General Information on Children and Teen Counseling

When do you refer a child or teen for therapy?

Parents often struggle with whether or not they should consult a professional in the mental health field regarding their child. On the one hand, I have seen children who need no professional intervention. They are doing well, but may have had a recent period of stress, trouble in one particular area of school or peer relations, but generally, this has not caused them or others distress beyond the specific areas of concern. On the other hand, parents have brought children for therapy and they have waited until every major area of their child’s life is affected by problems. Therapy, at this point, is long overdue. Thus, it is important for parents to have a “measuring stick” to help them determine when professional help is warranted. Of course, when in doubt, ask for help. Sometimes a phone call can clear up any indecision and help determine their child’s needs. I have listed some of the problems that likely would need professional attention and am offering this as a guideline and nobody should consider this a psychological diagnosis or treatment.

CHILD AND TEEN MAJOR PROBLEMS (MOST LIKELY NEED PROFESSIONAL INTERVENTION)

Anxiety/Overworry/Phobias
Examples: A consistent fear of separating from parents or school refusal based on fear. A phobia is an irrational fear of an object, person, animal or situation. We know now that a small percentage of children have social phobia, a part of which is the fear of being criticized or “noticed” in a public situation.

Depression and Suicidal Feelings
Symptoms of childhood depression are like those of adults, for the most part. Children may have an irritable mood, sadness, crying, weight loss or gain. A very small percentage of children have suicidal feelings and it is statistically rare for a child to actually attempt suicide. Teens are at greater risk for suicide and there are several factors that professionals should consider when evaluating the potential for self harm such as a family history of suicide, friends that have committed suicide, having a nihlistic outlook and the social support system.

Attention Deficit Hyperactivity Disorder
Generally, research indicates two general types of attention deficit disorder. These two types are likely unrelated. Hyperactive, impulsive children tend to respond to medication roughly 80 percent of the time and half or more children who are hyperactive and impuslive tend to exhibit symptoms into their adult years. The distractible or inattentive children -these children are not hyperactive for the most part-may have problems with school work, organization and following directions.

Conduct problems
These are children or teens who violate rules, threaten others, steal, set fires, harm animals or others or destroy property. Generally, research indicates that the younger a person begins to exhibit these type behaviors, the more difficult it will be to change these type of destructive patterns. For example, a 15 year old with current delinquent behavior who started violating curfew and skipping school before the age of 10, will typically have a less of a chance of changing behavior than will a teen who begins to have problems at 15. Youth with these types of problems are challenging in treatment, however, the earlier intervention takes place, the better. Additionally, most teens commit some kind of crime but do not come to the attention of law enforcement. In general, most "antisocial" teen behavior stops by the end of adolescence.

Learning disabilities/variant learning styles
Children who have average IQs, as measured by a standard intelligence test, can have significant problems with reading, arithmetic, spelling or other academic areas, such as written communication. If their achievement is significantly lower--as measured by an achievement test--then a specific learning disability can be diagnosed. Additionally, children may vary in their learning style. For example, some children learn better from visual presentation, some learn better from hearing or listening to new material and some learn better from a kinesthetic or “hands-on” type of teaching.

DEVELOPMENTAL DISABILITIES (SEIZURE DISORDERS, LOWER ABILITY)
EATING DISORDERS (REFUSAL TO EAT, LOSS OF BODY WEIGHT)
CHILD OR DOMESTIC ABUSE
DIVORCE ADJUSTMENT *
ADULT PROBLEMS THAT RESPOND TO OUTPATIENT COUNSELING
MILD TO MODERATE DEPRESSION AND ANXIETY
PANIC ATTACKS AND PHOBIAS
MILD TO MODERATE ANGER PROBLEMS *
DRUG ABUSE / PROBLEM DRINKING *
COMMUNICATION PROBLEMS IN FAMILY
ADULT LEARNING DISABILITIES
ADULTS COPING WITH DIVORCE *

* CAN BENIFIT FROM SUPPORT GROUPS, LIKE AA, NA, COPING WITH DIVORCE CLASSES, DOMESTIC VIOLENCE GROUPS