When to get professional help for your child

It is completely normal for youngsters to have emotional and behavioral ups and downs over the course of their childhood. Pediatricians like to remind parents that most problems disappear if they don’t overreact to them. Just take a deep breath in and a deep breath out, and they’ll be gone. Sleep problems tend to come and go, eating issues arise and then disappear, and friend concerns are like the weather in Western Washington — always changing.

But how do you know when a problem is worthy of getting professional help? To make matters worse, most parents are pretty nervous about seeing a psychologist or a counselor. On some deep level, we feel that asking for help is a sign that we’re a failure as a parent. In addition, we’re terrified that the therapist will make us feel even worse about ourselves than we already feel. What if the counselor is flaky? Maybe they don’t know anything about family life? The list of worries about getting professional help is long.

This is true for professional psychotherapists, too. I remember when one of our daughters was about 7 years old, we decided to see a psychologist after a long spell of her spirited behavior. We felt that we had tried everything we knew to do and were coming up dry. We just felt awful. But we didn’t want to be the shoemaker without shoes, and so we went to see a child psychologist, the entire family in tow. He helped us immensely after just a few visits. Let’s face it: In our own family, we sometimes can’t see the trees from the forest.

So what are the signs that a consultation with a mental health expert is in order?

First off, remember that it’s perfectly OK to make an appointment with a child therapist simply to find out if your concern merits more help. Frequently I will see parents and let them know that while they are concerned about their youngster, the problems they are worried about are minor. That alone can be a big relief.

Sometimes school performance concerns merit further consultation, especially when strategies the school suggests fall flat. Kids may do fine at school but don’t seem to manage well at home. Perhaps they’re defiant and negative, and parents are always fighting with them. If these problems extend for several months on end, a consultation with a behavioral specialist may be wise. Frequently, a quick tune-up of parenting strategies can make a huge difference.

Another set of symptoms that warrant additional evaluation are mood problems. Children can find themselves feeling depressed, hopeless, sad or withdrawn. If these symptoms persist for over several weeks, a meeting with your child’s primary care provider may be in order. Their provider can rule out any organic causes of these symptoms and help you sort out whether further help is needed.

Naturally, children can have periods of worry and fear. But occasionally, these concerns can intensify and extend into many areas of life. Children may become avoidant—they want to stop doing things that make them anxious. When these anxieties impact their mood and their ability to function, it’s time to get help.

As a psychologist, it is far more common for me to feel that parents have waited too long before consulting me than to think that they are overreacting. Problems that have begun to fester and turn into patterns of maladaptive behavior are far more difficult to change.

Here is some practical advice:

Talk to your pediatrician or family doctor. I find that pediatricians and family doctors are becoming increasingly sophisticated about behavioral pediatrics. They can often give you sound advice and strategies to try. Ask them for a referral.

Don’t wait too long. Better to get a consultation and be reassured than to wait too long for your child’s problems to become firmly established. Don’t let your pride or fears get in your way of helping your kid.

Paul Schoenfeld is a clinical psychologist at The Everett Clinic. His Family Talk blog can be found at www. everettclinic.com/ healthwellness-library.html.