7 signs your child should see a therapist, according to child psychologists

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Ever since the start of the coronavirus pandemic, we've been living in uncertain times, and the unknown can be scary no matter what your age. There have been so many changes for parents and kids alike that may be highlighting or exacerbating mental health issues.

"Children have likely been directly exposed to information that may create worry, especially as their ability to understand the information may be limited," says Kate E. Eshleman, Psy.D., pediatric psychologist at Cleveland Clinic Children's. Besides hearing scary news, kids have also had their schedules completely changed. "There has likely been significant disruption to children's routine, taking away many familiar aspects of the children's life — i.e., going to school, engaging in extracurricular activities, and spending time with extended family and friends — which has been difficult for many to cope with," says Dr. Eshleman.

While parents may not be able to control how quickly life gets back to normal, they can control how they react to stress and that may influence how their children react to stress. "If parents present the pandemic as a catastrophic event and model anxious behaviors, then in turn, that will alert a child to be more concerned," says Jenny Yip, Psy.D., ABPP, board certified psychologist. "Children look to adults to learn how to respond and react. One of the biggest things parents can do is model resilient, solution-focused behaviors."

Ultimately, each child is going to deal with stress differently. "His or her own developmental stage and temperament can affect how a child responds to the current situation," says Dr. Yip. "Some children may have a higher resiliency level, while others may be more cautious and anxious about the pandemic."

As a parent, it's important to know the signs that your child may need a bit of additional support from a mental health professional to help them better cope. We chatted with experts, and here, they share the top signs it may be time for your child to start working with a therapist, plus how to find one.

1. Your child is constantly seeking information.

"Constantly seeking information from social media or the news, or asking parents for reassurance is a key indicator of anxiety," says Dr. Yip. "It's the situation: 'I don't know, and therefore, that makes me anxious.' Obtaining absolute certainty isn't ever possible — now and in any situation in life. A clinician will expose the child to their particular fear of not knowing, help them resist the desire to seek information, and teach them how to build the resiliency to be OK on their own without knowing."

2. Changes in sleep patterns, including increased or decreased sleep.

"This may mean a child may be feeling anxious or depressed. Perhaps the child is having trouble falling asleep due to worries about the pandemic and its impacts, or the child may be feeling depressed by loss of activities resulting in increased sleep," says Dr. Eshleman. "A provider can further assess what the child is experiencing and implement strategies to address the symptoms and underlying cause. Treatment may come in the form of therapy, such as cognitive-behavioral interventions, or medication management."

3. Isolation at home.

"If you see your child or teen spending more time in their room and not reaching out to family or friends, this is another sign that they may need to get some extra support," says Cat Ryan, a case therapist at Northwestern Medicine Central DuPage Hospital. "Be mindful of how much alone time they have in their room. While most members of the family may want a little downtime to themselves, too much alone time can exacerbate depression."

4. Clinginess.

"Clinginess may signal anxiety. Clinginess happens when a child doesn't feel the confidence or resiliency to deal with being alone," says Dr. Yip. "Feeling like there's insufficient resources to deal with potential harms. A clinician will help a child build self-confidence—that feeling of 'I can do it', and 'I can figure it out!' This kind of attitude is needed to develop resiliency and confidence."

5. Increased irritability.

"In children and adolescents, anxiety is often manifested as agitation, irritability, and quick responses. Children are also likely experiencing increased frustration related to the loss of many important events such as birthday parties, end of school celebrations, family trips, and summer activities," says Dr. Eshleman. "The provider can further assess the child's worry and assist with strategies to challenge those concerns, or acknowledge and validate them and work with the child to develop active coping strategies to manage his or her distress (i.e., ways of relaxation or distraction)."

6. Withdrawal from favored activities.

"This may be a symptom of depression. It is especially important at this time to determine if the disinterest is related to mood, versus fatigue from engaging in that favored activity," says Dr. Eshleman. "For example, if a child typically enjoys art, though has been engaging in art projects daily for the past two plus months, he may just be tired of doing art. The provider can further assess what is underlying the change in interest, and address the underlying symptom/cause."

7. Changes in hygiene and eating.

"This is another warning sign that your child may be experiencing an increase in depression or anxiety. With teens and children sheltering in place, it can be easy for good healthy habits to fall to the wayside," says Ryan. "It is helpful to maintain a schedule for meals, and to make sure that kids are maintaining daily hygiene, such as brushing teeth and showering."

How to Find a Mental Health Professional for Your Child

A great place to start is by speaking with your pediatrician. "It is helpful to review your concerns with someone familiar with typical child development, and ideally someone who also knows your child to further discuss the concerns," says Dr. Eshleman. "The pediatrician also likely has a list of referral resources and can point you in the right direction.

Speaking to school personnel may also be helpful. "They likely have a list of providers that they have worked with and/or have made referrals to," says Dr. Eshleman.

Parents can also go to the therapist directories here at Keel and at ADAA.orgIOCDF.org, and ABCT.org. "Look for a mental health expert who specializes in treatment from a cognitive behavioral (CBT) approach, more specifically, if your child is struggling with anxiety, look for a therapist that specializes in exposure and response prevention (ERP) therapy," suggest Dr. Yip.

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