“Does My Child Need Counseling?” Liahona, February 2022
“Does My Child Need Counseling?”
Supporting children and youth with mental health challenges.
All photographs from Getty Images
For centuries, parents of children facing illness or trauma relied primarily on hope and prayer. Gratefully, we can now add better science, new parenting strategies, and professional resources to our hopes and prayers for our children’s healing, learning, and growth.
When a child struggles, parents often wonder who is at fault. The child? Their friends? The media? The other parent’s gene pool? Or (gulp) us?
When Christ healed a man born blind, His disciples also wondered who was at fault for the man’s condition, asking, “Who did sin, this man, or his parents, that he was born blind?” (John 9:2). The Lord answered, “Neither hath this man sinned, nor his parents” (verse 3). In other words, in this story, fault was not the issue. Similarly, when it comes to our children, let’s focus on helping them heal and grow.
We and the Lord play crucial roles in our child’s healing and growth. Four key questions can help us decide if mental health professionals might also have a role to play.
Four Questions
If you wonder if your child or teen needs counseling, ask yourself:
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Do they have
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troubling emotions (like worry, depression, anger, or shame);
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troubling ideas (like “God hates me” or “I caused the stock market crash”); or
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unexplained symptoms (like stomachaches, headaches, or trouble sleeping, focusing, or sitting still)?
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Have these difficulties gone on for more than a few weeks?
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Do these emotions, ideas, or symptoms interfere with how they function at school, church, work, or in relationships?
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Do you or others worry that your child feels suicidal?
First, if you answer “yes” or “maybe” to that last question, act now. (See accompanying sidebar “Assessing Suicidal Thoughts and the Temptation of Despair.”) Then, if you answer “yes” or “maybe” to the first three questions, keep reading.
The Four Questions in Action
Let’s consider an example of the four questions in action:
Imagine your daughter is Elizabeth, a delightful girl who usually loves life and loves to learn, but lately she complains tearfully that she hates school. She has had several stomachaches and trouble sleeping. She has always been impulsive and a little spacey, but now she drags her feet or simply forgets chores or homework without repeated reminders. Even if she starts her homework, soon she is doodling on it instead of completing it. Her teacher says Elizabeth is clearly smart but often doesn’t turn in her work, requires lots of reminders to stay on task, and blurts things out that make the other kids laugh at her.
In response to questions 1 and 2, then, we see that Elizabeth struggles to pay attention and stay on task both at home and at school and that these behaviors aren’t getting better. She is irritable and teary and has physical symptoms of excessive stress. Question 3 helps us see that Elizabeth isn’t functioning very well at school, at home, or with friends. Fortunately, question 4, about suicide, isn’t an issue in this case.
So, is Elizabeth dealing with anxiety? depression? diabetes? bullying? an attention deficit? (See accompanying sidebar “Attention Deficit Hyperactivity Disorder.”) Something else? If your love, teaching, and patience are not helping her function much better, medical and mental health professionals can help you clarify the problem and access resources to help her.
What Can I Do?
Before, during, or after any professional involvement, there is much you and your spouse can do at home to help your child while you sort things out. For example:
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Pray for guidance. Listen. Act on impressions you receive.
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Keep loving and delighting in your child. Point out her strengths. Catch her doing things well.
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In a calm and friendly way, ask about her thoughts and feelings and listen with the intent to understand. Comfort, support, and work together on a plan. (See accompanying sidebar “Three C’s for Talking with Children.”)
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Keep working at basic habits and routines at home to help your child regulate emotions and learn good habits.
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Ask your child’s schoolteachers and Primary or youth leaders about her functioning at school and church. Consult with your parents, siblings, ministering brothers and sisters, or Relief Society or elders quorum president for ideas and resources.
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Explore relevant podcasts, online screening tools, and books, making sure they are from reputable mental health professionals and based on solid, mainstream science.
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Make an appointment with your family doctor or pediatrician to rule out physical causes.
If your child is still hurting and not functioning well after several weeks, a mental health professional may be able to help. Ask to have your child evaluated by the school psychologist (at no charge), or see if your medical insurance (or savings) might pay for a private evaluation by a child psychologist. They can then provide recommendations, and public schools can provide extra resources.
Early counseling, skill building, and medication (if an option) are usually more effective together than alone at helping children’s brains and bodies function better—hopefully before children conclude they are just dumb or unlikable.
What about Teens and Young Adults?
The four key questions above also apply to teens and young adults, with whom we usually have less control and whose choices have bigger consequences. That can leave us feeling more anxious, making the ability to communicate all the more valuable, both for our young family members and for ourselves. (See “Three C’s for Talking with Children.”) Let’s practice:
Imagine your son Tanner, age 17, is starting his last year of high school. Tanner is a responsible student, a kindhearted friend, and a good athlete. He’s also quiet around adults, spends a lot of time alone in his room, will do anything to avoid giving talks at church or school, and flatly refuses to go to stake dances or youth conferences. Since turning 17, Tanner gets quiet or changes the subject when a mission comes up, even though you know he used to plan on one. When asked directly, he says he can’t imagine how he would make it through two years of talking to strangers every day, especially in a foreign country.
Going back to the four questions, what do you observe? (1) Tanner does have troubling emotions, thoughts, or symptoms. (2) You have noticed these symptoms recently, but he’s always been shy. (3) He functions well enough to get good grades, play sports, and have friends, and nobody is good at everything. (4) You can ask directly if Tanner has friends who talk about suicide and if he ever gets that down, but there are no obvious signs of despair. (See accompanying sidebar “Assessing Suicidal Thoughts and the Temptation of Despair.”)
However, let’s add one more question, especially for teens and young adults moving into adulthood: Is Tanner learning the skills to work through painful emotions or setbacks and resiliently pursue his goals or dreams?
Hmm. Maybe not. He seems to lack skills for managing his anxiety enough to pursue relationships and resiliently pursue goals he cares about. It will be hard to have a happy, meaningful adult life without those skills.
Anxiety and Depression
Anxiety disorders are now the biggest mental health challenge for teens and young adults, with depression a close second. Both have increased substantially in the digital age, especially during the last two years of global uncertainty. (See accompanying sidebar “Is the Digital World Making Us Anxious?”)
Not only do adolescents and young adults face increased stress and demands, but they have more access to “self-medicating” substances and screens that can interfere with learning healthier coping skills and resilience. Extracurricular activities, dating, a mission, and college are great ways to grow, but Tanner seems to have too much anxiety and not enough skills to tackle these options. Counseling now may help him learn to calm his emotions and become more resilient.
How could you talk this over with Tanner? Going for a drive or a walk is a good time to bring up what you’ve observed, always remembering to be calm, curious, and compassionate. (See accompanying sidebar “Three C’s for Talking with Children.”) Start with what you’ve observed: that he avoids giving talks, speaking to adults, or meeting new people. Ask what that’s like for him. Does he feel more anxious or depressed than he’d like? What has he tried? What else could he try? Perhaps he could find an online screening tool for anxiety, listen to a podcast, request a priesthood blessing, or pray about it and talk again tomorrow. How could you best support him? How will he decide if it is time to get more help, and what might that “more help” include? Pray together, and express confidence in him with love and a smile.
Our children may not be the best version of ourselves we secretly thought we could raise them to be. We may not be the perfect parents we assumed we could be. But as we are calm, curious, and compassionate with ourselves and our children, they can learn to be that way with themselves and trust that the Lord will be as well.