Therapy for Kids: How It Helps and When to Consider It

Therapy for kids is a structured way for children to learn skills for big feelings, stress, behavior and relationships, with a trained clinician guiding the process and parents usually involved. It can help with worry, sadness, grief, school problems and family changes. Consider it when concerns last for weeks, cause distress, or get in the way of home, school or friendships.

This guide is for parents, grandparents and other caregivers in Texas who are wondering whether counseling could help a child. It covers what child therapy does, signs to watch for, how to talk with your child, what to look for in a therapist and when to get help sooner.

What is therapy for kids?

Therapy for kids is talk-based or activity-based treatment designed for a child's age and stage. With younger children, sessions may use play, drawing or stories. With older children and teens, sessions often look more like conversation, practice and problem-solving.

The National Institute of Mental Health (NIMH) notes that rapport and trust are essential in psychotherapy. For children, that relationship often starts slowly, and it is normal for a child to need a few sessions to feel comfortable.

How does counseling help children?

Counseling helps children name feelings, practice coping skills and solve problems in ways that fit their age. It also gives parents tools to support those skills at home.

• Emotional regulation: learning to notice anger, fear or sadness and calm down.
• Coping with change: moves, divorce, new siblings, loss or illness.
• Social skills: making friends, handling conflict and speaking up.
• Thinking skills: catching worried or harsh thoughts and trying more helpful ones.
• Family patterns: improving routines, communication and consistency at home.

The Centers for Disease Control and Prevention (CDC) notes that cognitive behavioral therapy is used to treat anxiety and depression in children, often with parents involved. Our article on CBT for children explains that approach in more detail.

What are signs a child may benefit from therapy?

A child may benefit from therapy when changes last for weeks, cause distress, or interfere with daily life. NIMH advises seeking help when behaviors last weeks or longer and cause distress for the child or family.

• Ongoing sadness, irritability or tearfulness.
• Worry that keeps a child from school, sleepovers or activities.
• Frequent stomachaches or headaches without a medical cause.
• Big changes in sleep or appetite.
• Losing interest in friends, play or favorite activities.
• Frequent outbursts, aggression or trouble following rules at home or school.
• Difficulty coping after a loss, a scary event or a family change.

The CDC also lists irritability, trouble sleeping and physical complaints such as stomachaches among possible signs of anxiety or depression in children.

Can stressful or traumatic experiences affect a child's mental health?

Yes, stressful or traumatic experiences can affect a child's mental health, and counseling is one way to help a child process them. The CDC describes adverse childhood experiences (ACEs) as potentially traumatic events that happen between birth and age 17, such as abuse, neglect, witnessing violence, or growing up with household substance use or mental health problems.

Not every child who goes through something hard needs therapy. Many children recover with steady routines and supportive adults. A clinician can help you decide whether extra support makes sense.

How can parents take the first steps, step by step?

The first steps are gathering information, talking with people who know your child and asking for an evaluation. You do not need to be certain something is wrong before you ask.

1. Write down what you notice. Note when the behavior happens, how often, and what seems to trigger it.
2. Talk with your child's teacher or school counselor. Ask whether they see the same thing at school.
3. See your child's pediatrician. NIMH suggests the pediatrician as a starting point and to check for medical causes.
4. Ask for referrals. Your pediatrician, school or health plan may suggest child-focused clinicians.
5. Check fit before booking. Ask whether the clinician works with your child's age and concern.
6. Prepare your child. Use simple, honest words about what to expect.

The CDC notes that the first step in getting help is talking with a health care provider about your concerns.

What should you say to your child about therapy?

Tell your child about therapy in simple, honest and calm words, and present it as support rather than punishment. Children often take their cue from your tone.

• For a young child: "We're going to meet someone whose job is helping kids with big feelings. You can talk, draw or play."
• For an older child: "Lots of kids talk to a counselor when things feel hard. It's a place to figure stuff out, and you don't have to share everything right away."
• If your child is nervous: "It's okay to feel unsure. You can tell the counselor that, too."
• Avoid: "If you don't behave, you'll have to see a therapist."

These are example phrases. Adjust them for your child's age and personality. Our guide to preparing your child for therapy has more ideas.

What should you look for in a child therapist?

Look for a licensed clinician with experience treating children your child's age and the concern you are seeing, and who includes parents in a way that fits your family. NIMH lists questions to ask a therapist, such as what approach they use and how long treatment may take.

Use this checklist when you call or meet a clinician:

• What ages do you see, and what concerns do you most often treat?
• How will you involve parents or caregivers?
• How do you handle privacy with children and teens?
• How will we know if therapy is helping?
• How often will sessions be, and how long are they?
• Do you offer telehealth, and is it a good fit for my child's age?

The American Psychiatric Association notes that therapy sessions are typically held once every one to two weeks for about 30 to 50 minutes, and therapy can be short-term or longer-term.

Is telehealth therapy a good fit for kids?

Telehealth therapy can work well for some children, especially older children and teens, but it is not the right choice for every child or concern. The U.S. Department of Health and Human Services notes that telehealth may not be right for everyone or every condition.

Younger children may find it hard to stay engaged on a screen, while some teens prefer the comfort of home. If you try video sessions, choose a quiet, private room, test the device beforehand and agree on where a parent will be during the session. Ask the clinician whether in-person visits would be better for your child's age and needs.

How can parents support therapy at home?

Parents support therapy at home by practicing skills, keeping routines steady and staying in touch with the clinician. Progress is often faster when the whole family uses the same calm-down words or plans.

• Ask the clinician what to practice between sessions.
• Praise effort, not only results.
• Keep sleep, meals and screen time as predictable as possible.
• Take care of your own stress and support needs.

NIMH notes that when medication is part of a child's care, it is often combined with psychotherapy. For anxious children, our article on coping skills for children with anxiety offers practical ideas to use at home.

When should you get help for your child sooner?

Get help sooner if your child's safety is at risk or symptoms are severe or worsening quickly. NIMH advises families to seek help when concerns persist and cause distress, and some situations cannot wait.

• Talk about wanting to die, disappear or hurt themselves.
• Self-harm, such as cutting or burning.
• Hurting others or animals, or serious threats.
• Seeing or hearing things that are not there, or seeming confused.
• Refusing to eat, or rapid weight loss.
• Sudden refusal to go to school that lasts more than a few days.

In the United States, call or text 988 for crisis support, and call 911 for immediate danger. If you have a teen, our article on teen moodiness or depression may help you sort out what you are seeing.

What should Texas parents know about finding a counselor?

Texas parents can check a counselor's license and find local resources before booking. The Texas Behavioral Health Executive Council (BHEC) offers a public license lookup for licensed professional counselors, marriage and family therapists, psychologists and social workers.

2-1-1 Texas lists mental health clinic and counseling resources and can be reached by dialing 2-1-1 or 877-541-7905. Rules about minors' consent and privacy vary by state and situation, so ask any clinician to explain how they handle consent and confidentiality for children in Texas.

Getting support in Texas

Lyte Psychiatry offers therapy, psychiatric evaluation and medication management in Texas. The ages Lyte Psychiatry currently sees require confirmation, so please contact the practice before booking for a child. In-person visits are available at Lyte Psychiatry's clinic in Pantego, in the Dallas–Fort Worth area, and Lyte Psychiatry offers telehealth visits to patients who are physically located in Texas at the time of the visit.

All Lyte Psychiatry services are available in Spanish. Insurance, availability and clinician fit require confirmation. Lyte Psychiatry is an outpatient practice and does not provide crisis or after-hours coverage. Learn more about therapy or contact the practice with questions.

If you are in a mental-health crisis in the United States, call or text 988. Call 911 for immediate danger.

Educational information, not a diagnosis or individual treatment plan.