How Parents Can Tell What's "Normal Teen Stuff" Versus an Issue that Requires Therapy

A question I get from parents a lot will involve describing a teen's behavior - like moodiness, irritability, or sleeping a lot - and asking if this is them "just being a teenager" or if it's deeper than that and may require therapy. Every kid is different, but here are a few questions that might be able to guide you towards an answer:

• Do their symptoms cause a change in their daily functioning in school, with peers, or in activities they enjoy? For example, did they used to love playing soccer, but all of a sudden lost interest? Or they used to spend every afternoon with friends but now stay home alone in their room instead? Examples like this point to a bigger issue than just "teen stuff."

• Is there a safety issue involved, like self-harm or suicidality? If there is a safety issue, you should always seek professional support.

• Have you asked them directly if they feel depressed, anxious, or that they need more support? Hint: if they say "I don't know" to any of these (instead of a direct "no") then it usually points to a "yes."

• Have other people like their teachers or friends mentioned changes in them? Sometimes this can point out things that occur in other environments that you have less access to, indicating that an issue is bigger than you recognize.

• Do they have anything that they look forward to (whether they say this or not), or does everything make them irritable or upset? If no, this could potentially signify depression or anxiety.

• Do they have anyone who they feel comfortable talking to about what's going on with them - a friend, coach, teacher, other family member, etc. - or are they keeping it all in to themselves? If no, then they may benefit from an outlet for their emotions and any questions they have or support they need.

If any of these questions hit home, it may mean that your child could benefit from therapy. At the very least, a child therapist can be an objective third party to figure out if therapy really is the right solution or if there's other things that your teen could benefit from. If you could use some support with any of the above, schedule a free 15-minute consult with me today.

What is the Difference Between a School Counselor and a Child Therapist?

This is a really great question, and since I have been a school counselor, a school director, and a child therapist, I can provide some clarity.

A school counselor's role depends on your specific school. Some have academic counselors, where their primary role is to focus on academic planning, like what courses you need or how to apply to college; whereas other schools do have therapists or social workers. The difference between a school counselor and a child therapist in private practice, like me, is that typically school counselors get kids referred to them by teachers or school administration for issues that happen within school, and their job is to set goals around student behavior and school performance. For example, if a kid is having behavioral outbursts just within the classroom, a school counselor is a great fit for this; however, if kid is primarily having these outbursts at home, it's likely outside of school counselor's role. If your kid gets assigned to an evaluation to see the school psychologist, this is likely to evaluate for further educational support services, which can include special education, and can lead to either a 504 plan or an individual education plan (IEP), which are different levels of documented accommodations for your kid's learning and mental health that the school has to follow.

If your concerns about your kid are primarily within school, like their grades are dropping or they're having social skill issues with peers there, then the school counselor is a great fit for this; however, if any of these issues also present at home, like their grades are dropping because they're experiencing depression and they stay in their room all night and they’ve also lost interest in all outside activities, this is when a child therapist can be beneficial. A school counselor's role can feel limiting to only having kids on their caseload whose goals revolve around school activities; for example, a goal could be: "child will learn 2 new coping skills to use when talking in front of the class in order to reduce anxiety." A child therapist can be a bit more flexible; I can create goals like that for school plus nuanced ones for home, and also meet with the kid's teachers, parents, coaches, and outside family members, to ensure a holistic integration of these goals throughout a kid's entire life.

If you're not sure which one your kid could benefit from, I would start by reaching out to your school counselor or administration and ask what their service options are - for example, do they run groups, can they take on anyone to their individual caseload or is it limited, etc. - and then I would schedule a consult with a child therapist in order to compare services. Both child therapists and school counselors just want your kid to be thriving, happy and healthy; I will be very honest with you if I think that a school counselor is a better fit for your kid's needs than I am. Navigating these systems can be really complicated; if you’re a parent who could use some support to figure out what your child could benefit from, reach out to schedule a consult with me today.

How to Make Your Home a Safe Space for Kids to Talk About Their Mental Health

Every kid is different, but all kids need to know that their caregivers and homes are safe places for them to explore and express their mental health needs. Here are a few DOs and DON'Ts of creating a safe home to talk about mental health with your kids:

DO:

1. Talk about your own mental health in a way that is open and destigmatized, but with boundaries: This means using statements like, "I'm feeling a bit anxious today, so I'm going for a walk so that I can regulate my body because I know that helps me."

2. Ask wellness-specific questions based on age:

• "How did your heart feel after that happened?"

• "It's really common to feel upset after a friend says something like that, how did that make you feel?"

• "Taking a test can feel really stressful, do you ever feel that stress in your body? Where do you feel it?"

3. If you notice examples of people you know or characters on TV showing difficult behaviors, use compassionate language to point it out:

• "They sound like they are really struggling right now."

• "It looks like they could use some support. If you felt like that, what do you think would be helpful to make you feel better?"

• "That situation looks really hard, have you ever felt like that before?"

DON'T:

1. Don't use mental health terms as casual insults:

• "She's so up and down all the time, it's like she's Bipolar or something!"

• "He's a mess, he needs therapy."

• "I'm so glad you're not like that."

2. Don't use terms like "lazy" or "useless" if you notice your kid is low-energy or avoiding a task. Instead, replace that with a more proactive term like:

• "You seem tired, are you sleeping ok? What would give you the energy you need to complete this?"

• "I've noticed you've had a hard time getting motivated lately, is something going on? Is there anything I can help with?"

3. Don't use your kid as your friend or sounding board to fix your mental health needs:

• For example, saying "Sometimes I'm so depressed I don't even know what to do, and it feels like it's never going to get better." This can overburden your kid, and should be directed at a partner, friend or therapist.

• Instead, model how to talk about it in a safe way while showing that you are doing what it takes to manage your own mental health, so that your kid knows you can still manage their needs and they do not need to take care of yours. For example, "I've been feeling a little down lately, so I decided to see a therapist, which has really been helping me because it's a safe place to talk about it. Now I know that even if I feel down, I can still have perspective and do important things like getting to be your parent."

If you want to create a safer space to talk about mental health with your kids but aren't sure where to start, schedule a free 15-minute consult with me to see if I can support you and your family's needs.