Just prior to her son Grayson entering third grade, Dana Sachs’* alarm bells started ringing.
“Grayson was saying things like, ‘I’m sad and I don’t know why.’ Or sometimes, ‘I just want to blow up everyone,’” says Sachs. “Parents tend to downplay our kids’ moods and emotions, but this was extreme.”
When Grayson repeatedly begged for a birthday party and then retreated to his bedroom during the event, Dana realized that whatever was going on with her son was not only heartbreaking, but serious and beyond her ability to address.
Sachs began the process of searching for the right mental health professional for Grayson. Experts agree that, like Sachs, parents should start looking for the right professional, even if they are unsure of what’s wrong.
“If you’re concerned enough to be wondering if you should call someone, you should call someone. Trust your instinct,” says Dee Dee Woodman, a licensed professional counselor in Wheat Ridge who specializes in adolescent development and depression, and who has done extensive work with victims and families of the Columbine tragedy. “It never hurts to inquire.” Here are suggestions to help your search.
When to Make the Call
If you know that some traumatic event has occurred—an accident, loss, divorce, violence, or molestation—or you see the sudden onset of a behavior like bedwetting, isolating, self-harm, or tantrums, seek help. Don’t wait for things to escalate.
If fear or anxiety affects your child’s school attendance or social relationships, or is centered on a specific person or situation, those are red flags, too. Other concerns might be sudden or drastic mood swings, talking about self-harm or violence against others—particularly when combined with mental illness or chemical imbalances in your family history.
Sometimes even doctors will minimize your concerns, says Lina Smith,* a mom of two children with ASD (autism spectrum disorder), who have faced mental health and social challenges. “There are a lot of well-meaning people who will tell you not to worry and that your child is fine…but you have to push and advocate for your child when you know something is not right,” urges Smith.
Where to Start
There is no quick and easy path to the right professional for your child, but these tips can help you move forward.
• Start with your family doctor. It’s not unusual for behavioral issues to have a physical or biochemical cause. Your doctor can either confirm and treat, or rule out these causes, and then guide you in next steps. Ask your family doctor for a list of trusted mental health professionals. Even if you don’t go with one they suggest, it’s a good place to start.
• Check your insurance coverage and providers, advises Jennesa Yanez from Community Reach Center, a mental health agency providing intensive in-home services. “In-network is easier financially, but just because a provider is in-network doesn’t mean all services are included. Make sure to check,” she says.
• Ask people you trust. Sachs sought referrals from her close friends and her church. Families who have faced similar challenges can share their experiences and hard won wisdom. School guidance counselors are also a great resource. Get several referrals.
• Conduct interviews. “A phone call will tell you a lot. Do you feel like the therapist listens, asks good questions, is attentive to your concerns, and interested in your child? Trust your gut,” advises Angela Dancer, a professional counselor who specializes in working with children with anxiety and behavior issues, often as a result of trauma. See below for a list of questions to ask.
• Take advantage of free initial consultations that some therapists offer, advises Yanez. She adds that sometimes it takes checking out multiple people to make sure that you feel like you have a good match with a therapist.
• Don’t rely solely on internet searches. If you are looking for a specialized program, search online, but as a general rule, Google is not the place to find a therapist. Good therapists stay busy through word of mouth and referrals and build their practice through credibility, not marketing.
Before pursuing a therapist for Grayson’s situation, Sachs had experience working with pastoral and lay counselors. “But in this instance, it felt important that Grayson’s therapist be highly qualified and have extensive experience with kids,” Sachs says. As you search, keep in mind that Colorado’s requirements for practicing therapists are somewhat looser than many other states.
For example, the term “counselor” is not protected in the state of Colorado, meaning that someone can practice as a counselor without required training or credentials. The benefit is, you have more options, but this also requires you to do more research.
“There are incredibly gifted therapists who are registered but not fully licensed,” explains registered psychotherapist Wendy Valentine. “As long as they are registered, they have oversight and are accountable to DORA.”
DORA, the Department of Regulatory Agencies, holds any registered therapist or counselor in Colorado accountable to certain protocols and practices. Beyond that, though, there are many shades of gray. For example, a licensed professional counselor (LPC) has a master’s degree and has completed a required number of supervised hours for licensure. Someone with a master of arts in professional counseling (MAPC) also has a master’s degree but no license and less supervision. A psychologist has a doctorate but is not an MD. Only a psychiatrist or psychopharmacologist can prescribe medication.
A thorough explanation should be provided to you upon your initial consultation, so read carefully and ask questions about anything that is unclear regarding training and credentials. Also, a responsible therapist should refer you on if they cannot address your needs. But, ultimately, you as the parent will always be your child’s first advocate.
Choosing a Good Match
While a professional’s specialization is important, Dancer advises that “the relationship and the connection with your child is more important. You’ll know within a few minutes of talking to someone if it’s a good match.”
Make sure the person is passionate about working with your child’s age group and, whenever possible, find someone who specializes in working with your specific condition or issue.
“If your child is under 10 years old, definitely choose someone who is trained in play therapy,” says Woodman. “Also, find out what they have in their tool belt. Training in multiple modalities can be helpful when you’re not sure what’s causing the problem.”
Most important, remember that while you should have good rapport, the match is with your child. He or she needs to have agency in order to be invested in the outcome, so involve him or her in all initial consults and selection. That way, the first session will be less intimidating.
Bridgette Soekoe explains that when a therapist isn’t a good match, progress won’t be made. “After being molested by my friend’s dad, I was put into therapy with a male psychologist just because he was on our insurance and came highly recommended, but it was horrible. It made the whole thing worse,” Soekoe says. She simply told that first therapist what she thought he wanted to hear until she could stop seeing him, and find a female therapist.
Preparing for Your Visit
Smith suggests approaching a mental health visit as you would a traditional doctor visit. “Be bold. Never allow embarrassment or stigma to keep you from reaching out,” reminds Smith. “If your child was sick you wouldn’t hesitate taking him or her to the doctor for fear of being viewed as a bad parent. Getting help is being a good parent.”
It’s helpful to present therapy to your child in these terms: Just like we see a doctor when our body is sick, we also see a doctor when we feel sad, or scared or anxious. But there are no shots.
No one knows your child better than you, so the more information you gather, the better. Prepare a list of concerns, document behaviors and family history; bring any educational evaluations, classroom reports, and medical records. Be persistent.
Grayson’s mental health issues have taken him on a journey through many therapists and modalities. As a young adult now, he still struggles. But Sachs’ early responsiveness and persistence prepared and taught him to continue to tackle his challenges with honesty and courage.
Guiding Questions to Ask a Therapist
- What is your background and training for working with children?
- How do you include parents in therapy and how often?
- Do you collaborate with teachers, doctors, or guidance counselors?
- What is your approach to medication?
- How long does a child typically work with you?
- May I speak to a family with whom you have worked?