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Kids are hurting.
Data shows mental health-related emergency department visits for young children have been rising during the pandemic. And more support for them isn’t easy to find.
Schools continue to struggle with teacher shortages as they navigate changing COVID-19 mandates. Parents are dealing with their own stresses and burnout, too.
Meanwhile, videos from Russia’s Ukraine invasion are filling TikTok feeds alongside warnings of climate change.
It’s a lot to process for anyone.
A majority of parents polled by Morning Consult in 2021 said there has been a change in their children’s mental well-being due to remote learning (62%) and pandemic social isolation (59%), according to a September report. Over 70% also said COVID-19 has impacted the well-being of their K-12 children.
Parents and caregivers who want to help their kids manage stress and anxiety might consider seeking a therapist, but how old should children be to benefit from therapy?
When is a child old enough for therapy?
The answer differs from case to case, says Ciera Schoonover, assistant professor of psychology at Middle Tennessee State University.
“It depends on what type of therapy we’re looking at, and what the presenting problem is,” she said. “If we’re talking about individual therapy for kids, that answer is going to be different.”
Most of Schoonover’s clients include families and children with disruptive behaviors, which include tantrums and consistently defiant behavior.
Intervention techniques, such as parent-child interaction therapy, are “used, established, identified for children as young as 2,” Schoonover said. There is also preliminary evidence that the treatment can be developed to treat children under 2-years-old.
Family therapies can even be helpful for babies who have experienced trauma or other adverse experiences, according to Melissa Whitson, professor of psychology and a child trauma expert at The University of New Haven in Connecticut.
In parent-child interaction therapy, says Whitson, “We don’t usually consider the baby or toddler being in therapy, but it is a form of counseling or therapy, because it’s for the family. Or it’s for the parent and caregiver to kind of help figure out ‘how do I soothe the child? How do I think about the special considerations based on their experiences?’ Things like that.”
Older children ages 3-to-5 are ideal candidates for play therapy, according to Whitson.
“Play therapy allows children who are able to use their imagination … process different emotions and different feelings or different memories through those play sessions,” she said. “But oftentimes, counselors or therapists will still want to meet with the parents alone or with the child for a small portion of the time, and then give the child some time to explore through play on their own.”
A 2019 article published in the journal “Innovations in Clinical Neuroscience” describes a play therapy session where a little girl chose to act out stressful situations in her personal life with dolls, even bandaging one’s arm to simulate her father’s injured shoulder.
When should you consider a therapist for your child?
Teachers, other caregivers and even other children are useful sources for feedback on a child’s behavior, according to Whitson.
“Sometimes it’s helpful to see how (a child is) with other kids (or) talk to their parents, ask teachers or caregivers who might be able to compare them with other kids,” in order to gage
emotions or feelings they may be struggling with compared to other children, she said.
Red flags include difficulty completing basic needs or daily activities, like eating or sleeping, trouble engaging with other kids or struggles maintaining friendships or getting along with siblings as children grow older.
“If you see after a stressful event that some of these problems or emotions are started–or differences in behavior–then that’s a cue that there might be some processing that needs help in terms of that stressful event,” Whitson said.
The child trauma expert says the pandemic has been a collectively stressful event across all age ranges. Other obvious events include schools going virtual and caregiver changes like divorce. Less obvious events might include the arrival of a new sibling, moving into a new home or anxiety about tests or grades, according to the American Psychological Association.
Schoonover advised that parents and caregivers should be on the lookout for behavior outside of the realm of what is normal.
“We’re going to think about, kind of clinically, ‘What is typical?’ But also we want to validate caregivers,” Schoonover said of evaluating a child’s behavior. “If (the parents are) seeing this as a problem, or if they’re concerned about it, then we want to meet them where they are and provide some support for them.”
“And maybe that support means explaining to them what is typical,” she continued. “Even if we aren’t at a diagnoseable level of problem behavior, then we might still provide some some intervention for parent management of difficult child behaviors.”
How to find a therapist
Schoonover said parents and caregivers may face long waiting lists for a lot of different providers depending on which part of the country they’re in.
“It’s one of the things that we in the field are struggling with; how to navigate this,” she said. “But one of the first strategies that I would encourage is talk to a primary care provider.”
Schoonover encourages caregivers to ask questions about available resources and seek in-network providers covered by their insurance policy.
Support and social groups also provide benefits to children of families without ready access to therapy, says Whitson. Examples include Zero to Three, the Beyond Consequences Institute and the National Center for Cultural Competence.
“It doesn’t always need to be one-on-one therapy. It can be some support groups, fun social groups that provide that kind of connection that frankly, just (isn’t) available for a lot of kids in lower income families (who) don’t have the means to access them,” Whitson said.
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