Child behavior woes? Therapist can help

Does my child need help?

Yes, I have a couch in my office.

No, I don't analyze your 4-year-old's dreams.

Yes, I have an office full of toys.

No, seeing me does not mean your child is going to be placed on Ritalin.

Over the years, I have been asked many questions about the type of work that I do with children. Many people have some understanding of what goes on in a therapy session as an adult, but may not know what a child psychologist or therapist might do. There continues to be a needless stigma for so many people who consider seeking treatment for mental health.

Child psychologists provide a variety of services to help improve the lives of children and families. We can conduct testing to identify learning problems, attention difficulties, cognitive delays, giftedness and emotional challenges. This can be critical to understanding challenges and deciding on appropriate interventions or strategies.

Therapy or counseling with children varies, depending on age, the child's development and the types of challenges a child may experience. In most cases, therapy with young children is going to involve parents. As I tell parents, there is no magic in the words I might speak to your child. Each parent brings to the office his or her own expertise on their child. As professionals, we bring knowledge and experience. Along with the child, we can collaborate to come up with the best approach.

Most of the time, when you are referred to a psychologist for your child, the first meeting is with parents. This enables us to get a full history and provide consultation on areas of concern. We are looking at the child's social, cognitive, academic and emotional functioning. We may provide strategies to try at home even before seeing your child. In other situations, we will invite the child to the next appointment.

Whether you are 5, 15, 35, or 55 years old, the foundation of a successful experience with a therapist is going to be the strength of the therapeutic relationships. Clients need to feel safe and accepted to engage in the process in a productive manner. So our offices are filled with toys, games, crayons, markers, dollhouses, puppets and items that help children feel comfortable and express themselves in developmentally appropriate ways.

My rule of thumb is, the younger the child, the more parent or family work will likely be done. The good news with behavioral challenges is that many concerns may be normal and outgrown as the child develops. As preschool children experience physical growth spurts, they also can have emotional ones as well. Weeks of defiant behavior can often work itself out on its own or with a few changes in parenting techniques. However, for some children the problems continue and do not respond to traditional strategies.

I am often asked when the right time to seek help for behavioral or emotional difficulties is. There is no simple answer. According to most diagnostic categories that psychologists utilize, symptoms need to last at least six months. Beyond diagnosis, if a child or family is experiencing trouble that seems to be intense, or if there is an issue of the child's safety, it never hurts to talk with somebody.

For certain types of challenges, such as autistic spectrum disorder, early intervention can be crucial. I spend time on the phone each day with parents discussing certain behavior or emotions their children are displaying. Sometimes, a quick conversation with the child's pediatrician or nurse can help determine what is normal or not, and if professional help is necessary at this time.

As they say in school, "No question is a dumb question." Better to ask then to wait for a bigger issue to develop.