How do I know if my child needs therapy?

It's a few weeks into the new school year. Your child is struggling to settle back in, and you're wondering: rough patch, or the start of something more? Here are the questions I ask parents in this situation.

What are you noticing?

Is an easygoing kid dragging their feet about school, or melting down over things that never used to faze them? Is your social butterfly spending a lot more time alone? Are there complaints about stomachaches, headaches, or trouble sleeping? Or maybe it's what they're saying about themselves — “All the other kids are smarter than me.” And often it's just your parenting sixth sense that things aren't quite right.

What triggered these changes?

You may not know. An obvious event might explain it: a friendship ending, being bullied, harder homework. Or it's been building quietly, with no single moment behind it. Or there's no clear answer. Your child may be reluctant to share or may not fully understand the shift themselves.

How long has this been happening? How often?

We're looking for patterns. A couple of hard mornings isn't necessarily a red flag. But if you're seeing concerning symptoms for more than two weeks, that's a meaningful signal — not proof of a problem, but a real invitation to look closer.

Where to go from here

The pediatrician, school counselor, or therapist can all be good places to start. One can rule out physical causes. Another can tell you how your child is doing with peers, in the classroom, at lunch and recess. And a child therapist can explore what's underneath the behavior — helping you and your child understand the feelings driving the upset. Each conversation answers a different question, so the right starting point depends on what you're noticing.

You know your child better than any checklist ever could. None of these conversations is a wrong move, and none of them is a last resort. Trusting what you're observing, and following up on it, is a meaningful way to be there for your child.