How do I know if my child needs therapy?

One of the hardest parts of being a parent is figuring out when something is just a phase and when it's something more. You're not overreacting for asking the question. Most of the parents who reach out to me have been quietly wondering for weeks, sometimes months, before they ever picked up the phone.

So if you've found yourself googling "signs my child needs therapy" at 11pm, this one's for you. 

Let's start with the most honest answer I can give you: a child doesn't have to be in crisis to benefit from therapy. A lot of parents wait for a "big" reason. They worry that bringing their child to a therapist is overkill, or that they're somehow failing if they need help. Neither is true. Therapy can be a place to work through something specific, but it can also just be a space where your child gets to be themselves and learn tools they'll carry for life.

That said, here are some patterns I tell parents to pay attention to.

Signs that are worth a closer look:

1. Mood shifts that stick around. All kids have rough days, rough weeks, even rough months. What I look for is when sadness, anger, or worry has been the main note for a few weeks and isn't lifting on its own.

2. A change in sleep, appetite or energy. Kids who suddenly aren't eating much, or eating way more than usual. Trouble falling asleep, nightmares, and climbing into your bed when they used to sleep through. Dragging in the morning when they used to bounce out of bed.

3. Withdrawing from things they used to love. The soccer they begged to sign up for, the friend they were inseparable from, the art they used to bring you every afternoon. When those drop off and don't come back, it's worth a conversation.

4. Stomach aches and headaches with no medical cause. Kids feel a lot of things in their bodies before they have words for them. If their stomach hurts every Sunday night before school, their body is telling you something the words haven't yet.

5. School pushback. A sudden drop in grades, refusing to go in, or calling home from the office. Kids who can't tell you why they don't want to go but will fight tooth and nail not to.

6. Big feelings showing up as big behaviour. Meltdowns that feel out of control. Shutting down completely. Anger that explodes and then evaporates into shame. These are signs the inside isn't matching the outside, and it could really help to have someone to bridge it.

7. Harsh self-talk. "I'm stupid." "Nobody likes me." "I'm a bad kid." When you hear those phrases land more than once or twice, please take them seriously. They're worth a deeper look, even if your child shrugs them off five minutes later.

8. A loss or a change in the family. A grandparent passing, a divorce, a move, a new sibling, a friend group that fractured. Some kids talk about it. Some kids don't, and the feelings find another way out.

9. Something you can't quite put into words. This one matters. Parents know their kids better than anyone, and a lot of the calls I get start with, "I just feel like something is off." Trust that. You don't need to have the perfect explanation before you reach out.

What a first session actually looks like:

Part of the reason parents wait, I think, is that they imagine therapy as this serious, heavy thing. With kids, it really isn't. The first session is mostly about meeting, playing, and getting comfortable. We might draw, we might use toys, we might just chat. The goal is for your child to feel safe, not to dig into the hardest stuff right away, and just spend time getting to know each other.

Therapy with a child also isn't something done to them. It's something we do together, with you involved as the parent. You're not handing them off to be fixed. You're adding a person to their corner.

A note for the parent reading this

If you're reading this and worrying that you're somehow the problem, please stop. Bringing your child to therapy isn't a failure. It's one of the most loving things you can do. You're saying, "I see you. Something feels hard. Let's get you support." That's a gift.

If anything in this list felt familiar, book a free 15-minute consult. We can talk through what you're noticing and figure out together whether therapy is the right next step, or whether something else might be a better fit. There is no pressure to commit to anything past that conversation.