Can Your Child Benefit from Counseling?


 * Lydia Chang* was diagnosed with bone cancer after her eighth birthday. After enduring three years of cancer treatments, she is sad that her classmates avoid her, fearing that her cancer is contagious.
* Paul O'Neill* is six years old, and became very withdrawn after his parents separated. Struggling with a learning disability, he seldom speaks, but expresses his feelings through vivid crayon pictures.
* At age nine, Danny Simone* complains that he can't get rid of ?bad thoughts? in his head. Every night, he compulsively counts all his toys before going to sleep.

*Names have been changed.

These children are grappling with emotional pain and hardships at very early ages. Unfortunately, they are not alone - thousands of children today face complex life issues that often stem from fractured, dysfunctional family structures and a fast-moving, technological society.

The toll is high: a 1999 Surgeon General report estimated that 20% of American children and adolescents between the ages of 9 and 17 have diagnosable psychiatric disorders.

Can child therapy help?

Why Therapy?

Unresolved problems or disorders can impede a child's development or trigger emotional states that cause trauma for the child, the parents, and the family. The effects may be long lasting.

Child experts agree that significant childhood problems "including poor bonding with parents "shape future adult work and social relationships if not treated. "Children who don't get the attention they need in the early developmental years may have a limited capacity for intimate attachments, or an inability to commit or empathize as adults," notes Dr. Ana Badini, a psychotherapist who has treated adults and children for over 18 years.

Therapy can help children resolve current problems, as well as provide tools to cope with life challenges later on.
When Does Your Child Need a Therapist?

As a parent, you are likely to be the first to recognize changes in your child's behavior. According to the American Academy of Child and Adolescent Psychiatry, there are warning signs that indicate that your child is having difficulty, and may benefit from a psychiatric evaluation. Some of these signs are:

* Changes in school performance, such as dropping grades, missed homework, and skipping school
* Excessive worry or anxiety
* Loss of interest in usual activities
* Change in sleeping habits or frequent nightmares
* Mood changes, including temper tantrums, depression, anger, and aggression
* Dangerous and/or illegal behavior, including:
o Use of alcohol, cigarettes, or drugs
o Inappropriate sexual behavior
o Vandalism
o Theft
o Fighting

Sometimes, the symptoms are vague. "Often a parent brings a child to therapy because he/she knows there is a problem, but is not sure what it is," says Lorenzo Colon-Monroe, Director of the Den for Grieving Kids in Connecticut. "The minute you notice a change, sit down with your child and talk. If you need more help, it's never too early to start therapy."

What Happens Inside the Therapist's Office

The most common therapeutic approach for children ages 4-11 is play therapy. In play therapy, children use dolls, art, and games to express their thoughts, experiences, feelings, and conflicts to the therapist. The therapist may observe and/or interact with the child during play, using talk or play objects to communicate.

Depending on the child's verbal abilities and maturity, talk therapy or cognitive-behavioral methods may be used with children aged 12 and older.

Before the First Session

If you've decided on child therapy, Colon-Monroe suggests that you prepare your child before the initial session. "If they don't understand why they're here, children may be fearful, anxious, or may interpret therapy as punishment," he says. "This interferes with the initial bonding process, and can adversely affect the process." When talking to young children, he suggests you explain that a therapist is a "talk doctor" with "no needles," and emphasize to the child that they are free to tell the therapist any problems. Badini also suggests that parents present the therapy as "teamwork" something that "we" are going to do together to help "us."

If Your Child Needs Medication

Certain psychological or behavioral disorders may be treated with medication as an adjunct to other types of therapy. Some conditions treated with medication include:

* Anxiety
* Attention deficit hyperactivity disorder (ADHD)
* Obsessive compulsive disorder (OCD)
* Bipolar (manic-depressive) disorder
* Psychosis
* Severe aggression

Although medication can help reduce or eliminate symptoms, it should not be prescribed lightly. All psychiatric medication should be prescribed by a physician experienced in treating psychiatric problems in children and adolescents, and the course of treatment should be monitored very closely by both parent and physician. If medication is recommended for your child, discuss all ramifications of the treatment with your doctor.
Choosing a Therapist

There are many factors to consider when choosing a therapist, such as financial/insurance arrangements, scheduling, location, etc. But most importantly, you will need to choose a therapist with whom you and your child are comfortable. Good places to find therapy referrals include:

* Word of mouth from a health professional or trusted friend or family member
* Regional or local mental health centers
* Hospitals
* Human service organizations


"Being prepared: know when to seek help for your child"
American Academy of Child and Adolescent Psychiatry

"Psychiatric medication for children and adolescents - part III: questions to ask"
American Academy of Child and Adolescent Psychiatry

American Academy of Child and Adolescent Psychiatry

National Institute of Mental Health (NIMH) - Child and Adolescent Mental Health

Child Anxiety Network (Boston University)

Straight Talk about Psychiatric Medications for Kids . Guilford Press, New York, 1999.

Last reviewed March 2004 by Seth Scholer, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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