Does my child need therapy?

Because ten- to thirteen-year-olds change so rapidly, it can be hard for parents to distinguish between emotional problems and the normal upheavals of pre- and early adolescence. Is a child depressed or just moody? Seriously unmotivated or merely preoccupied? Deeply angry or beginning the inevitable separation from the family?

Parents won’t necessarily find answers to such questions in discussions with their child. Kids these ages often avoid sharing their thoughts with adults, whom they may see as sources of criticism, lectures, and unwanted advice. Parents may be left to evaluate their child’s situation based on their own observations.

Identifying serious, persistent problems is usually not difficult. Most parents know to seek help if their child shows clear signs of drug or alcohol abuse, an eating disorder, depression, or dangerous or illegal behavior.

Beyond such clear-cut cases, many parents are confused. They don’t know if their child needs help (“It’s just a phase. Everybody gets depressed sometimes.”) And they don’t know if they “believe” in counseling for any but the most critical problems. Some parents associate therapy with shame and embarrassment. They fear the implication that something is wrong with their child, and they worry that counselors will blame them for their child’s problems. They also may worry that he will speak badly of them or reveal family secrets. Such fears keep many families from getting the help they need.

If you are unsure about your child’s situation, ask yourself these questions: Has the troubling behavior been going on for a long time, despite your attempts to help? Do teachers, coaches, or other parents complain about him? Is he frequently angry? Does he regularly put himself down and act discouraged? Does he do poorly in school? Does he have trouble making friends? Is he consistently jealous of his siblings? If he has continuing difficulties in several areas of his life, he can benefit from professional help and possibly from medication.

He also can benefit if his problem is an unreasonable fear or phobia. A counselor experienced in treating phobias can desensitize your child. One boy who greatly feared elevators was able to ride them alone after six counseling sessions. A child who feared airplanes flew off on vacation with her family after only a few weeks of counseling.

You might turn to therapy to help your child deal with recent or continuing trauma, such as the death of an immediate family member or close friend, divorce, or a frustrating step-parenting situation. During counseling, he can express his pent-up anger, fear, and doubt to a sympathetic, experienced listener.

If you decide to try therapy, ask your pediatrician, family doctor, or local medical bureau for referrals. Set up an appointment with the therapist for a consultation without your child present. Describe your concerns and ask for advice. You may hear that therapy is not necessary and you may get helpful suggestions for improving your situation at home.

If the therapist does recommend counseling, talk to your child about it. Explain what therapists do: “There are some problems we can’t solve on our own.” Let him know there’s nothing wrong with seeking therapy. In fact, he may already know of friends who are in counseling, and some of the celebrities he admires may be quite open about seeing someone. Tell your child about the benefits of therapy: “Dr. Graham will help you feel happier and better about yourself.” “Susan is used to talking to children about their fears.” If your child resists, don’t give up on counseling. Ask the therapist for the best approach.

Therapy can take a number of forms: individual, group, or family counseling. Any one, or a combination, can be effective. If he is seen individually, schedule occasional consultations with the therapist so you can learn more about your child’s situation. You also may want to join a parents’ discussion or support group in which your questions and concerns can be addressed.

Therapy in any form can be prohibitively expensive. Most health insurance companies and HMOs cover a percentage of the cost. Local and state government agencies as well as some nonprofit organizations offer therapy at reduced or sliding scale fees. In addition, many private therapists are willing to lower their fees when patients are unable to pay the full rate.

Although it can be difficult to start therapy, it’s wise to work on emotional problems while your child is ten- to thirteen-years-old. As he gets older, his situation and behavior only will become more complex. If you get help for him now, your family will have a much easier time as he moves through adolescence.

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