When is it time to get my child counseling?

When children have emotional, learning or behavioral problems, the earlier they get treatment, the easier it is to help them. But as parents, you also want to avoid unnecessary treatment, misdiagnosis and costs in both time and money. You want your child to do well in school. But you might worry that if you ask for help, he’ll be labeled.

When you’re concerned about a child, you’re often told by family members, friends and maybe even your pediatrician to relax and wait—he’ll grow out of it. Sometimes this is good advice. Sometimes it’s not.

Kids develop at uneven speeds. But for every child who grows out of what seems to be a problem, another child gets worse.

When to Take Action

There are times when it’s clearly not a good idea to wait. For instance:

Autism: If your child seems to have the early symptoms of autism, the earlier it’s caught the better the chance he has of improving and enjoying a less restricted life.

Eating disorders: The longer a child lives with an eating disorder, the harder it is to recover. Getting treatment as quickly as possible can save her life.

Family history: If mental illness runs in your family, be aware of the increased possibility that your child will begin to develop a disorder. Act promptly.

When to Wait

Some life events can cause changes in your child’s functioning as a part of a process of adjustment. Things like:

  • Parental divorce
  • Changing schools
  • A new sibling

These can all have troubling effects on a child’s behavior. Most often this will pass with time. In fact, the criteria for many child and adolescent psychiatric disorders require problem behaviors or feelings to be present for at least a period of weeks or months. Sometimes you need to watch and wait.

Watching and Waiting

How long you decide to monitor feelings and behaviors that concern you, or “symptoms,” depends on the age of your child and what you think is wrong.

Learning and Development
When dealing with issues of early learning and skills, most people wait because development in the early ages is uneven. Milestones aren’t hard-and-fast rules. A group of kids in the same age range can show a wide variation in social skills, learning, attention and emotional maturity.

If delays, deficits or unusual behavior don’t go away, that’s when you might consult your child’s school counselor or pediatrician. They both have experience with the range of abilities and behaviors that are typical in your child’s age group.

If your child is struggling in school, a good place to start is his teacher. She can help you decide if your child needs to be evaluated for learning and attention issues. It’s important to act before kids develop negative feelings about school and their own abilities. Without a diagnosis, many kids conclude that they must not be as smart as other kids. This can damage their self-esteem. Getting help for your child teaches him that it’s healthy and smart to ask for help when he needs it.

Behavior Issues
If your child’s behavior is causing him chronic trouble in school or is seriously disrupting your family life, it’s important to get help. Disruptive, explosive or dangerous behavior can be generated by anxiety, trauma and frustration from an undiagnosed learning problem, among other things.

Once you understand what’s behind your child’s behavior, there are often therapies that can be effective in teaching kids to rein in their behavior. If a child is out of control with parents or teachers, he needs help. The health and well-being of your whole family may be compromised.

For behavior problems you’ll want to consult a mental health professional who can help diagnose and treat behavior disorders. You can consult a behavioral psychologist who specializes in children and adolescents, a child psychiatrist or a social worker with expertise in treating young people.

Emotional Issues
If a child seems unusually anxious or sad or irritable for a long period of time and it’s interfering with his ability to do things that are appropriate for kids his age, it’s a good idea to seek help. A child who is seriously anxious or depressed is not just suffering. He’s missing out on important parts of his childhood. You want to get him help as soon as possible, before he falls behind his peers in social and academic development.

It’s also a good idea because the longer your child lives with something like anxiety the likelier it is to shape his behavior in harmful ways. A young child who couldn’t sleep apart from his parents might become a school-age child who can’t have sleepovers with friends or go to camp. A child who is excessively fearful could become an adolescent whose identity and social life are structured around avoiding things that make him anxious.

Active Waiting

If you decide to wait to get help, keep an eye on the problem and be ready to act if it doesn’t improve. Monitoring your child’s behavior can help you collect valuable information. What you don’t want to do is ignore a problem. Don’t convince yourself that “something” is “nothing.”

Talking to Your Partner

Getting help for your child, or not doing it, can be complicated by disagreement between parents as to what is or isn’t a “problem.” It’s common for parents to have different pictures of a child’s behavior, and different opinions about the kind of response that would be helpful.

This is a major reason families wait to seek advice or care. But, like all waiting, it should be active. Set a timetable for when you will talk about the issue again, and see if you can agree on goals for behaviors you would like to see changed. If you keep track of the issues you’re concerned about, you’ll have clearer grounds for making a decision when you revisit the subject.

About the Author

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Child Mind Institute, Understood Founding Partner is dedicated to transforming mental health care for children everywhere.

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