When should my child see a therapist?

Steph Arnaldo

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When should my child see a therapist?


Hope isn't lost. Here's a psychologist's guide to the signs that your child may need to seek professional help, as well as the benefits and importance of child therapy.

When our mental health starts calling for our attention, most adults can already gauge when it’s time to amp up the TLC.

On the days that we feel down or overwhelmed, we choose among our arsenal of coping mechanisms – maybe it’s tuning out from social media and getting lost in a hobby; reaching out to loved ones; exercising; or booking a long-overdue therapy session with a psychologist.

Most of us are able to spot the warning signs in ourselves, our friends, and even in our partners – but can we do the same for our children? Most of us also know what to do when strong emotions arise – but can we say the same for the kids?

Maybe your child has been more lethargic than usual, or plagued by night terrors since the start of the pandemic, or maybe they’ve completely changed personalities since a death in the family.

Sometimes, our children are not okay, and that’s okay.

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As parents, you’ve learned to know what your child specifically needs physically, and to an extent, emotionally. As attuned as you are to those needs, there may still be psychological needs your child has that only a skilled professional can provide for. As worrisome as it may seem, hope isn’t lost. Considering a therapist for your child is a small but very important step in getting them the help they need.

When is it finally time for your child to see a therapist? With the help of psychologist and relationship therapist Lissy Ann Puno, here’s a guide on the signs to watch out for, as well as how child therapy works, its benefits, and its importance in your child’s well-being and life.

What is a child therapist?

When it comes to seeking professional help, most would seek a psychologist and/or psychiatrist – clinically-trained professionals who can diagnose and treat mental illnesses, with the former using talk therapy and the latter using prescribed psychiatric medications.

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For children, it’s a child therapist that can help. Child therapists (also called child psychologists) are highly-trained professionals specializing in the branch of child psychology, which theorist Jean Piaget spearheaded in 1896 after his research on child development.

“Child therapists are skilled in assessing children and teens. They offer a diagnosis and a treatment plan according to their age group that will help them cope with the situation presented and move forward to wellness and effective functioning,” Lissy Ann told Rappler.

Child therapists can also be called different professional titles, like developmental psychologist or child counselor, depending on their training, expertise, focus of treatment, and the age group they specialize in.

Child development is divided into structures, starting from infancy to adolescence – there’s early childhood (1-4 years old), middle childhood (5-8 years old), late childhood (9-12 years old), and adolescence (13-18 years old).

Do children really need therapy?

I’d like to believe that the world would be a better place if more children had access to professional help early on. At a young, ripe age, children can already learn the necessary skills and traits to better cope with life’s challenges. Children can also be taught how to deal with complex emotions in healthy ways and learn how to self-regulate in the process.

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“Children need mental health professionals to help them in facing their own challenges in life. Because there is rapid development in childhood and adolescence that brings about a series of quick changes, it is necessary to understand and support them by giving them the coping skills to deal with these changes and emotions,” Lissy Ann said. These rapid changes range from the physical, emotional, social, intellectual, and cognitive development of the child.

If a distressed child is left unattended to, especially in the pandemic, these rapid changes can create even more stress, resulting in emotional pressure and tension that can lead to trauma, worry, anxiety, and low moods.

“Because childhood and adolescence is a time of rapid development that has highly significant implications on adult life, it is essential that children and teens be guided in a healthy way so that they can be happy, competent, and responsible adults in the future,” Lissy Ann said.

Does your child need a therapist? Here are the signs

Has your teen been acting out lately? Has your child been in a funk the past days? Lissy Ann notes that if these instances happen once or twice, there’s no reason to panic. “Don’t quickly label it. It is normal to experience stress and distress, especially if your child is capable of overcoming it,” she said.

These behaviors need to affect your child’s daily function to some degree for it be a cause of concern. Action must be taken when the symptoms get worse, or the behaviors persist over a consistent period of time that it stops your child from living life as they should.

According to Lissy Ann, these are the signs and symptoms that your child may need to seek professional help:

  • Aggressiveness
  • Whining, temper tantrums
  • Lying, jealousy
  • Attention-getting behavior, disobedience
  • Regressive acts, like bedwetting, daytime wetting, soiling
  • Constant fears, new phobias, anxieties
  • Scared of school
  • Shyness
  • Speech delays, speech difficulties, reading difficulties
  • Overactivity/underactivity (lethargy, fatigue)
  • Boredom, apathy, sudden mood changes, irritability
  • Difficulty concentrating
  • Tics, oversensitivity
  • Eating problems, sleep problems, social problems
  • Behaving out of character, showing sudden and significant changes in personality, temperament

These are just a few of the many behaviors a child can present when they are stressed, struggling, or in need of support. It’s important to remember that a child will experience their own struggles in their own ways and may manifest stress differently.

Watch out for “emotional outbursts” that are more intense and difficult to manage, especially when they begin to create an unsafe environment of unpredictability and hostility.

“They may also show regression from behavior that they used to be able to do and now are unable to do. Their performance in school and friendships may be changing, too,” Lissy Ann added.

Why now? The pandemic, and other reasons

Being cooped up at home and forced to learn through a screen for almost two years has undeniably taken a toll on children – they have also been unable to socialize with other children and simply explore the outside world. The pandemic has brought about its own set of worries that have affected children’s mental health, which may result in new developmental, emotional, behavioral, and social problems.

Here are some of the problems the pandemic may have caused on kids:

  • Health anxiety
  • Worrying over their basic needs
  • Struggles with online learning
  • Social isolation and loneliness
  • Fear of missing out on their experiences of school, other activities
  • Boredom
  • Excessive social media/gadget usage, to the point of disconnection and indifference to other things in life
  • No sense of achievement

It’s also important to identify any current stressful situation in the household that may be silently taking a toll on your child, such as marital problems, separation, a health problem, new sibling, new home, new school, a death in the family, or financial problems.

“You also want to consider that the child may only be the symptom of the problem, if the problem is something else. The problem may involve the family or the system of the family,” Lissy Ann said. Self-awareness really is key – not just for yourself, but for the whole family.

What a child therapist can do

When it comes to working with children and teens, there is a wide range of available therapies used, including play therapy, where the art of play and language is used to help unpack and explore any life events and traumas, but at the own pace and comfort level of the child.

There is also behavioral therapy, where the focus is noting and then modifying problematic behavior, and cognitive behavioral therapy, where the focus is on distorted thoughts and beliefs that may be fueling problematic behavior.

A therapist can also do expressive therapy, which includes art, music, dance, and movement, or family systems therapy, where the family system, in which the child is a part of, is the one creating the dysfunction and is the focus.

The importance of starting young and now

“Therapy? ‘Di naman baliw anak ko.” “Bata palang sila, normal lang yan.” “They’ll grow out of it. They just need to toughen up.”

When it comes to the stigma of seeking help, it’s so important to start breaking it as early as now, Lissy Ann states, especially for your child and given the state of the world. Resilience and the right mental health tools are some of the best gifts we can give our children.

“Good well-being is so essential, because they can maintain the confidence, self-esteem, competence, and self-worth that is needed for them to develop well and function in areas of their life now and as adults,” Lissy Ann said.

Children have also been under a lot of stress in lockdown. The fast pace of online learning has caused greater competition among students, Lissy Ann said, building internal pressure within a child to question their self-worth and capabilities.

Children may also have busier schedules at home; if they’re over-scheduled, they may be missing on important downtime to play and just be children.

“Excessive demands can also be felt from parents, teachers, and other child caretakers. The pressure of showing your child’s best self on social media is also another area that can affect mental health,” Lissy Ann said.

Mental health awareness is important in every stage of life, and the earlier we take a preventive approach to problems, the better. A therapist can help prevent certain issues or problem areas from getting out of hand.

I want to help my child. Where do I start?

Congratulations! As a parent, you have made the first and most vital step in helping your child. Before seeking a child therapist, first understand what it is that you are concerned about. “Children go to therapy based on the judgement of an adult in their life that they need help,” Lissy Ann said.

If you’re lucky, your older children may already be self-aware enough to quickly voice out whenever they need mental help support. However, younger children may not be able to express their needs as well, so your observation as an adult is critical. It pays to know your child very well.

“Spend time with them where they are relaxed, so they can open up to you about their thoughts and feelings without feeling forced. Keep open and honest communication and connection with your child, so they can feel safe to bring their concerns to you,” Lissy Ann said.

Next, start by doing your own research in finding a recommended therapist. Ask your friends and family, or crowdsource online. You can also check out the Ateneo Bulatao Center, MLAC Institute, PsychConsult, BetterSteps, and RMT CEFAM for spiritual-family counseling.

You may also start with your child’s teacher or school counselor to check if they are observing the same behavior in school. Some schools may already have outsourced therapists they can recommend.

Make sure to find a therapist you and your child feel comfortable with. It’s about finding the right fit – usually, this may take more than one or two tries.

What about during the therapy session? Lissy Ann says to ask your child what they would be comfortable with in the first session – either to start the session on their own or to have you with them in session.

“Depending on their age, you may be around for some of the sessions while for older children they may be articulate and able to express themselves to the therapist. Accompany them to the appointments and reassure them of your support,” Lissy Ann said.

“You can meet the therapist on your own for parenting support. For very young children, the therapist may need your support at home to help introduce some of the therapeutic strategies that they started in session,” she added, reminding that child therapy is an all-around family effort.

How do I explain therapy to my child?

It’s completely natural if your child is worried or uncertain about trying out therapy for the first time. What’s important is being there to answer all their questions about this new situation, which is why meeting the therapist beforehand can be very helpful. You can also ask your child what they are worried about.

“Reassure them that it is like meeting a trusted adult who can help them with their emotions and the struggles,” Lissy Ann said.

Here are some examples on what to say:

  • “We will be meeting an adult who can help you manage your feelings, or what you are experiencing right now. They can teach you how to take control of your feelings so you don’t feel overwhelmed.”
  • “We will be meeting someone who is like your guidance/school counselor but they don’t work in a school. I thought you may want some privacy in seeking help about this matter.”
  • “You are meeting someone that has helped me as your parent. Sometimes I need to talk to someone to help me figure out how to be the best person I can be. They can help you too.”
  • “We have been having problems in our relationship and I would like to be the best possible parent I could be for you. In order to do that, we will ask a therapist to help us work this out.”

“Trust is very important between parent and child. When you are open and honest, then they are more willing to be influenced,” Lissy Ann said.

This means managing your own emotions so you don’t say anything that could make them feel worse. “Try to make them feel good and offer support, which is what therapy is about. Practice getting into their world and validate them,” she added.

It is important to emphasize that therapy is a normal, healthy activity, and that many kids participate in therapy for a variety of reasons.

What you and your child can expect

It helps to let your child know what to expect during therapy so they can feel more prepared, especially if they’re nervous.

The first session is usually called an “intake session,” where the therapist will spend time talking to the parent and/or child and ask why they are seeking professional help. The therapist will listen and ask a lot of questions to clarify and understand what you are experiencing. You may also have questionnaires to fill up about family and school history.

Remember that it may take a few sessions before a therapist can confirm a diagnosis, explain what is going on, and share how they can help. As expected, there will also be a lot of talking, and depending on your child’s age, activities to do – playing, drawing, worksheets, reading books, and games. These help to put your child at ease and hopefully open up more.

New skills or strategies may be introduced in session so the child can practice them in real life when a situation arises. Sooner or later, the child will leave sessions feeling more self-assured and relieved, more confident in their abilities to face life’s problems and hopeful about what’s to come.

‘It is a process’: Things to remember

Nothing good comes easy, Lissy Ann reminds parents. Therapy does not work like magic, and is not an overnight fix.

“Therapy is a process, with progress and challenges coming together to help your child accomplish what they need at this stage of their life,” she said. Keep at it, because nothing is more important than your child’s mental health.

“Don’t let stigmas stop you from offering your child the help they need. Also be prepared that the change needed may have to come from you as the primary adult in your child’s life.” As tough as it may swallow, the pill that the problem could be you is something a parent should be ready for.

“Be open to that as well. When communicated in a kind and gentle way, we as parents are more ready to embrace it and face it for our child and our family.”

Your child needs your support the most during this vulnerable time, so don’t forget to spend extra time with your child and express verbal and physical affection regularly.

Some other reminders from Lissy Ann: be available in a non-intrusive way, and don’t be a detective, teacher, or the therapist at home. “Offer an accepting and encouraging attitude as they work through their issues. Support them with their daily routine. Offer positive affirmations and express confidence in their coping skills.”

The end goal

“Therapy will help your child develop new and healthy ways of thinking about issues, learn new skills to cope, help them express their feelings, and regulate their own thoughts, behaviors, and feelings to stay positive,” Lissy Ann said. It’s giving our child the capacity to contribute positively to their own well-being, which alone can already be very empowering.

Therapy is not the sole answer to life’s problems – rather, therapy helps you find the answers within yourself by teaching you the best tools to cope with life’s circumstances, coupled with a newfound self-confidence, self-assurance, and optimism that things will be okay. Parents just want what’s best for their child, and non-judgmentally giving them the help they may need is already a step in the right direction. –

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Steph Arnaldo

If she’s not writing about food, she’s probably thinking about it. From advertising copywriter to freelance feature writer, Steph Arnaldo finally turned her part-time passion into a full-time career. She’s written about food, lifestyle, and wellness for Rappler since 2018.