When to Seek Help

Parents are usually the first to notice that their child has a problem
with emotions or behavior. These challenges don’t always require therapy.

If you are becoming concerned about your child’s behavior or lack of emotional regulation, one of the first things to try is gently talking to your child, explaining what you have noticed and wondering if your child is aware of the problem. An open, honest talk about feelings can often help—especially when parents remain calm, supportive, and curious. Teach your child coping and problem-solving skills so that minor setbacks don’t lead to major distress. Notice good behavior and let your child know you like it. Set clear, age-appropriate limits and be consistent, calm, firm, and fair in enforcing them. You might also want to talk with teachers, school counselors, doctors, coaches, spiritual advisors, or other adults who know your child well. These measures may resolve the difficulties for your child and family.

However, if problems persist for a long time or you feel overwhelmed and unable to help your child make positive changes, it may be time to seek professional help.

When to seek family or child-parent therapy:

  • You find yourself regularly bending your own rules, setting reasonable limits but not enforcing them, to avoid making your child angry or upset.
  • Interactions with your child frequently leave you feeling frustrated, angry, ineffective, or hopeless.
  • Ordinary communication between family members becomes difficult or impossible. No one speaks to anyone else except to yell, argue, or complain.
  • One child appears to have all the problems, and everyone else walks on eggshells.
  • You suspect attachment problems.
  • Your child or family has experienced a traumatic event or loss and is having difficulty recovering from it.
  • A young child or adopted child shows some of the warning signs below.

Signs that your child may benefit from family or individual therapy*:

  • Persistent feelings of sadness or hopelessness
  • Persistent worry, anxiety, or fearfulness, leading to regular refusal to go to school, go to sleep, or take part in activities that are normal for the child’s age
  • Frequent, unexplainable temper tantrums
  • Separation anxiety that persists beyond two years of age and interferes with age-appropriate activities or emotional wellbeing
  • Persistent nightmares or night terrors
  • Persistent anger and a tendency to overreact to normal stressors
  • Persistent disobedience or aggression (longer than 6 months) and provocative opposition to authority figures
  • A sudden, unexplained drop in grades at school
  • Loss of interest in activities your child used to enjoy
  • Changes in sleeping or eating patterns
  • Frequent physical complaints (stomachaches, headaches, fatigue) without medical cause
  • Withdrawing from friends or family
  • Difficulty concentrating, thinking clearly, or making decisions
  • Inability to meet age-appropriate expectations for sitting still
  • Performing routines or rituals compulsively throughout the day, such as washing hands, cleaning or arranging objects, or moving through particular spaces in a particular way
  • Talking about suicide
  • Hearing voices or perceiving things that aren’t there
  • Performing violent acts such as setting fires or hurting animals

Additional warning signs for preteens and teens*:

  • Inability to cope with problems and daily activities
  • Depression,  as evidenced by sustained, prolonged negative mood and attitude, often accompanied by poor appetite, difficulty sleeping or thoughts of death
  • Frequent outbursts of anger or aggression
  • Preoccupation with physical illness or their own appearance
  • Dieting obsessively, or binging followed by vomiting or taking laxatives
  • Abuse of alcohol or drugs
  • Sexual acting out
  • Self-injury or self-destructive behavior
  • Skipping school, running away, or other reckless behavior
  • Threats of suicide, giving away prized possessions
  • Aggressive or non-aggressive consistent violation of others’ rights; opposition to authority, truancy, thefts, or vandalism
  • Strange thoughts, beliefs, feelings, or unusual behaviors

*The lists on this page are not intended to be screening or diagnostic tools.  They are offered as examples of challenges that psychotherapy may be able to treat.  At the beginning of our work together, I take a detailed history and use valid, reliable, norm-referenced measures to assess emotional and behavioral problems.  If your child’s difficulties are outside my scope of competence, I will provide referrals to appropriate professionals.