Help Me Sara: Does my child need therapy?

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No one knows our children better than we do. We can often detect even the slightest change in their usual patterns. While we may take our child to the doctor if he’s sleeping or eating differently, when it comes to changes in behaviour we typically take more of a wait-and-see approach.

These behavioural changes may be dismissed by one or both parents as a phase. So, by the time I hear from parents in distress, months or years may already have passed. However, when behaviours have become so engrained, I ask for patience as we get to the root cause to understand and try to correct the behaviour. If you think your child might need professional help, ask yourself these questions:

Was the Change in Behaviour Sudden or Gradual?

If sudden, it may be in response to a physical ailment, such as strep throat or an earache, for example. If the behaviour goes away after the ailment is treated, then there’s no need to worry. However, if the behaviour has changed over time, or it appears suddenly and doesn’t go away, you might want to get help in understanding why. Look for changes in your child’s life such as a new school, the birth of a sibling, the death of a family member, stress at home or bullying at school.

Is the Behaviour Directed at One Person or Everyone?

If a child is an angel at school and friends’ homes, but a devil in yours, figure out why. Look at your parenting style versus the teacher’s style. Dynamics at home that might affect behaviour include how you discipline your child and his or her relationship with both parents.

Is Your Child at Risk of Hurting Himself or Others?

If your child is throwing objects or banging his head against a wall, get help sooner than later. Often, new parenting strategies can bring about change but sometimes, depending on the age of the child and the severity of the behaviour, start with a proper assessment.

How Does Your Child’s Behaviour Compare to His or Her Peers?

Watch your child with other similarly aged kids, either at play in your living room or in a more structured environment. Watching your child in comparison to same aged peers (or your experience after parenting other children) may give you some indication as to whether the behaviour is typical.

Are Both Parents Concerned?

It’s not unusual for one parent to be quite concerned while the other rolls his or her eyes and says “relax”. This can cause the worrying parent to second guess him or herself. However, if you spend more time with your child than your partner, you will pick up on slight changes more quickly. Again, trust yourself. There’s no harm in getting a professional opinion.

Next Steps

Once you’ve decided to investigate the causes of your child’s change in behaviour or ongoing difficulties, it’s often hard to know where to turn. Try asking other parents, your doctors, school administrators and colleges that govern psychologists or social workers.

When you contact a therapist, explain your concern and together determine the best course of action. A formal assessment to rule out a mental health or intellectual disorder may be recommended prior to any course of treatment. The therapist may also request permission to speak to other people in your child’s life, such as teachers.

The bottom line is that aside from experience and skills, it’s important to find someone with whom you and your child feel comfortable.

Through The Ages

Preschool: Often behavioural concerns can be resolved when parents approach the situation with new strategies. A therapist can help. After meeting with you, a therapist may request your child attend a subsequent session so that he or she can meet your child and observe the family dynamics. If individual help is recommended for your preschooler, then art or play therapy is often best for assessment and treatment.

School Age: It’s often best for parents to meet with a therapist prior to involving a school-aged child. This way, the therapist and parents can talk more openly about the concerns. A therapist may recommend meeting with the child alone or including him or her in a session with parents and sometimes siblings. Depending on the concern, a therapist may refer your child for an assessment, for one-on-one treatment or with an art or play therapist, or may recommend family therapy.

Teens: Parents often reach out on behalf of their teen who might be experiencing a range of mental health concerns. Sometimes, the therapist will meet with the parents to get a detailed history and sometimes the therapist will include the teen from the beginning – alone or with parents. Depending on the concern, the therapist may recommend a more formal assessment – to rule out a learning disability or an oppositional disorder for example – and/or suggest one-on-one counselling with the teen or with the family as a unit. Teens are very concerned about confi dentiality so what a therapist will and will not reveal to parents is important to creating a trusting environment.


Sara Dimerman is a psychologist, author and parenting expert in the Greater Toronto Area. Read more at

Originally published in ParentsCanada magazine, May 2015.

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