Once you decide your child may need some specialized help how then do you find the most effective treatment and therapist? Here are 8 things to consider as you seek help.
Identify Your Child’s Needs
Understand the Issue: If possible, determine the specific reason your child may need counseling (e.g., anxiety, depression, school issues, trauma). Developmentally your child may not have the experience or self-awareness to be able to describe what is bothering them so you may need some tools. Sometimes online symptom checklists can be helpful in identifying problem issues. A selection of sites with online checklists is listed below. Sometimes the internet can just have so much information it is overwhelming. It can be as important to figure out what it’s not as what it is. This might be the cart before the horse sort of thing. You may need a therapist to help you figure this out and you still don’t know what therapist to choose. However, even if you have a general idea it can help you find the right therapist.
Consider Their Preferences: Take your child’s age, personality, and comfort level into account. For example, younger children might benefit from a play therapist, while older children may prefer traditional talk therapy. A teen might prefer someone a bit younger who they would feel could better identify with them.
Look for a Match with Specialty and Expertise
Check Credentials and Experience: Look for professionals with qualifications such as Licensed Psychologist, Licensed Professional Counselor, or Licensed Clinical Social Worker. How much experience does the provider have in working children? Does the provider have certifications that might be relevant to what you child is experiencing?
Specializations: Seek counselors who specialize in pediatric or adolescent mental health or the specific issues your child faces. It is not uncommon for providers to have long lists of issues they treat but you may want to dig deeper to find out more specific detail. For example, virtually all therapists will list treating anxiety as a speciality but if your child is struggling with OCD you would need to know are they trained in exposure and response prevention.
Try to Match Approach with the Need
This may be a bit harder as most parents probably don’t know what treatment might be more effective for what problem. The expression used for treatments that are considered most likely to be effective is “evidence-based.” This is certainly not a guarantee but if you can match your child’s issue with an evidence-based approach, then with a provider who is skilled in that approach, you increase the possibility of a good outcome. Here is one list attempting to match the problem with the evidence-based treatment (if there is one).
Seek Recommendations
Ask Trusted Sources: If you have a relationship with a physician or pediatrician they may be an excellent source since they will often refer their patients. The nursing or support staff may also have information on referral sources. School counselors or teachers may have suggestions. Other parents or social media groups are likely to have experience with counselors in the area. If you are involved in a church or community group that might be the way to go and certainly friends and family can help.
Check Professional Directories: There are a number of online professional directories. One of the most used is the psychology today site. If your child has a particular problem like anxiety or ADHD the national organizations will have a referral section on their websites. See below for some specific links. Most of these sites don’t vet or review the professionals who are listed so you may need to look for credentials, certifications and post-graduate training.
Consider Practical Factors
This might be self-evident but the more impractical the treatment, the less likely for it to happen. Getting treatment is challenging in so many ways so do yourself and your child a favor by considering the practical aspects such as the location, how easy it is to get an initial appointment, subsequent appointments, and affordability. If you have an insurance plan, check on what is covered and if the therapist accepts that insurance plan. Most insurance plans will have out-of-network coverage but generally it won’t cover much of the fee. Usually, treatment is once a week or maybe every other week and may take several months so it is important to consider the cost. If a therapist or group accept insurance, they are unlikely to have a sliding fee schedule as the insurance contract would disallow that as it might be unfair to their members.
One Size Does Not Fit All
It is perfectly legitimate to ‘interview’ the counselor. Most counselors will have a parent interview first before seeing a minor. Some therapists may offer a free consult but regardless, use the first interview to give the needed background information as well as ask any questions you may have about the therapist’s experience, methods, how much parents are involved, etc. I have been practicing for nearly 40 years and every new client is sizing me up as much as I am trying to understand them. Therapists can be wildly different even if they have similar training. If the therapist is not a fit, then schedule with someone else. You do not need to give the therapist an explanation if you don’t want to do that.
If by the first 2 or 3 sessions, you or your child are not experiencing some sense of comfort, confidence, and rapport then don’t waste your time and money if there are other options. It is, of course, not always so cut and dried but I am encouraging you to be picky. Take your child’s reaction into account. Is your child’s reaction positive toward the therapist even if he or she is not necessarily positive about having to come to counseling? You and your child may spend months working with someone so that level of rapport is extremely important. You may meet with a pediatrician 2 or 3 times a year for 15-20 minutes, while you may spend many hours and weeks with a therapist.
Level of Involvement
The level of involvement with your child’s treatment can vary depending on your child’s age, the specific things being treated, the style of the therapist, etc. The necessity of confidentiality increases as your child gets older. This is something you should ask about at the start of treatment. If there is a complicated family situation such as separation or divorce, it is crucial that information and communication be clearly defined at the outset. Frustration and misunderstanding due to problems with this can significantly impair the whole process.
Often, part of the solution may involve changes in how the family interacts with the child who is the client and possibly with other family members. For example, with anxiety disorders, virtually every child will be asking for reassurance from parents and that will need to gradually diminish.
Monitor Change
I wish therapy was faster. Whatever your expectation, it will probably take longer. I always joke if someone says your house will be built in 5 months, double it. (My apologies to all the builders.) Similarly, there are so many factors involved in mental health issues it can take quite a while. It is important to be patient but you may also need to be clear about the outcomes you hope will happen. It would be a good idea to discuss that at the beginning of treatment and then periodically give feedback to the therapist and also check in on what they are thinking and seeing.
Persistence
No matter how complicated your child’s mental health issue(s) might be there is reason to be hopeful because in most cases significant healing or improvement can happen. Just the fact you and your child are working on solutions is a complete paradigm shift away from people who ignore, avoid, resist or otherwise never seek to change and grow. Frankly, that is one of the major forks in the road for anyone’s life. I am not saying everyone needs therapy, rather does one face obstacles or avoids them.
In the throw’s of her anxiety disorder I had to remind my child, “It is just anxiety, you will get through school, you will make friends, you will get a job, you can have a great life. This is a complicated obstacle but it does not define who you are.” (Honestly, I think when I said these things, it was much rougher and clumsier than I just wrote but you get the drift.) Don’t give up. Therapy can be expensive and the right therapist may be hard to find. There are more resources than ever available to people and it might take hours, weeks and years but keep looking for and working on change.
Pediatric Symptom Checklist
https://www.massgeneral.org/psychiatry/treatments-and-services/pediatric-symptom-checklist
List of screen tools
7 Free Screening Tools For Children’s Mental Health Concerns
Mental Health Screening Tools
ADHD resources
OCD and related disorders
Anxiety and Depression
https://adaa.org/
Emetophobia
David Russ
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