How do you know if your child needs psychological help?

“Your child needs help” they said.  “Something is not right with him” they said.  “Maybe you should take her to see someone”. 

That’s all very easy for other people to say, but how do they know?  How do you know if your child has a problem and if your child does have a problem? How do you find the best person to help them? Surely it takes more than just “seeing someone”?

How do you know when your child might need help?

Yes, there are some days when we could all use someone to talk to about our worries, fears or problems and children are no exception!  In terms of taking your child to see a psychologist, there is a general rule of thumb that can assist.  If your child’s problem has persisted for some time and is starting to get in the way of them having a happy and regular life, then it might be time to consider getting them (and you) some extra help.

For a child, a happy and regular life usually means that they sleep, eat, go to kinder/school, have fun with friends, maybe they are involved with a class or group outside of school and generally do what they are told (most of the time).  Things that might indicate that something is not right could include trouble regularly attending school, taking far too long and far too many companion toys and glasses of water before going to sleep at night, melting down at the idea of a sleep-over or school camp or suddenly they are not meeting the expected targets with their school work or their behaviour takes a change for the worse. If a child is in danger because of how they feel or what they are doing, your priority should be to get them help straight away.

What does a psychologist do?

A psychologist’s job is to help with emotions, learning and behaviour.  Psychologists use scientific research to understand how people think, feel and behave and to help them fix personal problems.  They can help to diagnose and treat mental health problems, learning issues or challenging behaviours and relationships.  Psychologists can work in hospitals, community health centre, for welfare agencies and in private practice.

To help a child with a problem, a psychologist needs to get to know a lot about the child, their experiences and the situation.  They need to ask personal information and keep it confidential.  In essence, the practice of good psychology is all much easier to do if the psychologist can make your child feel comfortable and retain professionalism.  You and your child and maybe even your child’s school, need to be able to form a good working relationship. 

So, how do you find the psychologist who is right for you?

The Australian Health Practitioner Regulations Agency (AHPRA) is responsible for regulating many health professionals in Australia.  The Psychology Board of Australia assists AHPRA to regulate the practice of psychology and protect the community by making sure practice guidelines are kept by registered psychologists.  Psychologists must be registered with the Psychology Board of Australia to practice psychology (by practice I mean to engage in the art and science of applying the theories of behavioural science to a person’s problem – I don’t mean that they are still working on trying to get it right).  If someone is not registered with AHPRA/PBA, then they are not legally allowed to practice psychology in Australia.  You can check a psychologist’s registration status, their qualifications and their endorsements (additional qualifications and supervised practice in a certain type of psychology) on the AHPRA website.

Like many professions, psychologists in Australian have a professional body that represents its members’ interests.  The Australian Psychological Society (APS) is a group that psychologist can join to help them stay abreast on what is happening in psychology in the country, to assist with keeping up to date with new findings and to lobby the government or other authorities about psychological issues.  Members of the APS pay an annual membership.   Membership of the APS is voluntary and psychologists don’t have to be a member of the APS In order to practice psychology in Australia.  The APS has a “Find a psychologist” service, but members also have to pay to use this service and there are many psychologists who choose not to use it.  The “Find a psychologist” service is largely for private practitioners so it does not tell you about all the psychologist in your area who might be working in a hospital, community health centre or in a school.

Your general practitioner may know the psychologists in your area.  Paediatricians and psychiatrists usually have a good idea about the psychologists who work with young people in their area. I always like to think that people could ask their doctor, paediatrician, psychiatrist, school principal or teacher...“If it was your child, which psychologist would you want them to see? “

Better still, call a few psychologists in your area and have a talk with them about what they do and how they do it.  You will need to ask about the costs of meeting with a psychologist.  Your doctor should be able to tell you whether any rebates apply to psychology fees.

You might also want to ask the psychologist about their qualifications.  The qualifications and requirements for being a registered psychologist have changed a bit over the years.  There are psychologists who have doctoral or masters level degrees from universities and some psychologists who have gained some of their qualifications from university and from learning in the field.  Some psychologists will have additional qualifications and experience in certain areas. 

Psychology is a growing profession and the research and information about the most helpful ways to assist others and it is important that a psychologist stay up to date. AHPRA/PBA keeps track of psychologists’ additional qualifications and they also check whether psychologists are keeping their skills up to date. 

 
 Shona’s tips

Parents and Carers – Don’t be frightened or put off by suggestions that your child get some help.  You know your child. Listen and watch them and spend time with them in the places or at the times when the issues seem to be biggest.  If you do decide to see a psychologist for your child, you may want to see the psychologist on your own first.  (You’ll need to check whether a session without the child is eligible for any rebates because this is sometimes a tricky area with funding bodies). Seeing the psychologist alone can mean you can talk without little ears hearing your worries.  Alternatively, ask the psychologist if you can have some brief time alone with them before the child joins you for each session. If you are still not sure about the type of help that would be best, you can always call Parentline or its equivalent in your State.

Teachers – It helps to encourage a family to engage with a psychologist if you can tactfully explain what you are seeing that concerns you.  It can help if you find out a few psychologists in your area that may be able to assist so that the family has less leg work to do to engage with a psychologist.

Psychologists and Helpers – Make sure you take time to welcome young people to your service with an age appropriate greeting.  Don’t try too hard to be “hip and jiggy with it”.  Children can tell when you are faking it or trying too hard and this can be off-putting.  Make sure you have some age-appropriate reading material in the waiting area and also that you have some “things and stuff” to visually demonstrate concepts.  Children don’t usually sit down opposite a grown up to talk. Be prepared to take some time to play or engage and explain what is going to happen. 

Kids – Seeing a psychologist doesn’t mean that you are looney or crazy. You would probably be surprised to know how many of your friends have seen someone else outside family and school to help them with different problems.  You may never know which of your friends is already seeing a psychologist because psychologists are good at keeping that information to themselves.  It’s not something they want to blab about.  You can find out more about what it might be like to see a psychologist by visiting http://kidshealth.org/kid/feeling/emotion/going_to_therapist.html. 

 

 

Kids These Days - What's Going On Out There?

Every day, the phone rings at our psychology practice with a range of calls about children with problems.  Parents, carers, doctors, psychiatrists, paediatricians, teachers and welfare workers all call about children that need help.  We get calls about tots, teens and "tweens".

Looking at the types of calls coming through can tell us a bit about what is going on for kids out there these days.  The health and happiness of our children is a great measure of how we are doing as a society.  So, if children aren't healthy and happy, what are the things that are not working for them?  What is it they need?

In no particular order, here is a broad sample of our current, most common, requests to help young people and some ideas about what these problems tell us about children's needs.  Please keep in mind that the enquiries we have won’t include the huge number of wonderful things happening for children in the world.  Remember, in a psychology practice, we are always going to see a skewed sample. It’s the nature of our business.

• Anxiety – There are so many things in the World you could be worried about.

When we see children who are anxious or frightened, it tends not so much to be about the fear of the dark or the bogey men anymore.  It seems to be more of a generalised sense they have that the world is a dangerous place.  Children might reflect the anxieties of their grown-ups. For some children and their families there is so much heightened arousal about the world and their role in it.   There is so much that can go wrong or so much that you might get wrong – exams, fitting in, missing out.  The child is convinced they need to be constantly prepared for catastrophe. 

Children need a balanced view of the world – sometimes it is beautiful and sometimes it is tragic – always has  been and, likely, always will be.

• Friendship and loneliness issues – from bullies to heart break. 

A number of children present with significant sadness and worry about having no friends, feeling left out or being avoided by other who used to be friends.  Some have broken hearts - not necessarily of the boyfriend/girlfriend type, but more about the abandonment of previously held friendships. Some of these children have autism and developmental problems and need help with skills.  It is so easy for some children to give up and stop trying to make friends because they can get so caught up in what’s wrong with them that they just don’t see how much of them is perfectly fine. 

Children need connections.

• Family breakdown – Can you really hate your ex more than you love your child?

The time and effort that ex-partners can put into hating each other is astounding.  It is tough to see a child who loves both parents being torn because the parents are at war with each other.  It’s great to know that many separated families can do an exceptional job or raising a child across two homes, but the Family Court is still busy with the couples who have a situation so complex, that the child or children miss out on so much of what is needed to be settled, healthy and content.   Long and extended Court battles over custody seldom bring out the best in grownups.

Children need grownups who put their needs ahead of their hate for the ex-partner.  They certainly don’t need to hear what an awful person Mum thinks Dad is or vice versa.

• Self harm – Trying to find ways that can soothe when life gets hard

Self harm - cutting, burning or injuring yourself - has spiked in referrals in recent years and can be complex to understand.  Ironic as it sounds, some of the presenting self harm issues are attempts to soothe when life gets too hard.  Sometimes talking and posting about your self harm is a way to belong with a large online community - an attractive proposition to the otherwise lonely.  The more recent trend in referrals to treat self harm include younger children in their late primary school years. Self harm is something that needs a proper, professional assessment.

Generally speaking, children need to be encouraged to speak up about their problems to attentive adults and to learn how to soothe themselves without the need for inflicting pain on themselves, or others.

• Child maltreatment and trauma – Oh, how I would love to live in a world where children could grow up without early exposure to abuse or neglect. 

Brain research is now showing us the biological and long term impacts of child maltreatment on young brains and the protective factors that abound when there is healthy early attachment to a predictable and loving grown up. Attention problems, hyperactivity, anxiety, depression, anger and difficulties regulating emotions and behaviours can all stem from abuse and neglect.  Mum and Dad may love you, but they may also be what I call “parentally-challenged”.  Their substance abuse issues, working hours, or their priorities about keeping up with the Joneses can trump time at home with the children.  These days neglect can also mean long hours spent on the internet or gaming devices without supervision or without someone to tell you to go to sleep or eat some breakfast.

Children need safety, affection, attention and boundaries.

• The cyber world – faster, broader, easier to access, difficult to monitor, but the way of the future.

At the nuisance level, children (and indeed adults), can have trouble moving from a most preferred activity to a least preferred activity – asking a child to get off the computer can sometimes cause a huge reaction. There can also be a gap between what Mum and Dad know and what children are actually exposing themselves to online. At the more sinister end is the exploitation of young ones who inadvertently click or swipe their way into a dangerous liaison.  There is also a trend to seeing more young people in trouble with the Law for sharing too much of themselves, or too much of their boy/girlfriend, with others. On the other hand, there are not too many school rooms with chalk boards these days – chalk boards may as well be stone tablets etched Fred Flintstone style. Connection to the cyber world is a really important part of current educations and learning.

Children need to be exposed to the cyber world because it will continue to be a large component of their lives and future lifestyles.  However, children need someone on yard duty in the cyber playground!

• Access to substances – using alcohol and illicit substances can make the dumb decisions sometimes expected in adolescence, even dumber! 

It would be great if we knew that children were never going to be exposed to substances that could harm them.  Some of the most harmful substances are the ones that are legal and  used often in the household.  While the brain is still growing, it needs to be sheltered form additional toxic chemistry associated with alcohol and drugs.  The thrill seeking that naturally accompanies adolescence means that often alcohol and substance use is combined with fast cars and other potential dangers.

Children need to learn about harms and their risk-taking in age appropriate ways and to feel supported to make a brave, smart decision even though it may be unpopular with their friends.

• Perfectionism and body image – Eat (or starve), sleep, school, repeat.

While eating disorders remain some of the most dangerous mental health problems amongst young people, there is also an insidious amount of perfectionism sneaking into to the belief systems of our younglings.  Some young people can freeze or melt down at the thought of making a mistake or not getting an “A” on an assignment.  They are driven to make tighter and tighter rules and higher benchmarks for themselves to avoid an ever present fear of letting someone down or not being good enough.

Children need to know that it’s human to make mistakes and to know that they are already so very loveable.  There is also a need for children to understand the importance of balance and healthy fun with good friends.
 
So, the issues that children bring to their psychological treatment reflect a lot about what is going on in our society.  Child safety and the need for affectionate and warm relationships with grownups are still paramount. Their current issues show difficulties adapting to, and getting the most out of, our fast paced and changing society without compromising themselves.  Children need healthy and safe grownups and lots of opportunities for connecting and communicating with others to help them find their way.

Shona’s tips

Everyone - It’s really important to remember that there is always going to be more right with a child than wrong with them.  When we help, we need to consider what is happening with their developing biology and brain and their thinking and beliefs, but also their home, their school, their friends and the society that they live in.