thoughts with positive ones. In this case, they could recognize that he received an appropriate reprimand for not completing his work, but that he is usually treated well.
CBT also works on managing behaviors, such as those associated with anxiety or depression. If a child is experiencing anxiety, the therapist may work on relaxation techniques to help ease anxiety in stressful situations. For depression, a CBT therapist may focus on creating an activity schedule to guarantee that the child does not withdraw from friends and important events.
Dialectal Behavioral Therapy (DBT) is designed to work with people who have problems with emotional or behavioral dysregulation. These patients are highly sensitive to emotional stimuli – a small incident sets them off, their reactions are very intense and their ability to return to their normal state is much slower than average.
“There are different components of DBT, such as skills training where they learn emotional regulation, distress tolerance and mindfulness skills,” Dr. Butler says. “These skills help patients work on the factors that lead to emotional dysregulation.”
With DBT therapy, parents are a key component. They must learn the skills along with their children and provide a validating environment that focuses on changing behaviors and accepting themselves. For example, a child may learn that her plans to go shopping have been changed. Instead of sulking for a few minutes, she completely melts down – crying, screaming, stomping, kicking or even hitting. With DBT, a parent learns to remove the child from the situation, help them use a skill to calm down and then validates their feelings. Later, they work together to address the situation and determine what can be done differently the next time.
When selecting a behavioral therapy, Dr. Butler recommends parents speak to a variety of providers and ask about their approach. “It’s important to ask if they believe CBT or DBT would be right for your child,” she recommends. “Some therapists combine and integrate different techniques so it is important to understand their approach, experience and training beforehand.”
Selecting the right therapist takes research, understanding and insight into your child’s strengths and weaknesses. And while these programs can be intense, says Dr. Butler, they do obtain results.
— By Gia Miller