How do I know if my child needs therapy?
If you are struggling with your child or are receiving negative reports from your child's daycare or school, it is time to seek help. Below is a list of common mental health symptoms in young children. If you are reading this website, there is a good chance that your child is exhibiting at least one or two of these.
The beauty of early intervention is that young children are so flexible and adaptable. That is because their brain cells are busy making new connections. Neurologically speaking, patterns of behavior and interaction are not yet fixed in young children. By seeking help early, you can treat problems faster and more easily, and prevent bigger problems from developing in the future.
- Relationship problems. Your child's teachers may report that your child is aggressive towards other children (ex. hitting or biting) or has a hard time relating to them. His relationship with you and his teacher might be marked by power struggles and strife. A common refrain I hear from parents is, "I did not sign up for this!"
- Another indicator of mental health difficulties in young children is difficult transitions. Bedtime, drop-offs and pick-ups, and changes in activity quickly escalate into power struggles and tantrums. Instead of exhibiting flexibility during moments of change, children respond with rigidity and fear.
- An inability to concentrate, or even a teacher report of hyperactivity, may be an indication that your child is experiencing mental health difficulties. Children who are temperamentally sensitive, highly anxious, have witnessed fighting and discord between their parents, or have experienced a death or other traumatic event may be distracted by worry or fear.
- Low tolerance for frustration is another indication of mental health issues in young children. Children may become agitated or frustrated to an overwhelming degree when faced with a seemingly simple task. They may erupt into a tantrum, storm off, or say things like "I hate myself."
- Disturbances in sleep are another common sign of mental health issues in young children. They may wake up in the middle of the night from nightmares or even night terrors. Night terrors are when a child awakens a few hours after falling asleep screaming, crying, and thrashing. Their eyes are wide open and they may appear awake, but they are not. Both nightmares and night terrors in young children are associated with anxiety about daytime events, particularly conflict between their parents.
- Children who exhibit withdrawn behavior are of equal concern to children with more disruptive behavior but rarely get the same attention. This includes children who shy away from social interaction and generally do not exhibit the same spontaneity and joy for life that other children do.
- Frequent wetting and soiling once a child has been potty training is also an indication of mental health issues in young children, as are all longstanding developmental regressions (losing a previously mastered skill or developmental milestone).
- Sudden changes in a child's behavior may also be a sign that support is needed (ex. an outgoing child becomes withdrawn and sad).
How do I know if I need help as a parent?
Many parents feel isolated when it comes to raising their children. They may not have had exposure to children until they became parents, and are baffled about how to respond to their child's many demands and needs. Or they may never have imagined how difficult being a parent can be.
Parents cannot be all things to their children. They certainly cannot solve all their children's problems alone. By seeking therapy, parents have the opportunity to think together with a trained professional about their and their child's needs and problems. This helps develop parenting skills exponentially! Child therapists like myself have expertise in parenting, child development, child psychology, and child behavior. We can provide individualized guidance on how to parent your child, and help you see things from a different perspective. This is especially important when parents feel stuck in relational patterns from their own childhood.
This is how you know that you need help as a parent:
- You have questions or concerns about your child's behavior.
- You are looking for guidance on parenting.
- You feel frustrated and aggravated as a parent, and want to know how to have a more satisfying relationship with your child.
What are the skills I will learn from therapy?
Asking for help can be hard, but it is a worthwhile investment. You will feel more confident as a parent, and more prepared to handle developmental challenges to come.
Here are some examples of things you will learn in therapy:
- Increasing your understanding of your child's needs and temperament
- Improving your ability to respond to your child's difficult moments
- Improving communication and listening skills with your child
- Understanding the connections between how you were parented and how you are parenting your own child
- Changing old behavior patterns and developing new ones
- Improving your effectiveness as a parent
If my child and I start therapy, will we be in it forever?
What is Individual Play Therapy?
Play is the language of children. Sensations, ideas, thoughts, and feelings that children cannot express with words they can act out in their play. From imaginary play with dolls, legos, and figurines arise rich metaphors of children's life experiences. For example, a child feeling unsafe may play out scary scenarios until s/he acquires a sense of mastery and safety.
Board games and card games are other play therapy tools. Psychologists like to see how children navigate rules and turn-taking, and how they handle winning and losing.
Drawing, painting, and other forms of artistic expression are also used to access a child's inner world during individual play therapy.
What is Parent-Child (Dyadic) Therapy?
Parent-Child Therapy is when the parent-child dyad comes to a therapy session together. ("Parent" is loosely defined to indicate any of the child's primary attachment figures: mother, father, grandparent, step-parent). The psychologist has activities ready for the pair to engage in, and will at times hang back to observe and at other times participate in the interaction.
During a parent-child therapy session, the psychologist may narrate what she sees occurring in the parent-child relationship. This will help both parent and child gain a better understanding of their needs and how to appropriately express them, in addition to understanding the parent-child relationship dynamic. Because the psychologist is "in the moment" with parents and children during these sessions, her interventions are "at the moment," as well, leading to immediate shifts in the parent-child relationship.
What are Parenting Guidance Sessions?
No matter what those parenting books say, there is no one-size-fits parenting. Parenting effectively means knowing and understanding your child's temperament and needs. It also means knowing who you are as a person and parent, and what outcome you want for your child and your family's future.
Parenting Guidance Sessions will help you understand your child's needs, temperament, and behavior, and help you gain clarity about the parent you want to be. These sessions will give you insight into how your own experience of being parented is influencing your parenting, for better or for worse, and help you leave painful patterns of interaction from your childhood behind. The goal of these sessions is to help you become a more confident and intentional parent.
Why is a School Observation a good beginning to therapy?
An integral part of getting to know your child is having the opportunity to observe him at school. Similar to the workplace for an adult, preschool is where young children spend the majority of their days and weeks. It is important to understand what his experience is like where he spends most of his time.
This is what I look for when I perform a school observation:
- Social Interaction: How does your child interact with other children? Are his peer relationships a source of satisfaction or distress? Does he collaborate with other children, or prefer to play alone? Does he have developmentally appropriate social skills? Is he able to communicate his needs? Does he make eye contact with his teachers and peers? Does he like his teacher? How does the teacher feel about him? Does he follow directions from his teacher? If not, what is getting in the way?
- Transitions: How your child handles the transition back into the classroom from the playground, or getting onto his mat for a nap following lunch may sound superfluous. But watching how he manages and navigates these transitions can say a lot about a child's temperament, how much stress he is currently experiencing, and how he manages his stress.
- Self-Regulatory Skills: The last area of focus is on how your child recovers from strong emotions and uncomfortable sensations, a skill called self-regulation. Does your child have command over his body? How does this change when he is frustrated? How long is his attention span? Does he have issues with anxiety or hyperactivity? Does he withdraw under stress? Are his self-regulation cues being misread by his teachers and peers as obstinance or defiance?
When do you do Home Observations or provide In-Home Support?
If a child does not attend a school or is having a problem specific to the home environment, I will perform an in-home observation. The focus of the in-home observation is the quality of interactions between the parent and child, and other members of the family. I may suggest an activity to do together or watch as the family carries on their daily routine. Does the parent-child relationship appear strained? Is it marked by frustration and strife, or is it harmonious? Are family members deriving satisfaction from one another? What are the strengths of the family? Do family members appear securely attached? Or is attachment insecure or disorganized?
During my observation, I will also watch for the circumstances under which the child's target behavior arises. What is happening in the environment to prompt the behavior? What cues is your child giving that he or she is becoming anxious, angry, or stressed? What are the responses from the family members that calm the child, or make the situation worse?
Following my in-home observation, I may recommend a period of in-home support. This support consists of modeling parental responses to children's behavior, such as specific language, interventions, or developmentally appropriate boundaries and limits setting when a child's target behavior arises.
Sometimes, after I know a family well, I will come to the home to do Individual play therapy with a child (assuming there is a private place to play with no interruptions) or carry out Parenting Guidance Sessions (assuming that children are not anywhere in the home). This helps me get a good understanding of a child's home life, in addition to relieving scheduling conflicts.
What is Teacher Consultation and why is it important?
Teacher Consultation is a collaboration between two or more adults looking to support a young child's development. Teacher consultation aims to put together the expertise and knowledge of trained professionals who know and interact with a child regularly: a mental health professional, such as a Psychologist or Marriage and Family Therapist, and the child's teacher. Mental Health Professionals who work with young children are specialized in young children's mental health issues, complicated group dynamics in the classroom, and children's social and emotional development. They are astute observers of young children's behavior.
Teachers who work with young children are specialized in supporting their cognitive growth and development, helping them resolve conflicts, supporting children's friendships, and managing the classroom environment (and all of the children within). Experienced teachers have many years of hands-on work with young children, and hence have a huge knowledge base about their needs and behaviors.
Together, teachers and mental health professionals share observations, discuss concerns, and brainstorm about the best ways to support children and their families both in the classroom and at home. This mutual sharing and support can be transformative not only for parents and children but to the professionals themselves.