Choosing a Child Therapist: Your Questions Answered

It is heartbreaking to see your child struggling.

But when you’ve hit that point of “I just don’t know how to solve this problem,” or “I need some help!” choosing a child therapist can seem like an overwhelming task.

If this is you, trust that you are not alone.

In a post-COVID study of over 3,500 US parents of children under the age of 18, their top worry was their child’s mental health, over violence, drugs, and pregnancy (Minkin & Horowitz, 2023).

So where do you start your search for therapy for kids near you? What type of therapy would your child need? How do you select the best child therapist for your situation?

We understand the turmoil, and for that reason, this article will answer your questions and help you choose the right fit for your child. We start with a monster of a question: “Does my child need therapy?”

Before you continue, we thought you might like to download our three Positive CBT Exercises for free. These science-based exercises will provide you with detailed insight into positive Cognitive-Behavioral Therapy (CBT) and give you the tools to apply it in your therapy or coaching.

Does My Child Need Therapy?

Every one of us with children has probably asked this question at some point. After all, our kids change every day. Our babies experience separation as they go off to childcare. We watch in amazement as our preschoolers play out complex emotions and negotiate relationships in pretend play. We know our teenagers are experiencing all the firsts that come with time spent away from us.

Every child experiences new friendships, unexpected hardships, and well-earned successes; some we know about, but most we do not. How can we figure out if their clinginess, moodiness, or rule breaking are simply important challenges that will help them grow or if they signal difficulties associated with their mental health?

This is not a question you are expected to tackle alone.

Do some digging

It is empowering to ask questions and share your concerns with others who know your child, know their friend group, or who have training in child development.

• Ask your child’s teacher, “What does my child’s behavior look like in the classroom? Is it interfering with their learning or making friends?”
• Ask the parents of your child’s friends, “What do you see when the kids are hanging out together?” They may have experiences to share that are new to you.
• Ask your pediatrician, “Do you see this behavior as typical or cause for concern? Describe signs I should look for.”

Dig in to reputable web-based resources about child mental health. Many have resources specifically for parents:

• National Alliance on Mental Illness – Kids, teens, and young adults
• American Academy of Pediatrics – Mental health resources for families
• National Institute of Mental Health – Children and adolescent mental health
• American Academy of Child & Adolescent Psychiatry – Facts for families

The answers you get from your data gathering can make it easier to get out of your head and into problem-solving mode.

According to the National Institute of Mental Health (2021), working with a mental health professional may be beneficial for your child if the behavior you are concerned with:

1. Persists for more than a few weeks
2. Causes distress to your child or other family members
3. Make it hard for your child to function as usual at home, at school, or with their friends

Check out this infographic for signs and symptoms in younger and older children that may show when to seek help.

Also consider this helpful resource from the American Academy of Pediatrics: How to Talk About Mental Health With Your Child and Their Pediatrician.

What Types of Therapists for Children Are There?

If you consider therapy for your child, take comfort in knowing there are a range of professionals trained specifically to work with children.

Select a therapist who is licensed, which requires at least two years of post-graduate education. The license ensures they have the training to work as a mental health professional and have received supervision to practice.

Counselors, clinicians, therapists, and social workers

Depending on the region where they’re practicing, these titles are commonly reserved for individuals who have earned at minimum a master’s degree in a mental health-related field. Each has been trained to evaluate a person’s mental health and provide therapeutic treatment. Social workers have additional training in case management and advocacy.

The most common titles and credentials to look for in your search for a licensed therapist include:

• Licensed professional counselor
• Licensed mental health counselor
• Licensed marriage and family therapist
• Licensed independent clinical social worker
• Licensed clinical social worker
• Academy of Certified Social Workers

Each of these professionals are qualified to work with children. They may simply differ in their training, experience, and approach.

Psychologists and psychiatrists

A licensed psychologist may be recommended by your therapist or pediatrician if psychological testing is needed as part of your child’s treatment. A licensed psychologist holds a doctoral degree (PhD. or PsyD) in clinical psychology or a related subfield such as school or counseling psychology. They are trained in psychological diagnoses and may also practice therapy.

A psychiatrist holds a medical degree and has specialized training in psychiatry. They can prescribe and manage medication and may have additional training to support therapy goals.

Therapists, psychologists, and psychiatrists often work as a team to provide comprehensive care. For example, if your child experiences a complex mental health issue, a licensed psychologist may provide appropriate evaluations and diagnoses.

This information informs treatment and intervention plans for the therapist. A psychiatrist may be seen to prescribe and manage medication. A social worker may help secure additional services and coordinate your care.

When selecting a therapist, ask, “If my child needs additional resources such as assessment, medication, or specialized therapy, who do you work with? How do you communicate with one another about my child?”

Now you know what to look for in a qualified therapist, but how do you know what kind of therapy will work for your child?

What Kind of Therapy Does My Child Need?

This is the fun part. Countless clinicians and researchers have dedicated their life’s work to developing and testing evidence-based assessments, treatments, and interventions designed specifically to improve mental health in children.

Each therapist will have their own approach to treatment and a variety of therapeutic tools to use based on a child’s specific needs. Factors they consider include your child’s age, family environment, personal experiences, diagnoses, developmental level, symptoms, and goals.

When selecting a therapist, ask them to describe their approach to treatment. “Which evidence-based treatments do you use? Describe your experience with children like mine.”

Scientific research supports evidence-based treatments.

Telehealth

There has been a rapid transition to telehealth by mental health professionals since the COVID-19 pandemic (Pierce, Perrin & Tyler, 2021). Telehealth is the remote delivery of health care, usually online using videoconferencing through a smartphone or tablet. It is not unusual to find therapists who offer only telehealth appointments.

In adults, video-conferencing psychotherapy is shown to be effective in reducing symptoms of depression (Berryhill, Culmer et al., 2019) and anxiety (Berryhill, Halli-Tierney et al., 2019), with no statistical differences between in-person and videoconferencing groups.

In children post-COVID, there is evidence that telehealth is feasible and effective for delivering interventions to treat Autism Spectrum Disorder (de Nocker & Toolan, 2023).

There are pros and cons to telehealth. If transportation and childcare make in-person therapy difficult, telehealth can be a lifesaver (Berryhill et al., 2019). However, telehealth may not be possible if access to reliable internet and technology is a barrier for your family (Ramsetty & Adams, 2020).

When selecting a therapist, ask, “Are your appointments and treatment offered in person or through telehealth? How should I prepare for a telehealth appointment? What if we find telehealth is not a good fit for my child?”

Play therapy

Talk therapy is appropriate for adolescents and adults who have the ability to think abstractly. To use language to reason about feelings, complex problems, and motivations in what Piaget would describe as operational thinking (Piaget, 1952).

However, young children do not think in abstract concepts required for talk therapy and do not have the verbal skills to support this type of thinking until age 10 or older (Kool & Lawver, 2010).

Young children think by using symbols beginning around age two. They use mental images, objects, and actions to represent that which is not present or able to be seen (Piaget, 1952). A banana is a phone, a shark is a bad guy, a drawing can represent their family.

Children communicate through their play, and toys are their words (Landreth & Bratton, 1999). Play therapy uses children’s play in a therapeutic context.

During play, children hold the power and control they lack in their day-to-day interactions. This power allows children to work through their fears, beliefs about themselves, anger, and shame without negative consequences that would occur in real life (Kool & Lawver, 2010).

One role of the play therapist is to create a play environment where the child feels safe to play out their big emotions without fear or frustration and with complete acceptance by the therapist (Kool & Lawver, 2010).

Play therapy is an evidence-based treatment widely used with children aged 3–10 years who are experiencing behavioral, emotional, social, or relational issues. Many mental health treatments for children include some form of play therapy (Bratton et al., 2005). It is suitable for children with autism spectrum disorder (Francis et al., 2022) and attention deficit hyperactivity disorder (ADHD) (Abdollahain et al., 2013).

In this video, play therapist Dr. Brenna Hicks explains why child-centered play therapy is so effective for children and how it differs from talk therapy used with adults.

Familiarize yourself with different approaches to Play Therapy: What Is It and How Does It Work?

Interested in using play therapy at home with your child? Visit the Play Therapy Parenting Podcast to scroll through episodes about topics ranging from TikTok to divorce.

Parent–child interaction therapy

Parent–child interaction therapy (PCIT) is an evidence-based treatment to improve disruptive behaviors in children aged 2 to 7 years by improving parent–child interactions (Lieneman et al., 2017).

During a PCIT session, a therapist behind a one-way mirror communicates secretly with the parent through an earpiece while they play with their child. Parents are coached in the moment on how to talk and interact with their child to increase child compliance and positive behaviors and decrease their own frustration (Herschell et al., 2002).

Telehealth-delivered PCIT (iPCIT) uses videoconferencing technology with a mobile device as the therapist coaches parents in real time by video rather than in person. iPCIT is an evidence-based treatment for effectively treating behavioral issues in children with disruptive behavior disorder and developmental delays (Ros-DeMarize et al., 2021, Bagner et al., 2023).

Find a PCIT therapist in your area.

Behavioral therapy

Behavior therapy uses behavior modification to increase the behaviors you want to see in your child and reduce unwanted behaviors. Behavior therapies are used to treat a wide variety of problem behaviors in children and adolescents. Many mental health treatments for children include some form of behavior therapy.

Behavioral parent training (BPT)

BPT programs are designed specifically to teach parents skills to manage their child’s behavior, such as structure, consistent consequences, and to have realistic expectations. BPT programs differ in content depending on the age of the child and their symptom severity.

Applied behavior analysis (ABA)

ABA is individualized therapy to teach communication, social, self-regulatory, and pre-academic skills. When used with younger children, it is called early intensive behavioral intervention. ABA is an evidence-based treatment for autism spectrum disorder.

Cognitive-Behavioral Therapy (CBT)

CBT is a short-term treatment to teach children and adolescents to change unhealthy patterns of thinking. A therapist helps a child identify harmful thought patterns and replace them with thinking that is healthy and adaptive. CBT is effective in treating disruptive behavior disorders, depression, anxiety, and post-traumatic stress disorder (Donnelly & Amaya-Jackson, 2002; McCart & Sheidow, 2016; Oud et al., 2019; Sigurvinsdóttir et al., 2020).

Trauma-focused CBT (TF-CBT) is an evidence-based treatment option for children and adolescents who have experienced trauma (Pollio & Deblinger, 2017). Watch this video describing TF-CBT for children aged 3 to 18.

Therapy for kids with ADHD

Being a parent of a child with attention deficit hyperactivity disorder (ADHD) can be challenging. Therapy that focuses on improving your relationship with your child, alongside managing disruptive behavior, can be extremely motivating.

For children under the age of 6, the American Academy of Pediatrics recommends behavior therapy as a first line treatment for ADHD (Wolraich et al., 2019). Your therapist may recommend an evidence-based behavior training program. Two of the most effective and flexible parenting programs are The Incredible Years and Triple P (Positive Parenting Program).

Both programs are tailored to meet the different needs of parents and their young children from 0 to 12. Each can be delivered as telehealth and have been used with culturally diverse families. Triple P Teen is designed to meet the specific needs of teens with ADHD.

Watch this video of a mother’s experience using Triple P online with her son.

EndeavorRx™ is a digital therapeutic to treat ADHD in children aged 8–12. It is an immersive video game experience on a mobile device used alongside your child’s treatment plan. It has been cleared by the US Food and Drug Administration and requires a prescription from a health care professional. Hear families describe their experience with EndeavorRx™ in this video.

For children 6 and older, the American Academy of Pediatrics recommends a combination of behavior therapy and medication. Teacher-led behavioral classroom management is recommended to support positive behaviors in the classroom and improve academic engagement.

Check out this infographic on what to expect from behavior therapy for children with ADHD.

Also view this infographic for finding a therapist for your child with ADHD.

Therapy for kids with autism

Every child with autism spectrum disorder (ASD) experiences their own strengths and challenges. Children with ASD may also experience additional medical and co-occurring behavior problems. If you are a parent of a child with ASD, your child’s treatment plan will be designed around their specific needs.

Both applied behavior analysis (ABA) and developmental social-pragmatic (DSP) interventions are well established as evidence-based therapies for children with autism (Smith & Iadarola, 2015).

Applied behavior analysis for ASD

ABA therapy views ASD as a learning difficulty. ABA interventions use rewards such as praise or a preferred toy to teach target behaviors that are useful in everyday life (e.g., play, communication, and social skills).

Individual comprehensive ABA intervention is led by a trained therapist and comprises 20–40 hours of therapy a week for two to three years starting at age 5. It can be implemented in the home or in the classroom.

Developmental social-pragmatic (DSP)

DSP therapy views ASD as difficulties with joint engagement with others. Interventions teach parents and teachers to be responsive to social behaviors initiated by the child (e.g., imitating, expanding upon, and joining in on the child’s play). The caregiver provides DSP intervention in the home in coordination with a trained therapist and/or in the classroom by a trained teacher.

This guide is useful to evaluate treatment options for your child with ASD based on their age, co-occurring conditions, and desired outcomes.

What to Do If Your Child Refuses Therapy

What if your child says they don’t want to go to therapy or tells you they want to stop therapy?

Strategies will depend on your child’s developmental level and their specific mental health needs.

Clear up misconceptions

For older children, ask why and then listen. Older children may be worried about their privacy. Children may not know what a therapist is or what to expect in therapy. Younger children may think a therapist is like a doctor and have fears of shots or procedures. For children of all ages, explain what a therapist can and cannot do and describe what will happen during therapy.

Give your child more power

Therapy should not seem like a punishment. Sometimes children will refuse because they feel they are being forced or have no choice about therapy. In these situations, empower your child by involving them in the selection process.

Share with your teen how you feel and ask for their input. For example, “I don’t want you to feel this way,” or “I feel like I don’t know all the answers. Do you think it would be helpful to talk to someone besides me?”

What to do in a crisis

If your child is self-harming or feeling suicidal, then mental health support is critical. Establish firm boundaries. In a crisis situation, call or text 988 (in the United States). A trained crisis worker will answer the phone to provide support and get you the help you need. The 988 Lifeline is free, confidential, and available 24/7. Call emergency services if your child is in immediate danger.

For other countries:
UK: Samaritans hotline at 116 123
The Netherlands: Netherlands Suicide Hotline at 09000767
France: Suicide écoute at 01 45 39 40 00
Australia: Lifeline at 13 11 14
Germany: Telefonseelsorge at 0800 111 0 111 or 0800 111 0 222

For a list of other suicide prevention websites, phone numbers, and resources, see this website.

How to Choose the Best Child’s Therapist Near You

Use the following directories to get started in your search for a child therapist near you. You can search by location then narrow your search by practice area, insurance, credentials, and more.

Once you find a few potential matches, go to their actual practice website. You will find detailed information about their practice, how they deliver therapy, other practitioners they work with, telehealth interventions they may offer, and much more to help you narrow down your selection.

• American Psychological Association Therapist Locator
• Psychology Today Find a Therapist
• GoodTherapy.org

A Take-Home Message

It will take time and effort to find the best therapist for your child. Be prepared that it may take a few sessions with someone before you know if they are the right fit. If they are not, it is completely acceptable to discontinue treatment and pursue a different therapist.

Get comfortable with the feeling that you may never know with certainty the answer to “Does my child need therapy?” because it isn’t a yes or no question. Human behavior and experiences are complex and always changing. Even the most savvy parent is not expected to have all the answers.

If you are still uncertain and interested to learn more about child mental health from a parent perspective, check out NAMI Basics. It is a free, six-session online educational course for parents. The program covers child mental health symptoms, choosing a therapist, types of therapies, real-life experiences of parents, advocating for your child at school, and much more.

We hope you enjoyed reading this article. For more information, don’t forget to download our three Positive CBT Exercises for free.

Ed: Updated July 2023