11 Early Signs Your Child Needs Counseling
Being a parent can be so draining sometimes. Why is my kid acting out? Why are there tantrums all the time? You may feel lost as to what to do — especially during those highly emotional moments.
You’re not alone, and it’s not just your child who may be struggling. A 2023 study found that COVID-19-pandemic-isolation increased the prevalence of anxiety issues in children by four times. That’s a huge spike!
If you’re worried about your child’s behaviors, mental health, or ability to cope, it’s natural to wonder, “Does my child need counseling?” In this article, I’ll help you make that decision, sharing what I’ve learned through my practice as a child therapist about the early signs that your child needs therapy.
How do I know if my child needs counseling?
Certain situations, such as a child self-harming or where a child is a threat to themselves or someone else indicate that professional mental health support is urgent and necessary.
But this article will focus on the earlier and subtler signs that your child should talk to a therapist to address declining mental health symptoms before it may start to get out of hand. As a child therapist with over eight years in the field and over 15 years working with children, I will draw on real-life stories from my practice — of course, changing any identifying information.
Early signs your child should talk to a therapist
There can be different moments in your child’s day-to-day experience that may indicate they are beginning to struggle with their mental health, and seeking a therapist could benefit them. Let's talk about some of those early signs that may be subtle — and yet important — to look out for.
1. Social anxiety
Social anxiety can look like your child being scared, cautious and/or unsure in social situations. This can be any social situation or it could be limited to specific situations, such as going to school.
Your child may prefer to be alone and not have plans outside of school. Your child may not interact much with their peers during the school day, and you may hear this from your child’s teacher. Social anxiety can also present more like fear — such as your child being scared to hang out with peers, or being hesitant of you leaving them alone at a friend's birthday party.
In my practice, I’ve worked with kids whose social anxiety shows up as being hesitant to try activities such as being on a sports team. They’ll say things like how they're “sure” their peers will think they “suck and are not good.” Anxiety and avoidance then occur, even when you encourage them.
Therapy helps by getting your child to look at the different beliefs they have about themselves that cause them to feel anxious. Therapy can also help your child expose themselves safely and slowly to their social anxiety fears eventually helping your child work through the social anxiety and begin to see they are safe and okay in said social situations.
2. Lack of friendships
Lack of friendships can look like your child not having plans outside of school. You may even get calls from the school teacher to hear your child is isolating or struggling to make friends or keep friendships. Or, your child may be coming home and talking to you about how they feel like they don’t have any friends or are constantly fighting with friends.
Lack of friendships could also present differently. For example, I’ve worked with parents who had no idea their child was suffering until the school called them about how their daughter seemed to get into lots of arguments with her peers at school and how her peers have come up to the teacher to complain that she is “bossy” — and therefore had little to no friendships.
Therapy can help by helping your child identify what's happening in their friendships and look at how they approach them. For example, by modeling appropriate social cues and ways of interacting through play therapy, your child learns how to socialize more effectively and show up confidently as themselves.
3. Low self-esteem
Low self-esteem can show up in many different ways. It can show up by seeing your child talk rudely about themselves, saying they feel “nobody likes me”. Maybe your child doesn’t want to participate with friends or in school because they “don’t like themselves.”
Typically, with low self-esteem, we notice kids talking and saying things about themselves that are negative. They may also isolate often as well.
Therapy helps by exploring where the low self-esteem may have come from and/or how it is being continually perpetuated.
4. Perfectionism
Perfectionism looks just like what it sounds like: your child being obsessed with perfection. A child may have placed such high expectations on themselves and may hold themselves to a high, unrealistic standard, such as expecting that they will be getting a 100 on every single test they take, no matter what. Or, they may expect that everyone must like them and want them as a friend, and if they don’t, there is something wrong with them.
For example, I have worked with children who get one point off of a test, and they get so upset that they isolate, don’t talk to anybody, and shut down completely.
Therapy helps by modeling a realistic understanding of expectations around certain things your child may feel perfectionistic about as well as looking at the positives of holding oneself to a high standard and using it as a strength instead of letting it take over to the point where it hurts your child rather than helps them.
5. Defiance
Defiance can look like your child constantly saying no to you. Anything you feel you tell them to do, the answer is no, or it is not done. Defiance can look like your child is even “purposely” trying to get you upset.
Alternatively, defiance can look like your child saying they are going to do something and then very quickly decide to do the very thing you told them not to do.
If you don’t feel like you're being listened to and like your child is doing things when you have already told them you don't want them doing that specific thing, you may be experiencing a child who is defiant.
Therapy can help by looking at and exploring why the child feels the need to be defiant. This would include parenting work and helping parents and children better communicate and get both needs met from each other. By fostering healthier, more constructive communication, we can help your child feel heard — as well as you as the parent! — which leads to less defiance over time.
6. Emotional regulation issues
Emotional regulation issues mean your child cannot handle their emotions well. For example, they may jump from one extreme emotion to the next. They may get really upset easily, and when they get upset it takes a long time for them to move past it.
Therapy helps your child by teaching them new tools and coping skills to better regulate and identify what and why they may be feeling the way they are.
7. General anxiety
Generalized anxiety looks like your child being scared of typical things — except the intensity of their fear is to a high degree.
For example, a child may be scared of clowns, thunder, and giant football stadiums. These are all normal fears for children, but someone with generalized anxiety disorder may not be able to go to friends’ houses because they are scared clowns will show up, they may not go to camp because they are scared of thunderstorms happening, and they may not go to a sporting event or show because of fear of the large crowds. The anxiety takes over and seriously disrupts daily functioning.
Therapy helps by exposing your child to the fears slowly and safely and building new positive experiences around what the child may be afraid of so their brain sees the fear from a new perspective.
8. Conflict with you or their siblings
Conflict with siblings can look like siblings verbally attacking one another — or even physically attacking each other. It can feel as if you, the parent, have tried everything to help your kids get along and it feels helpless. It might even feel like you are causing more harm than good when you try to help.
Therapy can help by teaching your child how to communicate better with their siblings and learn conflict resolution skills so parents do not have to be involved in sibling rivalry. In terms of conflict with you, the parent, therapy would work with addressing the relationship between parent and child and help each of you understand more of what the other needs.
9. Struggling in school
Struggling in school can look like your child’s grades suddenly declining, getting phone calls from teachers saying they are concerned about your child’s academic performance, or your child refusing to do homework when they get home. In more extreme cases, school problems could escalate to the point that your child has so much anxiety about school they are scared to go each morning.
Therapy can help figure out what exactly is contributing to the struggle, be it academic difficulties, learning disabilities, or emotional struggles that are interfering. Having someone familiar with the school system who can help collaborate with the school and make plans for your child can help your child feel more confident in school overall.
10. Inability to follow direction
This can look like a child struggling to do something when asked or the parent giving the child a bunch of directions and then the child forgetting what the parent asked and/or doing one thing and then forgetting the rest of what was asked of them.
You may even get a call from the school explaining that teachers have also noticed your child is struggling to remember what they’ve been told or seem to never follow through on things.
This could happen for a variety of reasons — maybe your child feels like they cannot do the tasks being assigned at hand because they are too difficult or they have deficits in executive functioning.
Therapy helps because we teach your child executive functioning skills which can not only improve their ability to follow directions, but it can also improve the relationship between parent and child, strengthening communication between you both.
11. Struggling to adjust to a life change
Struggling to adjust to a life change is very common for kids. For example, maybe your child has had to switch schools, and now they’ve started acting out and showing behaviors you haven't seen before.
In my practice, I worked with a child who had a very close relationship with their grandfather, and then the grandfather moved to a different state, and now the child can only see the grandfather by traveling by plane. The child started to isolate and spend a lot of time in his room. Moreover, he seemed very irritable and was acting out towards peers and family members. The school even sent two calls home due to the child skipping class and being in the bathroom for too long.
The examples of life changes are endless: parents going through a divorce, a friend moving away, your whole family moving cities or states, and so much more. The trouble occurs when your child is struggling to adjust and behaviors you don’t normally see are getting in the way of their daily functioning.
Therapy helps by really exploring with your child what this life change means to them and giving them that safe space to discuss it. Coping skills may be taught amongst other therapeutic tools as well to help your child move through and better adapt to this current life change.
Taking your child to a therapist: What’s your gut telling you?
The decisions to make around therapy can be highly personal and complex. A lot of times, finances are involved and so is insurance. Sometimes other people are involved such as another parent or guardian. There are lots of reasons why you may not feel now is the right time.
However, I will say this: as a child therapist, I’ve often seen parents regret not starting therapy for their child sooner. They initially felt they could put it off … until it got so distressing that they realized they could have saved themselves some heartache had they begun sooner.
If you’re not sure, I recommend a few (free!) resources that can help you ascertain if it’s worth it to take your child to a therapist. The first is The Child Mind Institute, a nonprofit with hundreds of helpful resources dedicated to kids’ mental health.
And if your child is old enough to read and self-reflect, I recommend Mental Health America’s free screening tool for youth mental health. This is an online quiz you can ask your child to take, which then delivers their assessment of their mental health!
Finally, I encourage you to ask yourself to think about how life has been recently for you. Are you struggling as a parent? Do you feel more stressed, irritable, anxious, or alone? Maybe the person who needs support right now is not your child, but you. If that is the case, I highly encourage you to reach out. A child therapist can also help you with parenting strategies, as well as help you cope.
Finding a child therapist: where to start
If, after reading this article and learning more about early signs to watch for, you realize that your child could benefit from a therapist, and being in this alone without therapy is no longer an option for you, it is time to find a therapist who fits and works for you.
I recommend booking an appointment with two to four different providers and seeing who you and your child connect best with. Then you can continue with whatever provider you feel is best!
Places to find a therapist:
Through your insurance provider
Through Psychology Today
School Psychologist/ School Social Worker
Pediatrician
If you are a NY resident, you can book a consultation with me, at Mindful With Mel
Thanks for taking a read. I am Melissa Tract, an LCSW. I work with kids, teens, and young adults. If you live in New York, I can see you virtually or in person. Please feel free to click my contact page to schedule a free 15-minute consultation with me. Looking forward to it!