One of the questions I get asked the most by acquaintances is, “My child does x…Is this normal? Should I take him/her to see a therapist?” It can be tricky to know whether or not a behavior warrants counseling. While this post is not intended to provide answers, dictate what anyone should do, or provide an assessment, here is some food for thought.
Better Safe than Sorry
First and foremost, play it safe. If you are worried about a child or yourself, there is no harm in seeking an assessment from a licensed therapist. An assessment is a first appointment where a therapist will diagnose what is going on and provide recommendations for treatment.
I know that therapy can be expensive and the price can be a deterrent to seeking counseling. But, there are some little tips to help ease this worry if you are on the fence about seeking an assessment.
First, many insurances will cover the first session. So, if you are unsure whether or not x behavior is diagnosable, and hence covered by insurance, rest easy knowing that several insurances will cover at least one session for you to find out if the diagnosis is covered. But, obviously all insurance plans are different. Check with your insurance provider first before trying this.
Several therapists will also offer a free 15 minute consultation. While this isn’t enough for a full assessment and recommendation by the therapist, it could be enough for you to decide if you want to go ahead with a first session or not.
Lastly, research what other payment options there are if you do not have insurance that covers it. For example, state programs are in place to help victims of crime and abuse. College students may have discounted sessions provided to them at the university clinic. Sometimes local church clergy are willing to help. Some therapy clinics offer discounted rates for cash/out-of-pocket payments. I recognize that many clients still pay out of pocket and most don’t have different programs or people to help them out, but know that some do and you can research or ask your therapist if they know of any.
Look for Overall Big-Picture Patterns
When trying to determine if therapy is needed, look for overall patterns. Let’s say your child yells, “I hate my life.” What is the broader pattern? If your child yells that once every long while when they are really mad, but overall they are able to age-appropriately remain calm, enjoy playing, express happiness, and are acting “normal” then it probably isn’t a big deal (Emphasis on probably). However, if your child is also not as interested in hobbies, if they make comments or pictures or play involving dying, if their personality has changed and they are more withdrawn (lock themselves in room, or don’t interact as much) or are more irritable, or is displaying other concerning behaviors then it could be indicative of an overall pattern of depression. In this case I would recommend seeking help from a professional.
Does it Disrupt Your Life or Family Life?
This brings me to my next question: does the behavior disrupt your/their life? Does it disrupt family life? Is x big enough that life is just hard? Does the problem have a significant impact in an area of life? Using the above examples, if your child gets angry at a sibling a couple times a month, but overall your child is happy and siblings are happy, then it probably isn’t outside the norm of sibling relationships. But, if it is causing discord in your home and your other children are becoming scared or hurt, then it is definitely disrupting family life.
With the depression example, if you feel down in the dumps occasionally and it doesn’t disrupt your life too much then it probably isn’t too big of a deal. But, if these feelings are causing you to miss work or negatively impact your relationships because it’s too much effort to get out of bed, etc. then chances are it warrants seeking outside help.
It should go without saying that any behavior that is unsafe is cause for concern and professional help is recommended. Such behaviors include but aren’t limited to suicidal thoughts, self-harming, engaging in risky behaviors, and harming others.
What is the Frequency of the Behavior?
If you are concerned about a behavior, try figuring out how frequent it is. For example, is your child yelling at siblings and expressing that they hate their life once every several months? Or are they yelling they hate their life a few times a week and gets in intense fights with siblings very often?
The same goes for adults as well. If you feel down in the dumps and it’s hard to get out of bed about one day a month then it probably isn’t that big of a deal if the rest of the time you are able to go through life normally. (Again, emphasis on probably. Other things need to be taken into account). But, if it’s difficult to get out of bed a few times a week and this is impacting your daily life, then it might be wise to seek the help of a professional to get an assessment for Major Depressive Disorder or other mental illnesses.
What Else is Going On?
If you are trying to decide whether your child is exhibiting a typical or more concerning problem, try finding context for the behavior. What else is going on in your child’s life? Are they being bullied at school or has their support from friends never been better? Are they falling behind in their studies or do they love going to school every day? Is there stress in the home between parents or other siblings? Are they still involved in their hobbies or have they distanced themselves from that lately?
Talk to Others to Get Their Insights
It can be very helpful to get other people’s insights into your child’s behaviors. For example, school teachers often notice different behaviors and interactions that aren’t seen at home. This comes from being in a different environment with different people.
It’s often been said that being friends with your children’s friends is very helpful because then you can have a bigger pulse on what is going on in their friend group. I’ve known of teens who will talk to their friend’s mom because they’re concerned about their friend.
The same principle works for adults as well. If you are having difficulty knowing how you’ve been acting lately, ask your close family and friends. They will hopefully give you an honest opinion on what they see in you and if they think you could use a little extra help.
Is What You’re Doing Working?
There is a problem that needs solved. Most people are going to try different approaches to try to solve it. For example, you may read self-help books for yourself. For your child, you may put together a behavioral plan or read different books to try to talk through the issues. If these approaches are working and the problem is lessening, then awesome! Keep doing what’s working.
If, however, you’re at the end of your rope and can’t figure out how to approach the problem and solve it, then that’s probably a good indicator that it is time to seek outside help.
What If You Just Want to Talk?
If you feel like you or your child doesn’t meet the criteria for any diagnosis (such as a depressive or an anxiety disorder) but would still like to talk to someone then that’s okay! If you want your child to talk to someone about your divorce, even though they aren’t exhibiting any symptoms of anxiety or depression, then that’s all the more awesome. If you want to talk to someone to help get you through the holiday stress when your in-laws stay for 3 weeks then that’s wonderful! Just know that insurance probably won’t cover it and you’ll most likely be paying out of pocket.
What if You Tried Therapy and It Didn’t Work Out?
I like to think of therapy like schooling. In school, there are many different subjects. Some people love math and others complain about it until the day they die. Other people love English while their peers couldn’t care less. In therapy, there are many different research-backed theories that then translate into approaches therapists use to try to extend help. I have found that different clients like different styles and theories. So, if one theory doesn’t fit your personal style then try finding another approach to therapy.
In school, people have different opinions of teachers. Some people love Mr. Jones while others do not care for his teaching style. I learned that a friend did not like one of my all-time favorite college classes. The same goes with therapists. We’re just people, after all. If one therapist doesn’t work out then it doesn’t mean all therapists aren’t a good fit for you or your family. Try finding another therapist that may be more compatible with your style.
Also recognize that some therapists are more specialized in some areas than others. One therapist may be specialized in treating ADHD and Autism, but is not as competent in treating abuse.
To Sum It Up
None of these questions have definitive, yes or no answers. Knowing whether or not to see a therapist isn’t black or white. Hopefully these questions will give you food for thought and a greater understanding of how you can approach knowing when to see a counselor.
Disclaimer: This post is not intended to provide therapeutic services or offer an assessment for various challenges and mental health disorders. These points are not meant to be definitive or provide answers. Readers should seek the help of a licensed therapist if they are concerned about a psychological problem, cannot figure out how to overcome it themselves, and/or believe it is above typical behaviors and typical intensity of emotions.