10 Signs That Your Child May Need a Therapist

All kids have emotional ups and downs. It’s a normal and healthy part of growing up. But we also have to contend with some pretty scary statistics about children’s mental health. According to the National Institutes of Health (NIH), nearly 20% of U.S. kids between the ages of 3 and 17 have a mental, emotional, developmental or behavioral disorder.

There’s nothing wrong with a few bumps in the road. But how can you tell if your child is struggling with something more serious? And when should you seek professional help? Psychologist Kristen Eastman, PsyD, shares 10 indicators that it’s time for your child to see a therapist.

Signs your child needs a therapist

“Some moodiness, anxiety, social and school difficulties are to be expected as children develop,” says Dr. Eastman. These setbacks are usually temporary. And overcoming them can help build resilience.

“They present opportunities for your child to build new skills to add to their toolbox,” she notes. “In most cases, if you offer support, validation and patience, your child can usually figure it out.”

So, how do you know if they’re dealing with something more intense than a speed bump on the road to adulthood?

First things first: Dr. Eastman recommends that parents trust their gut.

“You know your child best,” she reinforces. “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.”

Dr. Eastman recommends considering therapy if your child:

1. Has problems in multiple areas of their life. If your kid’s acting up at home, school and on the football team, that could indicate that something is going on that may warrant your attention.
2. Has a significant change in sleep habits, hygiene or appetite. Your kid being extra sleepy, hungry or stinky isn’t always a sign that something’s wrong. Depending on their age, they may just be experiencing the joys of puberty. But behavior changes can also signal mental health conditions. The only way to know what your child is dealing with is to ask them.
3. Feels bad about themself. We all have down days. But if your kid’s feeling less confident or less effective than they used to, that’s worth investigating. Ditto if the down days have become more frequent or severe.
4. Has repetitive, self-destructive behaviors. Repetitive behaviors aren’t an inherently bad thing. But self-destructive, body-focused repetitive behaviors can be a sign of anxiety or distress. Examples include hair-pulling or skin-picking.
5. Worries excessively and can’t control it. Being nervous about a spelling test, the school play or a first date is understandable. But if that nervousness becomes more frequent and severe, makes them physically ill or makes it difficult to get things done — it could be that they need help learning new strategies to reign this in.
6. Becomes withdrawn. Kids sometimes need alone time. And that’s OK! But if they start isolating and stop interacting with family and friends, it’s important to understand why. The same’s true if they stop expressing interest in social or extracurricular activities they used to enjoy.
7. Engages in new, excessive attention-seeking. When a child engages in attention seeking-behavior, they’re trying to express distress or an unmet need of some kind. Working with a therapist could help them understand the root cause of their behavior.
8. Makes distressing comments. Dr. Eastman recommends you take your child seriously if they’re making statements like, “I wish I weren’t here,” or “Nobody would care if I ran away.” The same goes for conversations about self-harm of any kind.
9. Is unusually defiant or aggressive. A little rebellion is normal as children grow and develop. But if your child is persistently short-fused or quick to temper, resulting in bullying, fighting or threatening other people — yourself included — that’s a sign that you may be dealing with something more serious.
10. Engages in any kind of self-harm. If you learn that your child’s been cutting, throwing up after meals (bulimia), misusing substances or injuring themselves in another way, that’s a sign that they need professional help.

How to help your child

It’s natural for parents to want to jump in quickly and try to problem-solve for their kids. Especially if they’re displaying worrying behavior.

But first, Dr. Eastman says that your child just needs to know they’re being heard and understood. She suggests using validating phrases like, “I see this is really hard for you,” or “I notice you’ve been struggling lately.”

Dr. Eastman adds that validation is key.

“You’ll be surprised how far validating your child’s experience can go in helping them feel supported,” she emphasizes. “That will make them more receptive to talking about how to get through their challenges. 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.’”

Parents are often surprised by how willing their children are to get extra help. That help is as close as your pediatrician. Virtual mental health support may be an option, too, depending on where you live.

Don’t be afraid to broach the topic of therapy with your child’s doctor, Dr. Eastman urges.

“Pediatricians are often very good at helping parents differentiate what is and isn’t normal and can offer reassurance,” she reassures. If necessary, your pediatrician can refer you to a counselor who is a good match for your child and recommend other resources.

Parents sometimes assume that mental health treatment will mean medication or hospitalization. Those services do exist for kids who need them — and that’s a good thing! But getting mental health care for your child doesn’t have to look that way. It can be as low-key as learning about time management and learning new skills to make things easier.

“Their issues don’t have to be severe for therapy to be worthwhile,” Dr. Eastman clarifies. “Getting some extra support can help your child — and even you as a parent — learn new coping skills and strategies for handling problems,” she adds. “We need to de-stigmatize the idea of mental health treatment.”

When your child’s mental health is an emergency

If your child is thinking or talking about suicide, respond in a calm, supportive way. After all, they’re doing exactly what they’ve been taught to do in a crisis: They’re trusting you.

If you’re comfortable that your child isn’t in immediate danger, call their provider as soon as possible. If your kid’s in imminent danger of harming themselves or someone else, call emergency services or take them to the emergency room.

If you’re not sure what to think, or need somebody to talk to, consider calling a 24/7 hotline.

• If you live in the U.S., call, text or visit the 988 Suicide and Crisis Lifeline.
• If you live outside the U.S. or want to be connected with local resources, visit the International Association for Suicide Prevention website. They have a searchable database of crisis helplines.

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 them and you.