The Moment Every Parent Dreads

Your child just told you they want to die. Or you found the cuts on their arm. Or they’re having a complete breakdown and you don’t know how to help. Or they just took a bottle of pills. Your heart is pounding. Your hands are shaking. You don’t know what to do. Every second feels critical. You need help. Now. This article is your emergency guide—the numbers to call, the resources available, the steps to take when your child is in a mental health crisis. Save this. Screenshot it. Print it. Put it somewhere you can find it immediately. You hope you never need it. But if you do, it’s here.

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What Qualifies as a Crisis

A mental health crisis is when your child: ✓ Is actively suicidal with a plan ✓ Has attempted suicide or self-harm requiring medical attention ✓ Is having a psychotic episode (hallucinations, delusions, complete break from reality) ✓ Is a danger to others ✓ Cannot be kept safe at home ✓ Is experiencing severe panic or dissociation and cannot function If you’re unsure whether it’s a crisis, call a crisis line and ask. Better to overreact than underreact.

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Immediate Crisis Resources

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988 Suicide & Crisis Lifeline

Call or Text: 988 What it is: Free, confidential, 24/7 crisis support by phone, text, or chat. Trained counselors help people in suicidal crisis or emotional distress. When to use:

• Your child is having suicidal thoughts
• Your child is in severe emotional distress
• You’re worried about your child and need guidance
• You need support navigating a mental health crisis

What happens:

• You’re connected to a trained crisis counselor
• They listen, provide support, and help de-escalate
• They can help create a safety plan
• They can connect you to local resources
• They do NOT automatically send police (only if there’s immediate danger and you request it)

Available in Spanish: Press 2 after dialing 988 For Deaf/Hard of Hearing: Use your preferred relay service or dial 711 then 988 Website: 988lifeline.org (also has online chat)

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The Trevor Project (LGBTQ+ Youth)

Call: 1-866-488-7386 Text: “START” to 678-678 Chat: TheTrevorProject.org/get-help What it is: 24/7 suicide prevention and crisis intervention for LGBTQ+ young people (ages 13-24). Why it matters: LGBTQ+ youth are at significantly higher risk for suicide. Trevor Project counselors are trained specifically in LGBTQ+ issues. Available 24/7.

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Crisis Text Line

Text: “HELLO” or “HOME” to 741741 What it is: Free, 24/7 crisis support via text message. When to use:

• Your child prefers texting over talking
• You can’t talk on the phone (noisy environment, privacy concerns)
• Panic attacks or anxiety make talking difficult

What happens:

• You’re connected to a trained crisis counselor via text
• They text back and forth with you
• Completely confidential

Available for both youth and parents.

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National Alliance on Mental Illness (NAMI) Helpline

Call: 1-800-950-NAMI (6264) Text: “NAMI” to 741741 Hours: Monday-Friday, 10 AM – 10 PM ET What it is: Information, resource referrals, and support for individuals and families affected by mental illness. When to use:

• You need help finding local resources
• You need information about mental health conditions
• You need support navigating the system
• You need someone to talk to who understands

Not 24/7, but incredibly helpful during business hours.

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National Suicide Prevention Lifeline (Veterans Crisis Line)

Call: Press 1 after dialing 988 Text: 838255 Chat: VeteransCrisisLine.net For veterans, service members, and their families.

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SAMHSA National Helpline

Call: 1-800-662-HELP (4357) What it is: Treatment referral and information service for individuals and families facing mental health and/or substance use disorders. Available 24/7, 365 days a year. When to use:

• You need help finding treatment
• You need information about mental health services
• Your child has co-occurring substance use

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When to Call 911

Call 911 if: ✓ Your child has attempted suicide ✓ Your child has taken an overdose ✓ Your child is actively trying to harm themselves and you can’t stop them ✓ Your child is threatening violence toward others ✓ Your child is having a medical emergency related to mental health (seizure, unconscious, severe self-harm)

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What to say: “I need help with my child who is having a mental health crisis. [They’ve taken an overdose / They’re actively harming themselves / They’re threatening suicide]. We need immediate medical assistance. If possible, please send Crisis Intervention Team (CIT) officers.” Emphasize:

• It’s a mental health crisis, not a criminal situation
• Request CIT officers (specially trained in mental health)
• Mention any weapons in the home
• Give clear address

What will happen:

• Police and/or ambulance will arrive
• They’ll assess the situation
• If your child is determined to be a danger to themselves/others, they’ll be transported to an emergency room
• This can be traumatic, but it’s necessary when safety is the immediate concern

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Important consideration for BIPOC families: Police involvement carries additional risks for Black, Indigenous, and People of Color. If possible, use 988 or mobile crisis teams first. But if immediate danger exists, don’t hesitate to call 911.

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Mobile Crisis Teams

What they are: Teams of mental health professionals who come to your location during a crisis (like mental health 911). When to use:

• Your child is in crisis but doesn’t need medical intervention
• You want professional help without involving police
• Your child needs assessment and de-escalation

How to access:

• Call 988 and ask if mobile crisis is available in your area
• Google “[your county] mobile crisis team”
• Call your local mental health center

What happens:

• Team comes to your home (or wherever the crisis is)
• They assess the situation
• They provide de-escalation and support
• They connect you to services
• They determine if higher level of care is needed

Availability varies by location. Not available everywhere, but expanding rapidly.

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Emergency Room

When to go:

• Your child has self-harmed and needs medical attention
• You cannot keep them safe at home
• They’ve taken an overdose (even if they seem “fine”)
• They’re actively suicidal and you can’t de-escalate
• They’re having a psychotic episode
• 988 or mobile crisis recommends it

What will happen:

1. Triage: You’ll be seen by intake nurse who will assess urgency
2. Medical evaluation: If they’ve harmed themselves or taken something, medical treatment first
3. Psychiatric evaluation: Mental health professional will assess
4. Possible admission: If they’re determined to be a danger to themselves, they may be admitted to a psychiatric unit

What to bring:

• Insurance card
• List of current medications
• Any relevant medical/psychiatric records you have
• Phone charger
• Comfort items (if they’re calm enough)

Important: ER psychiatric care is often not ideal (long waits, chaotic environment), but it’s necessary when safety is the immediate concern.

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Crisis Stabilization Units

What they are: Short-term residential facilities (3-7 days) where your child can stay during a crisis. Middle ground between ER and home. When to use:

• Your child is in crisis but doesn’t need ER-level care
• They need 24/7 supervision for a few days
• Home environment isn’t safe right now
• Step-down from ER or alternative to hospitalization

How to access:

• Call 988 and ask about crisis stabilization in your area
• Contact your local mental health center
• Google “[your county] crisis stabilization unit”

What happens:

• Voluntary admission (usually)
• 24/7 supervision by mental health staff
• Medication management
• Crisis counseling
• Discharge planning and connection to ongoing care

Availability: Not available in all areas.

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Warmlines (Non-Crisis Support)

What they are: Peer support lines for when you need to talk but it’s not a crisis. When to use:

• You’re stressed but not in immediate danger
• You need someone to talk to
• You need support between therapy sessions
• Late night and feeling anxious/sad but safe

National Warmlines:

• NAMI Warmline Directory: nami.org/warmline
• State-specific warmlines: Search “[your state] mental health warmline”

Many states have youth-specific warmlines.

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Online Resources

Crisis Text Line (listed above)

IMAlive (Online Crisis Chat)

Website: iimalive.org What it is: Online crisis chat staffed by trained volunteers. Available 24/7.

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Teenline

Call: 310-855-HOPE (4673) or 800-TLC-TEEN (852-8336) Text: “TEEN” to 839863 Hours:

• Call: 6 PM – 10 PM PT daily
• Text: 6 PM – 9 PM PT daily

What it is: Teens helping teens. Hotline staffed by trained teen volunteers (supervised by licensed professionals). For teens who might feel more comfortable talking to a peer.

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YouthLine (Oregon-based but available nationally via text/chat)

Call: 877-968-8491 (Oregon only) Text: “teen2teen” to 839863 (National) Chat: theyouthline.org/chat Hours: 4 PM – 10 PM PT Peer-to-peer support.

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Resources by Specific Situation

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Self-Harm

S.A.F.E. Alternatives Website: selfinjury.com Call: 1-800-DONT-CUT (366-8288) Information, resources, and support for people who self-harm and their families.

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Eating Disorders

National Eating Disorders Association (NEDA) Helpline Call: 1-800-931-2237 Text: “NEDA” to 741741 Chat: nationaleatingdisorders.org Crisis support, information, and treatment referrals.

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Substance Use

SAMHSA National Helpline (listed above) Substance Abuse and Mental Health Services Administration 1-800-662-HELP (4357) Treatment referrals, information, support.

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Sexual Assault

RAINN (Rape, Abuse & Incest National Network) Call: 1-800-656-HOPE (4673) Chat: online.rainn.org 24/7 support for survivors of sexual assault.

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Domestic Violence

National Domestic Violence Hotline Call: 1-800-799-SAFE (7233) Text: “START” to 88788 Website: thehotline.org 24/7 support for people experiencing domestic violence.

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Human Trafficking

National Human Trafficking Hotline Call: 1-888-373-7888 Text: 233733 24/7 support and referrals.

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Runaway Youth

National Runaway Safeline Call: 1-800-RUNAWAY (786-2929) Text or Chat: 1800runaway.org 24/7 crisis intervention and referrals for runaway and homeless youth.

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What to Do BEFORE a Crisis

Preparation makes crises more manageable.

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1. Create a safety plan with your child

(See Safety Plan article in “For a Loved One” section—same principles apply) Include:

• Warning signs
• Coping strategies
• People to contact
• Professional resources
• How to make environment safe

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2. Know where your local ER is

• Know the address
• Know the route
• Know if they have a psychiatric unit

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3. Save crisis numbers in your phone

• 988
• Crisis Text Line: 741741
• Local mobile crisis team
• Your child’s therapist/psychiatrist
• Trusted family/friend who can help

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4. Know your insurance coverage

• Does your insurance cover ER visits?
• Psychiatric hospitalization?
• What’s your copay/deductible?

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5. Have a crisis kit ready

In one bag/folder:

• Insurance card
• List of medications
• Medical history
• Psychiatric records (diagnoses, recent evaluations)
• Contact info for therapist/psychiatrist
• Emergency contacts
• Phone chargers

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After the Crisis

Once immediate danger has passed:

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1. Follow-up care is critical

Your child needs:

• Follow-up with therapist within 24-48 hours
• Possible medication adjustment
• Increased level of care (IOP, PHP, hospitalization if recommended)
• Updated safety plan

Don’t just “go back to normal.” The crisis was a sign that current treatment isn’t sufficient.

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2. Debrief

With your child (when they’re stable):

• What triggered the crisis?
• What helped?
• What do they need going forward?

With your support system:

• Process your own feelings
• Ask for help

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3. Take care of yourself

You’ve just been through trauma.

• Talk to your own therapist
• Lean on support system
• Rest
• Give yourself grace

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What You Need to Remember

✓ 988 is the main number to know—call or text for any crisis ✓ Mobile crisis teams and crisis stabilization units are alternatives to ER/911 ✓ Have crisis numbers saved in your phone before you need them ✓ Create a safety plan before a crisis happens ✓ Follow-up care after a crisis is critical Crises are terrifying. But help exists. You’re not alone. Resources are available 24/7. When your child is in crisis, you’ll know what to do. Because you’ve prepared. And because help is just a phone call away.

The Truth You Don’t Want to Admit

You haven’t slept through the night in months. You can’t remember the last time you did something just for yourself. Your own doctor’s appointment has been rescheduled three times. You’re eating whatever’s fast and requires no thought. You haven’t seen your friends in weeks. When someone asks how you’re doing, you say: “Fine. I’m fine.” But you’re not fine. You’re running on fumes. You’re holding it together with duct tape and willpower. You’re one bad day away from falling apart completely. And when someone suggests you “take care of yourself,” you want to scream. Take care of myself? When? How? With what energy? My child is in crisis. I don’t have time for self-care. Here’s what no one tells you: If you don’t take care of yourself, you will break. And when you break, you can’t help anyone. Self-care isn’t selfish. It’s survival. This isn’t about bubble baths and face masks (though those are nice). This is about the minimum requirements for you to keep functioning without completely destroying your mental and physical health in the process.

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Why Parents Ignore Their Own Needs

Let’s name the reasons you’re not taking care of yourself:

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1. Guilt

“How can I focus on myself when my child is suffering?” You feel selfish for even thinking about your own needs.

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2. Time

“I literally don’t have time. Every minute is spoken for.” True. Your schedule is packed. But that’s exactly why you need to create time.

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3. Energy

“I have nothing left to give. I’m too exhausted to even think about self-care.” You’re running on empty. Self-care feels like one more demand.

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4. Belief it won’t help

“What’s a yoga class going to do when my kid is suicidal?” You’re right—a yoga class won’t cure your child’s mental illness. But it might keep you from burning out.

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5. Martyrdom

“I’m a parent. My needs come last.” You’ve internalized the belief that good parents sacrifice everything.

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All of these are understandable. And all of them will destroy you if you don’t challenge them.

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The Cost of Ignoring Self-Care

What happens when you don’t take care of yourself:

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Physical health deteriorates:

• Sleep deprivation
• Weight gain or loss
• High blood pressure
• Weakened immune system (you get sick constantly)
• Chronic pain (headaches, back pain)
• Increased risk of serious illness (heart disease, stroke)

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Mental health deteriorates:

• Depression
• Anxiety
• Burnout
• Compassion fatigue (you stop caring because you have nothing left)
• Irritability and anger
• Difficulty concentrating

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Relationships deteriorate:

• Snapping at your partner
• Withdrawing from friends
• Impatient with all your children
• Resentment toward struggling child

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Your ability to help deteriorates:

• Poor decision-making (you’re too exhausted to think clearly)
• Overreacting to situations
• Inability to stay calm in crisis
• Missing important details
• Can’t advocate effectively

When you’re running on empty, everyone suffers—including the child you’re trying to help.

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Reframing Self-Care

Self-care is not:

• Selfish
• Indulgent
• Optional
• Something you do “when you have time”

Self-care is:

• Maintaining the minimum requirements to function
• Protecting your capacity to help your child long-term
• Modeling healthy behavior for your children
• Preventing burnout
• Survival

Think of yourself as a car. If you never refuel, never get oil changes, never do maintenance—you will break down. And when you break down, you can’t drive anyone anywhere. Self-care is maintenance, not luxury.

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Minimum Viable Self-Care

Forget the Instagram version of self-care (spa days, elaborate morning routines, hour-long workouts). This is minimum viable self-care—the bare minimum you need to not completely fall apart.

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Category 1: Physical Basics

Sleep

Minimum requirement: 6-7 hours per night (ideally 7-8) Why it matters: Sleep deprivation impairs judgment, emotional regulation, immune function, and physical health. You literally cannot function without sleep. How to get it: ✓ Go to bed at the same time every night ✓ Limit caffeine after 2 PM ✓ No screens 30 minutes before bed ✓ If your child’s sleep is disrupted, take turns with your partner (one parent handles nights Mon-Wed, other handles Thu-Sat) ✓ If you’re a single parent and child wakes frequently, ask family/friend to do occasional overnight respite ✓ Consider short naps (20 minutes can help) If you’re not sleeping, nothing else works.

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Food

Minimum requirement: Three meals a day that aren’t just coffee and whatever your kid didn’t finish Why it matters: Your brain needs fuel. Skipping meals leads to blood sugar crashes, irritability, poor concentration, and low energy. How to do it: ✓ Keep easy, nutritious foods on hand (protein bars, yogurt, pre-cut veggies, rotisserie chicken, frozen meals) ✓ Meal delivery or grocery delivery (if affordable) ✓ Cook once, eat multiple times (make a big batch on Sunday) ✓ Lower your standards (a sandwich is a meal) ✓ Eat WITH your child at mealtimes (model healthy eating, plus you won’t forget) You don’t need gourmet. You need fuel.

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Movement

Minimum requirement: 15-30 minutes of movement most days Why it matters: Exercise reduces stress hormones, improves mood, improves sleep, and gives you energy (counterintuitive but true). How to do it: ✓ Walk around the block (you can do this even when exhausted) ✓ YouTube workout videos (15 minutes at home) ✓ Dance in your kitchen ✓ Park farther away and walk ✓ Involve your kids (family bike ride, hike) It doesn’t have to be intense. It just has to happen.

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Medical care

Minimum requirement: Go to your own doctor/dentist appointments Why it matters: You can’t help your child if you’re sick. How to do it: ✓ Schedule appointments now (don’t wait until you have time) ✓ Treat them as non-negotiable (you wouldn’t skip your child’s appointment, don’t skip yours) ✓ Ask partner or family to cover while you go

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Category 2: Mental/Emotional Basics

Therapy for yourself

Minimum requirement: Individual therapy for you Why it matters: You’re dealing with chronic stress, possibly trauma, definitely burnout. You need someone to process this with. How to do it: ✓ Find a therapist (see resources in previous articles) ✓ Telehealth makes this easier (can do from your car, your bedroom) ✓ Weekly or biweekly sessions ✓ This is not optional If cost is a barrier: Sliding scale therapists, community mental health centers, online therapy platforms.

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Emotional release

Minimum requirement: A way to release emotions regularly Why it matters: You’re holding so much. If you don’t release it, it will come out sideways (snapping at people, physical symptoms, breakdown). Options: ✓ Cry (actually cry, don’t hold it in) ✓ Journal (even 5 minutes of brain dump) ✓ Scream in your car ✓ Punch a pillow ✓ Talk to a friend who gets it Emotions are energy. They need somewhere to go.

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Boundaries

Minimum requirement: Saying no to some things Why it matters: If you say yes to everything, you’ll collapse. How to do it: ✓ “No” is a complete sentence ✓ “I can’t take that on right now” ✓ “I need to check with my partner/check my capacity and get back to you” ✓ Let go of non-essential commitments (PTA, volunteering, hosting events) You’re in survival mode. Act like it.

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Category 3: Connection

Support system

Minimum requirement: At least 2-3 people you can be honest with Why it matters: Isolation makes everything worse. You need people who can hold space for you. Who: ✓ Partner (if you have one) ✓ Close friend (who won’t judge or give unsolicited advice) ✓ Family member ✓ Support group (NAMI, online communities) ✓ Therapist How to use them: ✓ Be honest: “I’m not okay. I’m really struggling.” ✓ Ask for what you need: “Can I just vent?” or “Can you help with X?” ✓ Let them help: Don’t refuse when people offer You cannot do this alone. Stop trying.

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Your relationship (if partnered)

Minimum requirement: 5 minutes of connection per day Why it matters: Your relationship is the foundation. If it falls apart, everything falls apart. How to do it: ✓ 5-minute daily check-in (How are you? What do you need?) ✓ One date per month (even if it’s sitting in the car talking) ✓ Say thank you (for things your partner does) ✓ Physical touch (hug, hold hands, sit next to each other) ✓ Couples therapy (if needed) Your relationship doesn’t have to thrive right now. It just has to survive.

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Category 4: Joy/Meaning

One thing you enjoy

Minimum requirement: One small thing per week that brings you joy Why it matters: If your entire life is crisis management, you’ll burn out. You need something that reminds you life can still be good. Examples: ✓ Read for 20 minutes ✓ Watch a show you love ✓ Listen to music ✓ Garden ✓ Craft/create something ✓ Call a friend ✓ Take a bath It doesn’t have to be big. It just has to be something.

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Perspective

Minimum requirement: Something that reminds you of the bigger picture Options: ✓ Gratitude practice (name 3 things you’re grateful for before bed) ✓ Spiritual practice (prayer, meditation, nature walks) ✓ Remind yourself: “This is a season, not forever” When you’re drowning in the day-to-day, you need something that lifts your head above water.

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The 5-Minute Self-Care Menu

When you have literally 5 minutes: ✓ Deep breathing (box breathing: 4-4-4-4) ✓ Step outside and feel the sun ✓ Stretch ✓ Drink a glass of water ✓ Listen to one song you love ✓ Text a friend ✓ Pet your dog/cat ✓ Close your eyes and rest 5 minutes is better than nothing.

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The 30-Minute Self-Care Menu

When you have 30 minutes: ✓ Walk outside ✓ Take a real shower (not a rushed one) ✓ Watch a show ✓ Read ✓ Journal ✓ Nap ✓ Call a friend ✓ Do yoga (YouTube) ✓ Hobby/creative activity

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The 2-Hour Self-Care Menu

When you have 2 hours (rare but essential): ✓ Get out of the house alone ✓ Coffee shop + book ✓ Movie ✓ Hike ✓ Massage (if affordable) ✓ Lunch with a friend ✓ Bookstore/library ✓ Whatever you want This should happen at least once a month.

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How to Actually Make Self-Care Happen

“This all sounds great, but when am I supposed to do this?” Fair question. Here’s how:

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1. Schedule it

If it’s not on the calendar, it won’t happen.

• Therapy: same day/time every week
• Movement: block 30 minutes, 3-4x/week
• One-on-one time with partner: every Sunday evening
• Time for yourself: Saturday morning, 2 hours

Treat it like a doctor’s appointment. Non-negotiable.

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2. Trade off with your partner (if you have one)

Take turns.

• Saturday morning: Partner A gets 2 hours off. Partner B handles kids.
• Saturday afternoon: Switch.

Both of you need breaks.

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3. Ask for help

Ask family/friends:

• “Can you watch the kids for an hour on Saturday so I can go for a walk?”
• “Can you bring dinner on Tuesday?”
• “Can you drive [child] to therapy this week?”

People want to help. Let them.

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4. Lower your standards

Your house will be messier. Your meals will be simpler. Your kids will watch more TV. That’s okay. You’re in survival mode. Prioritize:

1. Your mental health
2. Your child’s safety
3. Basic functioning for everyone else
4. Everything else (optional)

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5. Use respite care

Respite care = temporary relief for caregivers. Options:

• Family/friends watching your child for a few hours
• Paid babysitter
• Respite care programs (some community organizations offer this for families dealing with mental health crises)
• Teen programs or day camps

You’re allowed to take a break.

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What to Do When You’re Already Burned Out

Signs you’re burned out:

• Physically exhausted all the time
• Emotionally numb or constantly irritable
• Detached from your child’s struggles (you just don’t care anymore)
• Difficulty concentrating
• Health problems
• Feeling hopeless
• Thoughts of escape or self-harm

If you’re burned out, you need more than self-care. You need intervention.

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Steps:

1. Tell someone: Partner, friend, therapist, doctor 2. Get medical evaluation: (Could be depression, could be physical illness) 3. Get therapy immediately 4. Consider medication (if doctor recommends) 5. Take emergency time off (if possible—family leave, medical leave, ask partner to take over for a week) 6. Reduce your load: What can you cut? What can someone else handle? Burnout is serious. Don’t push through it.

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When You Feel Guilty for Taking Care of Yourself

The guilt is loud: “My child is suffering and I’m getting a massage?” “How can I take time for myself when they need me?” “I don’t deserve to feel good when they feel so bad.” Here’s the reframe: Taking care of yourself is not selfish. It’s strategic. You are more patient when you’re rested. You make better decisions when you’re not burned out. You can be present when you’ve had a break. You model healthy behavior when you prioritize your own health. Your child needs a healthy parent more than they need a martyr.

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What Your Child Needs to See

Your child is watching you. If they see you:

• Ignoring your own needs
• Running yourself into the ground
• Never resting
• Never asking for help

They learn:

• “My needs destroy people”
• “I’m a burden”
• “Self-care is selfish”
• “Asking for help is weak”

But if they see you:

• Taking care of yourself
• Setting boundaries
• Asking for help
• Resting when you need to

They learn:

• “It’s okay to have needs”
• “Taking care of yourself is healthy”
• “Everyone needs support”
• “I don’t have to destroy myself to be worthy of love”

Modeling self-care teaches your child that they’re allowed to do the same.

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Self-Care Is Not the Solution (But It’s Essential)

Let’s be clear: Self-care will not:

• Cure your child’s mental illness
• Make the situation easy
• Fix everything

But self-care will:

• Keep you functional
• Prevent complete burnout
• Preserve your physical and mental health
• Make you a better parent
• Help you survive this

Self-care doesn’t solve the problem. But it keeps you alive while you’re solving the problem.

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Building a Self-Care Plan

Write this down. Literally. Right now.

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My non-negotiables:

✓ Sleep: _____ hours per night ✓ Food: _____ meals per day ✓ Movement: _____ minutes, _____ days/week ✓ Therapy: Every _____ (weekly/biweekly) ✓ Time with partner: _____ minutes per day, _____ hours per month ✓ Time for myself: _____ hours per week ✓ One thing I enjoy: _____ (what and when)

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My support people:

1. ---

2. ---

3. ---

Who can I call when I’m struggling? Who can I ask for help?

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My red flags:

When I notice these signs, I know I need to take action:

• ---

• ---

• ---

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My emergency plan:

If I’m completely burned out, I will:

1. ---

2. ---

3. ---

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Permission Slips You Need

✓ You’re allowed to take a break ✓ You’re allowed to feel joy even when your child is suffering ✓ You’re allowed to prioritize your own health ✓ You’re allowed to say no ✓ You’re allowed to ask for help ✓ You’re allowed to not be perfect ✓ You’re allowed to have needs ✓ You’re allowed to rest You don’t have to earn these. They’re yours by default.

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What You Need to Remember

✓ Self-care is survival, not selfishness ✓ If you don’t take care of yourself, you will burn out—and then you can’t help anyone ✓ Minimum viable self-care: sleep, food, movement, therapy, support, boundaries ✓ Schedule it or it won’t happen ✓ Your child needs a healthy parent more than a martyr ✓ You’re allowed to have needs You’re carrying an impossible load. You’re doing something incredibly hard. And you’re allowed to need support. Taking care of yourself isn’t abandoning your child. It’s ensuring you’ll still be standing when they need you tomorrow. You can’t pour from an empty cup. So fill the cup. Even if it’s just a little. Even if it’s just for five minutes. You matter too.

The Guilt That’s Crushing You

You’re at your son’s soccer game. But your mind is somewhere else. Is she okay? Did she go to school today? Should I check my phone? What if she’s having a crisis? You’re physically here. But mentally, you’re with your other child—the one who’s struggling, the one who needs you, the one you’re constantly worried about. Your son scores a goal. You clap. But you’re not really present. Later that night, he says: “You didn’t even see my goal, did you?” And your heart breaks. You’re drowning in guilt. Guilt that you can’t give everyone what they need. Guilt that one child is consuming all your energy. Guilt that you’re failing everyone. Guilt that you resent your struggling child for making everything so hard. Guilt that you’re not enough. Here’s the truth: When one child has significant mental health needs, family balance becomes nearly impossible. Not because you’re failing, but because the demands are unsustainable. This article will help you navigate the impossible: how to give one child the intensive support they need while not destroying your relationship with your other children, your partner, or yourself.

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The Reality: Balance Is a Myth

Let’s be honest. True “balance”—where everyone gets equal attention, equal resources, equal time—is not possible when one child is in crisis. And that’s okay. What you’re aiming for isn’t balance. It’s sustainability. Sustainability means:

• Everyone’s basic needs are met (not perfectly, but adequately)
• No one is being neglected to the point of harm
• You’re not burning out
• Family relationships are strained but not destroyed

Some seasons of life are unbalanced. That’s reality. Your job isn’t to achieve perfect equality. It’s to survive this season while minimizing damage.

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The Impact on the Whole Family

Let’s acknowledge what’s happening:

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Impact on siblings:

• Feel invisible
• Resentful
• Scared
• Guilty (for resenting or for being “the easy kid”)
• Pressure to be perfect
• Taking on adult responsibilities

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Impact on your partner/co-parent:

• Disconnected from each other
• Arguing about how to handle things
• No time for your relationship
• Resentment (feeling like you’re handling it alone or like they’re not doing enough)
• Exhaustion

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Impact on you:

• Burnout
• Guilt
• Anxiety
• Depression
• Loss of identity (you’ve become “the parent of a kid with mental illness”)
• Physical health declining

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Impact on the struggling child:

• Guilt for “ruining everything”
• Shame
• Feeling like a burden
• Increased symptoms from family tension

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Everyone is suffering. And there’s no perfect solution. But there are strategies that can help.

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Strategy 1: Triage—Who Needs What Right Now?

Think of your family like an emergency room. The person in critical condition gets immediate attention. The person with a broken arm waits. The person with a cold goes home. That doesn’t mean the person with a cold isn’t in pain. It means priorities have to be set based on severity.

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Step 1: Assess severity

Critical:

• Child is suicidal
• Severe crisis (psychotic break, hospitalization needed)
• Can’t function at all

Urgent:

• Significant symptoms interfering with daily life
• Needs intensive treatment (IOP, PHP)
• Behavioral issues affecting safety

Important but not urgent:

• Stable but needs ongoing support
• In therapy, making progress
• Can function with accommodations

Routine:

• Typical childhood needs
• Can wait a bit
• Not time-sensitive

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Step 2: Allocate resources accordingly

If your child is in critical or urgent category: They get priority. This doesn’t mean others are ignored, but they get maintenance care, not intensive attention. As severity decreases, you can rebalance.

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Step 3: Communicate this to the family

“Right now, [child] is going through a really hard time and needs more of our attention. That doesn’t mean we don’t care about the rest of you. It means we’re in crisis mode. Once things stabilize, we’ll have more energy for everyone.” Naming the reality helps everyone understand.

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Strategy 2: Create Non-Negotiable Time for Each Child

Even 20 minutes a week of undivided attention can make a difference.

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How to do it:

1. Schedule it (put it on the calendar) 2. Protect that time (don’t cancel unless it’s a true emergency) 3. Let the child choose the activity (within reason) 4. Be fully present (no phones, no talking about the struggling sibling)

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Examples:

• Wednesday night ice cream run with Child A
• Saturday morning pancakes with Child B
• Sunday afternoon walk with Child C

It doesn’t have to be long. It has to be consistent and present.

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Strategy 3: Protect Family Rituals

Rituals create stability in chaos. Identify 1-3 family rituals that are non-negotiable (unless true emergency):

• Family dinner on Sundays
• Movie night on Fridays
• Game night once a month
• Bedtime stories every night

These anchors remind everyone: we’re still a family.

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Strategy 4: Set Boundaries Around Crisis

Not every crisis requires everyone’s immediate attention.

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Differentiate between:

True emergency:

• Suicidal with plan
• Severe self-harm
• Psychotic episode
• Can’t be kept safe

Action: Everyone drops everything.

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Crisis, but not emergency:

• Panic attack
• Severe meltdown
• Emotional dysregulation

Action: One parent handles it. Other parent continues with other children’s activities/needs.

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Elevated but not crisis:

• Bad day
• Heightened symptoms
• Increased irritability

Action: Monitor, provide support, but don’t derail everything.

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Set this up in advance: “If [child] has a panic attack, I’ll handle it. You stay with [other child]. We don’t both need to respond every time.”

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Strategy 5: Divide and Conquer (If You Have a Partner)

Don’t both parents do the same thing. Split responsibilities.

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Example division:

Parent A:

• Primary point person for struggling child’s treatment (therapy appointments, psychiatrist, school meetings)
• Crisis response for struggling child

Parent B:

• Primary point person for other children (homework help, activities, emotional support)
• Handles household management

Switch off periodically to prevent burnout and resentment.

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If you’re a single parent:

You can’t divide. You need external support:

• Family members
• Friends
• Respite care
• Hired help

Ask for help. You cannot do this alone.

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Strategy 6: Communicate Openly With the Whole Family

Family meetings can help everyone feel heard.

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How to run a family meeting:

1. Set a regular time (weekly or bi-weekly) 2. Everyone shares:

• One thing that was hard this week
• One thing they need
• One thing they’re grateful for

3. Problem-solve together:

• “We have [child’s] therapy on Tuesday, which means we miss [other child’s] practice. How can we handle that?”

4. Make adjustments:

• “Okay, so next week Dad will take [child] to therapy and Mom will go to [other child’s] practice.”

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This helps everyone feel:

• Heard
• Part of the solution
• Like their needs matter

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Strategy 7: Give Siblings Permission to Have Their Own Lives

Siblings should not have to sacrifice their childhood.

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What to say:

“I know things are really focused on [sibling] right now. But I need you to know: you don’t have to give up your activities, your friends, your plans. You’re allowed to do your own thing. You’re allowed to be a kid.”

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In practice:

• Let them do extracurriculars even if it’s hard logistically
• Let them have sleepovers even if you’re stressed
• Let them go to parties even if home is chaotic
• Encourage them to spend time away from the family

Their life doesn’t have to stop because their sibling is struggling.

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Strategy 8: Address the Financial Impact

Mental health treatment is expensive. And it might mean sacrifices.

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Be honest (age-appropriately):

With younger kids: “We’re spending a lot of money on [sibling’s] doctors right now, so we might not be able to do some expensive things for a while.” With older kids/teens: “Therapy and medication for [sibling] are costing a lot. We might have to cut back on some things. I’m sorry. I know that’s not fair to you.”

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But also:

Don’t make siblings feel guilty for having needs that cost money. Balance honesty with reassurance: “We’re figuring it out. You don’t need to worry about money—that’s our job.”

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Strategy 9: Protect Your Relationship With Your Partner

Your relationship is suffering. Guaranteed. But if your relationship falls apart, the whole family falls apart.

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Minimum viable connection:

1. Check in daily (5 minutes) “How are you? Really. What do you need from me today?” 2. Touch base on the plan (who’s handling what) 3. One date night per month (even if it’s just sitting in the car talking for 20 minutes) 4. Assume positive intent (you’re both doing your best) 5. Go to couples therapy (if needed)

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Your relationship doesn’t have to be thriving right now. It just has to survive.

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Strategy 10: Let Go of Guilt (As Much As Possible)

The guilt will eat you alive if you let it.

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Reframe the guilt:

Instead of: “I’m failing everyone.” Try: “I’m doing the best I can in an impossible situation.” Instead of: “My other kids are suffering because of me.” Try: “My other kids are going through a hard season, but I’m making sure they have what they need.” Instead of: “I’m a terrible parent.” Try: “I’m a parent dealing with extraordinary circumstances.”

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You’re not failing. You’re surviving.

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Strategy 11: Get External Support

You cannot do this alone.

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Support you might need:

For struggling child:

• Therapist
• Psychiatrist
• Case manager
• IOP/PHP program
• School counselor

For siblings:

• Individual therapy
• Support groups
• School counselor

For you:

• Individual therapy
• Support group (NAMI, etc.)
• Friends
• Family

For your partner:

• Couples therapy
• Individual therapy

For the household:

• Babysitter/respite care
• House cleaner (if affordable)
• Meal delivery
• Family/friends helping with logistics

Ask for help. People want to help—they just don’t know what you need.

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What Siblings Need to Hear (Regularly)

Say these things often: ✓ “I see you.” ✓ “You matter.” ✓ “I’m sorry things have been so hard.” ✓ “I love you.” ✓ “It’s okay to be frustrated/angry/sad about this.” ✓ “You don’t have to be perfect.” ✓ “This isn’t your fault.” ✓ “I’m proud of you.” Words matter when time is limited.

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What the Struggling Child Needs to Hear

They’re carrying guilt too. ✓ “You’re not a burden.” ✓ “This isn’t your fault.” ✓ “We love you.” ✓ “We’re going to get through this.” ✓ “You don’t have to feel guilty for needing help.”

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When Professional Help Is Needed

Signs the family is in crisis: ❌ Siblings are showing significant behavioral or emotional problems ❌ Your relationship with your partner is falling apart ❌ You’re having thoughts of harming yourself ❌ Family is becoming abusive or violent ❌ You’re completely burned out Get family therapy. Immediately.

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The Long View: This Is a Season

This won’t last forever. Mental health crises are acute. Even chronic conditions have periods of stability. Right now is hard. But it won’t always be this hard. Things that help long-term: ✓ Your struggling child gets effective treatment ✓ Symptoms stabilize ✓ You build sustainable routines ✓ You get support ✓ Time One day, you’ll look back and realize: you survived. Your family survived. It won’t be perfect. But you’ll make it.

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What You Need to Remember

✓ Perfect balance is impossible—aim for sustainability ✓ Triage: allocate resources based on severity ✓ Protect rituals and one-on-one time with each child ✓ Divide responsibilities with your partner (if you have one) ✓ Siblings need permission to have their own lives ✓ Get external support—you can’t do this alone ✓ This is a season, not forever You’re not failing. You’re holding your family together during the hardest thing you’ve ever faced. That’s not failure. That’s strength.

The Conversation You’ve Been Avoiding

Your 8-year-old asks: “Why does Emma get to skip school but I don’t?” Your 12-year-old says: “You spend all your time worrying about Jake. What about me?” Your teenager mutters: “Everyone tiptoes around her like she’s made of glass.” They see everything. They feel everything. And they’re confused, resentful, scared—and you have no idea what to tell them. You’re exhausted from managing one child’s mental health crisis. The thought of having another difficult conversation with your other children feels overwhelming. So you say: “Your sister/brother is going through something right now. Just be patient.” And you hope that’s enough. But it’s not enough. Your other children need more than vague explanations. They need:

• To understand what’s happening
• To have their feelings validated
• To know they still matter
• To be equipped to support their sibling without taking on too much

This article will show you how to talk to siblings about mental health in age-appropriate ways, how to validate their feelings without burdening them, and how to maintain healthy family dynamics when one child needs more attention.

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Why Siblings Need to Know

When you don’t talk about it, siblings: ❌ Fill in the gaps with their own (often wrong) explanations ❌ Blame themselves (“It’s my fault”) ❌ Become resentful (“They get all the attention”) ❌ Feel scared (“Is this going to happen to me?”) ❌ Feel invisible (“My parents don’t care about me anymore”) ❌ Learn that mental health is shameful (“We don’t talk about it”) When you do talk about it, siblings: ✓ Understand what’s happening ✓ Feel included and trusted ✓ Learn that mental health is normal to discuss ✓ Know their feelings matter too ✓ Can be appropriately supportive The conversation might be uncomfortable. But silence is more damaging.

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What Siblings Are Experiencing (That You Might Not See)

Your other children are going through their own emotional journey:

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1. Confusion

“Why is my brother acting like this? Why won’t they just snap out of it?” They don’t understand mental illness. They see behaviors (tantrums, withdrawal, aggression) without understanding the why.

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2. Fear

“Will this happen to me? Is my sibling going to die? Is our family falling apart?” When things are chaotic and no one explains what’s happening, their imagination fills in terrifying blanks.

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3. Guilt

“Did I cause this? Was I mean to them? Is it my fault?” Kids often think they’re the center of the universe. If something bad happens, they assume they caused it.

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4. Resentment

“They get all the attention. Mom and Dad canceled my recital because of them. Why do they get special treatment?” They see their sibling getting accommodations, attention, and flexibility that they don’t get. It feels unfair.

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5. Anger

“I’m so sick of everything revolving around them. What about me?” Valid anger at having their needs deprioritized.

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6. Worry

“Is my sibling okay? Will they ever be normal again? What if they hurt themselves?” They love their sibling and they’re scared.

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7. Parentification (taking on adult responsibilities)

“I need to be perfect so I don’t add to my parents’ stress. I need to take care of my sibling.” They might suppress their own needs, act overly mature, or take on caregiving roles they’re not ready for.

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8. Invisibility

“No one notices me anymore. I could disappear and they wouldn’t care.” They feel like they’re not seen, not heard, not important.

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All of these feelings are normal. And they all need to be addressed.

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How to Talk to Siblings (By Age)

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Ages 3-5: Preschool

What they can understand:

• Feelings (happy, sad, scared, mad)
• That people get sick and need help
• Basic cause and effect

What they can’t understand:

• Abstract concepts (mental illness, brain chemistry)
• Long-term consequences
• Why someone can’t “just feel better”

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What to say:

“Your brother/sister is having a hard time with their feelings right now. Sometimes their brain makes them feel really [sad/scared/angry], and it’s hard for them to control it. It’s not their fault, and it’s not your fault. We’re helping them feel better. You might notice that [specific behavior: they cry a lot, they don’t want to play, they stay in their room]. That’s because they’re not feeling well. But we’re taking care of them, and we’re taking care of you too.”

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Use simple metaphors:

“Remember when you had a tummy ache and you felt really bad? Your sibling’s brain has an ache right now. We’re helping them get better.”

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Reassure them:

“This is not your fault.” “You are safe.” “Mommy and Daddy are taking care of everything.” “We love you very much.”

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Answer their questions simply:

Child: “Why is she crying?” Parent: “Her brain is making her feel very sad right now. We’re helping her.” Child: “Is it because I was mean?” Parent: “No, it’s not because of anything you did. This is something happening in her brain.”

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Ages 6-9: Early Elementary

What they can understand:

• That mental health is part of health
• That mental health issues are medical, not choices
• That treatment helps (therapy, medication)
• That feelings are normal

What they struggle with:

• Differentiating between “regular sad” and “depression”
• Understanding why their sibling gets accommodations they don’t
• Managing their own feelings about the situation

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What to say:

“You know how some people need glasses to see, or medicine for allergies? Sometimes people’s brains need help too. Your brother/sister has [anxiety/depression/ADHD], which means their brain works a little differently and makes things harder for them. It’s not their fault, and it’s not a choice. They’re seeing a doctor and going to therapy to help their brain work better.”

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Explain specific behaviors:

“You might notice that [sibling] gets really upset about things that seem small to you. That’s because their anxiety makes things feel much bigger and scarier than they are. They’re not being dramatic—their brain is telling them something scary is happening even when it’s not.”

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Validate their feelings:

“I know it can be frustrating when [sibling] gets more attention or when we have to change plans because of them. That’s a totally normal feeling. You’re allowed to feel frustrated. Do you want to talk about it?”

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Set boundaries around their role:

“It’s not your job to fix your sibling’s problems or make them feel better. That’s our job as parents, and we’re working with doctors. Your job is just to be their sibling and be kind.”

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Make space for their questions:

“Do you have any questions about what’s going on with [sibling]? You can ask me anything.”

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Ages 10-12: Late Elementary/Middle School

What they can understand:

• Mental health conditions are medical
• Brain chemistry and how it affects behavior
• That mental health issues can be long-term
• That treatment includes therapy and sometimes medication
• More nuanced emotions (they can feel love and resentment simultaneously)

What they struggle with:

• Managing their own resentment
• Feeling invisible
• Balancing empathy with their own needs
• Peer pressure (embarrassment about sibling’s behavior)

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What to say:

“I want to talk to you about what’s going on with [sibling]. They’ve been diagnosed with [anxiety/depression/ADHD/etc.]. This is a medical condition—their brain chemistry is different, and it makes [specific symptoms]. It’s not their fault, and it’s not a choice they’re making. They’re getting treatment (therapy and/or medication), but it’s going to take time.”

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Acknowledge the impact on them:

“I know this has been hard on you. I know we’ve had to cancel plans, I know I’ve been distracted, I know you’ve seen some scary things. I’m sorry. That’s not fair to you, and I see that.”

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Validate complex feelings:

“It’s okay to love your sibling and also feel frustrated or angry about how this is affecting your life. You can feel both things at the same time.”

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Set realistic expectations:

“Things might be like this for a while. We’re working on getting [sibling] the help they need, but it won’t be fixed overnight. I want you to know what to expect so you’re not blindsided.”

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Address their fears:

“This doesn’t mean you’ll develop [condition]. Mental health issues can run in families, but that doesn’t mean you’ll get it. And if you ever start feeling [symptoms], you can tell me and we’ll get you help right away.”

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Make space for one-on-one time:

“I know things have been really focused on [sibling]. Let’s make sure you and I have time together. How about we do [activity] together this weekend, just the two of us?”

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Ages 13-18: Adolescence

What they can understand:

• Everything (they’re capable of adult-level understanding)
• Nuance, complexity, long-term implications
• Their own mental health needs

What they struggle with:

• Resentment at having their own needs deprioritized
• Embarrassment (especially if sibling’s behavior is public)
• Taking on too much responsibility
• Their own mental health (higher risk if sibling has mental illness)

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What to say:

“I want to talk to you honestly about what’s going on with [sibling]. They’re struggling with [diagnosis], and it’s been really hard on all of us, including you. I know you’ve had to deal with [specific impacts: canceled plans, me being stressed, things being chaotic]. That’s not fair, and I’m sorry.”

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Be honest:

“This is hard. I don’t have all the answers. I’m doing my best, but I know I’m not perfect. If you’re feeling frustrated or angry or scared, I want to know.”

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Give them permission to prioritize themselves:

“I need you to know: you don’t have to sacrifice your life for your sibling’s illness. You’re allowed to do your own activities, see your friends, focus on school. You’re allowed to have needs. You’re allowed to be a teenager.”

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Address parentification:

“I need to make sure I’m not putting too much on you. You’re not responsible for taking care of [sibling] or fixing their problems. That’s my job. Are there ways I’ve been relying on you too much?”

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Check in on their mental health:

“How are you doing? Really. Not ‘fine.’ How are you actually feeling? Are you okay?”

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Normalize therapy for them too:

“Given everything that’s been going on, would you want to talk to someone? Not because there’s something wrong with you, but because this is a lot to deal with and it might help to have your own support.”

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What NOT to Say (Any Age)

❌ “Your sibling is crazy/broken/messed up” Stigmatizing language teaches them to fear and shame mental illness. ❌ “Don’t tell anyone about this” This teaches that mental health is shameful and must be hidden. ❌ “Just ignore it” / “Pretend everything is normal” They can’t ignore it. It’s affecting their life. ❌ “You need to be the strong one now” This puts unfair pressure on them and encourages them to suppress their needs. ❌ “Stop complaining—your sibling has it worse” This invalidates their feelings and teaches them their pain doesn’t matter. ❌ “It’s not a big deal” It is a big deal. Minimizing doesn’t help. ❌ “You wouldn’t understand” Give them age-appropriate information. They can handle more than you think.

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How to Validate Sibling Feelings Without Making Them Feel Guilty

The formula: 1. Acknowledge their feeling 2. Normalize it 3. Hold space for it 4. Don’t try to fix it

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Example 1: Child: “I’m so sick of everything being about Emma! She gets all the attention!” Wrong response: “That’s not true. We love you just as much. Stop being selfish.” Right response: “I hear you. You’re feeling like Emma is getting all the attention and you’re being left out. That makes sense—we have been really focused on her lately. That’s got to feel really frustrating and unfair. I’m sorry. You’re right that things have been unbalanced. Let’s talk about how we can make sure you’re getting attention too.”

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Example 2: Child: “I hate when she has meltdowns. It’s so embarrassing.” Wrong response: “She can’t help it. You need to be more understanding.” Right response: “I get that. It is embarrassing when that happens in public. That’s a totally normal feeling. It’s okay to feel embarrassed and still love your sister. Both things can be true.”

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Example 3: Child: “Why does he get to stay home from school when he’s anxious but I have to go even when I don’t feel good?” Wrong response: “Because he has anxiety and you don’t. Stop complaining.” Right response: “That’s a good question. It does seem unfair. The difference is that his anxiety is so severe that forcing him to go to school when he’s having a panic attack would make things worse. But I hear that it feels like he’s getting special treatment. Let’s talk about what you need too.”

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Sibling Roles to Watch Out For

Sometimes siblings develop unhealthy roles in response to a sibling’s mental illness:

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The Invisible Child

• Never asks for anything
• Tries to be “easy”
• Suppresses their own needs
• Flies under the radar

What to do: “I’ve noticed you never ask for anything. I want you to know: it’s okay to need things. It’s okay to not be fine. I want to hear what you need.”

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The Perfect Child

• Overachieves to compensate
• Never causes problems
• Takes on parental worry (“If I’m perfect, that’s one less thing for them to stress about”)

What to do: “I’m proud of you, but I need you to know: you don’t have to be perfect. You’re allowed to struggle, to fail, to need help. I love you no matter what.”

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The Parentified Child

• Takes care of struggling sibling
• Monitors sibling’s mood
• Sacrifices their own activities to “help”
• Feels responsible for sibling’s well-being

What to do: “I appreciate that you care about your sibling, but it’s not your job to take care of them. That’s my job. Your job is to be a kid. Let me handle the adult stuff.”

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The Acting-Out Child

• Gets in trouble to get attention
• Figures “bad attention is better than no attention”
• Becomes the “problem child”

What to do: “I see you. I know I’ve been distracted. You don’t have to act out to get my attention. Let’s figure out how to make sure you’re getting what you need.”

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How to Maintain Balance

This is the hardest part: giving one child the intensive support they need while not neglecting the others.

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1. Schedule one-on-one time

Even 20 minutes a week of undivided attention matters.

• Take them out for ice cream
• Play a board game
• Go for a walk
• Let them choose the activity

No talking about the struggling sibling during this time. This is THEIR time.

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2. Attend their events

Don’t miss their recital, game, or performance because of sibling’s crisis (unless it’s truly an emergency). If you have to miss, acknowledge it: “I’m so sorry I missed your game. That wasn’t okay. Let’s figure out how to make sure I’m there next time.”

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3. Check in regularly

“How are you doing? What’s been hard this week? What’s been good?” Make it a routine (weekly check-ins over breakfast, bedtime conversations, etc.)

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4. Validate their feelings often

“It makes sense you feel that way.” “That must be really hard.” “I’m sorry this is affecting you.”

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5. Protect them from adult responsibilities

They should not:

• Be responsible for their sibling’s safety
• Be your therapist
• Have to manage your emotions
• Give up their childhood to accommodate their sibling

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6. Get them their own support if needed

• Their own therapist
• Support groups for siblings of kids with mental illness
• School counselor

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How to Help Siblings Support Each Other (Without Overburdening)

Siblings can be supportive—but there are limits.

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Healthy sibling support looks like:

✓ Being kind ✓ Not teasing about mental health struggles ✓ Inviting sibling to join activities (if they want) ✓ Giving space when needed ✓ Telling a parent if they’re worried

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Unhealthy sibling support looks like:

❌ Monitoring sibling’s mood constantly ❌ Trying to “fix” sibling ❌ Sacrificing their own needs ❌ Keeping secrets about sibling’s safety ❌ Being sibling’s therapist

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What to tell them:

“The best way you can support your sibling is by being kind and by telling me if you’re worried. You don’t have to fix them or take care of them. That’s my job.”

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What If They’re Mean to Their Struggling Sibling?

Kids are kids. Sometimes they’ll be cruel, even when they know their sibling is struggling. Don’t excuse it. Address it. Wrong approach: “Leave them alone! They have [anxiety/depression]! You’re making it worse!” Right approach: “I know you’re frustrated, but it’s not okay to be mean. Your sibling is struggling with [condition], and that makes things harder for them. I need you to be kind. At the same time, I hear that you’re frustrated. Let’s talk about that separately.” Set boundaries, but also validate their feelings.

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When to Get Professional Help for Siblings

Signs a sibling needs their own therapy: ✓ Showing signs of depression or anxiety ✓ Declining grades or social withdrawal ✓ Acting out or behavioral problems ✓ Expressing extreme guilt, fear, or resentment ✓ Taking on too much responsibility ✓ Asking for help Don’t wait. Get them support.

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Taking Care of Your Relationship With All Your Kids

You’re not failing if you can’t give everyone equal attention right now. Equality isn’t always possible. But equity is. Equity means: Each child gets what they need, even if that looks different. Right now, one child needs more. That’s okay. But make sure the others know they still matter.

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What You Need to Remember

✓ Siblings need age-appropriate explanations about what’s happening ✓ Their feelings (resentment, anger, fear) are valid—don’t dismiss them ✓ They should not be responsible for their sibling’s care ✓ One-on-one time with each child is essential ✓ Watch for unhealthy roles (invisible child, perfect child, parentified child) ✓ Get them their own support if they need it Your other children didn’t choose this. But they’re living with it. The best thing you can do is see them, validate them, and make sure they know: they matter too.

The Question That Terrifies You

The psychiatrist just recommended medication for your child. And your mind is racing: Will this change who they are? Will they be a zombie? Is this safe? Are they too young? What if there are side effects? What if we can’t get them off it? Am I failing as a parent if I can’t help them without medication? And then there’s the voice in the back of your head—maybe your own parent’s voice, maybe society’s voice—saying: “Kids don’t need pills. They just need discipline. They just need to try harder. You’re drugging your child.” So you hesitate. You research obsessively. You ask everyone you know. You agonize. Meanwhile, your child is suffering. They can’t focus in school. They’re paralyzed by anxiety. They’re so depressed they can’t get out of bed. They’re thinking about suicide. Here’s what you need to know: Psychiatric medication is not “giving up.” It’s not “the easy way out.” It’s not admitting defeat. It’s treating a medical condition. If your child had diabetes, you wouldn’t hesitate to give them insulin. If they had asthma, you’d give them an inhaler. Mental health conditions are no different. Sometimes the brain needs medication to function properly. This article will give you the information you need to make an informed decision—what medications are used for kids, how they work, what the risks are, and how to navigate this decision without guilt or fear.

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The Truth About Medication and Kids

Let’s address the stigma head-on.

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Myth 1: “Kids are overmedicated.”

Reality: While some kids are prescribed medication unnecessarily, many more kids who need medication aren’t getting it. Studies show that less than 50% of children with mental health conditions receive treatment—and even fewer receive medication when it’s indicated. Undertreatment is a bigger problem than overtreatment.

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Myth 2: “Medication will change their personality.”

Reality: Well-prescribed medication should help your child be MORE themselves, not less. When a child is paralyzed by anxiety or trapped in depression, they’re not fully themselves. Medication can lift that fog so their true personality can emerge. If medication drastically changes their personality or makes them numb, that’s a sign the dose is wrong or the medication isn’t right—not that medication is inherently bad.

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Myth 3: “Once they start, they’ll be on it forever.”

Reality: Some kids need medication long-term. Some don’t. Many kids take medication for 1-2 years, then taper off once they’ve built skills in therapy and symptoms have stabilized. Starting medication doesn’t mean a lifetime commitment.

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Myth 4: “Medication is a crutch.”

Reality: Medication isn’t a crutch. It’s a tool. If someone breaks their leg, you give them crutches so they can heal. Once healed, they don’t need crutches anymore. Medication supports the brain while your child learns coping skills and heals.

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Myth 5: “Kids just need to try harder / have more discipline / get outside more.”

Reality: Mental health conditions are medical conditions caused by brain chemistry, not moral failure. You can’t willpower your way out of depression any more than you can willpower your way out of diabetes. Lifestyle changes (exercise, sleep, nutrition) help. But they’re not always sufficient for moderate to severe conditions.

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When Does a Child Need Medication?

Not every child with mental health struggles needs medication. Consider medication when: ✓ Symptoms are moderate to severe ✓ Functioning is significantly impaired (can’t go to school, has no friends, can’t do daily tasks) ✓ Therapy alone hasn’t been sufficient (after 3-6 months of consistent therapy) ✓ Child is in crisis (suicidal, severely depressed, psychotic) ✓ Certain diagnoses (bipolar disorder, schizophrenia, severe ADHD usually require medication) ✓ Psychiatrist or pediatrician recommends it Medication is most effective when combined with therapy. Medication addresses the biological component. Therapy addresses the behavioral and cognitive components. Medication + therapy > medication alone or therapy alone.

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Types of Medication Used for Children

Let’s break down the most common medications by category:

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1. Antidepressants (SSRIs and SNRIs)

Used for:

• Depression
• Anxiety disorders (GAD, social anxiety, panic disorder, OCD)
• PTSD

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Common SSRIs:

• Prozac (fluoxetine) – FDA approved for kids age 8+ for depression, OCD
• Zoloft (sertraline) – FDA approved for kids age 6+ for OCD
• Lexapro (escitalopram) – FDA approved for teens age 12+ for depression
• Luvox (fluvoxamine) – FDA approved for kids age 8+ for OCD

Common SNRIs:

• Effexor (venlafaxine)
• Cymbalta (duloxetine)

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How they work:

Increase serotonin (and sometimes norepinephrine) in the brain. These neurotransmitters regulate mood, anxiety, and emotional stability.

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Timeline:

• Takes 4-6 weeks to feel full effect
• May notice small improvements in 2 weeks
• Need to take daily (not as-needed)

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Common side effects:

• Nausea (usually temporary)
• Headache
• Sleep changes (insomnia or drowsiness)
• Appetite changes
• Sexual side effects (in teens)

Most side effects decrease after 1-2 weeks.

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Black box warning:

The FDA requires SSRIs to carry a black box warning about increased risk of suicidal thoughts in children and teens. What this means:

• In clinical trials, a small percentage of kids on SSRIs had increased suicidal thoughts
• However, untreated depression carries a much higher risk of suicide
• The risk is highest in the first few weeks of starting medication or changing doses

What to do:

• Monitor your child closely, especially in the first 8 weeks
• Ask them directly about suicidal thoughts
• Report any changes to the psychiatrist immediately

The risk of NOT treating severe depression is greater than the risk of the medication.

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Important notes:

• Don’t stop suddenly: Needs to be tapered to avoid withdrawal
• Not addictive
• Can take multiple tries to find the right medication and dose

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2. Stimulants (for ADHD)

Used for:

• ADHD (Attention-Deficit/Hyperactivity Disorder)

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Common stimulants:

Methylphenidate-based:

• Ritalin, Concerta, Focalin, Quillivant

Amphetamine-based:

• Adderall, Vyvanse, Dexedrine

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How they work:

Increase dopamine and norepinephrine in the brain, improving focus, attention, and impulse control.

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Timeline:

• Works within 30-60 minutes
• Effects last 4-12 hours depending on formulation (short-acting vs. extended-release)

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Common side effects:

• Decreased appetite
• Weight loss
• Difficulty sleeping
• Increased heart rate
• Irritability when medication wears off (“rebound effect”)
• Stomachaches

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Important notes:

• Controlled substances (Schedule II)—require special prescriptions, can’t be called in
• Need to monitor growth (can slow growth temporarily)
• Not addictive when taken as prescribed
• “Medication holidays” (taking breaks on weekends or summer) are sometimes used
• Works immediately, so you know right away if it’s effective

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3. Non-Stimulants (for ADHD)

Used when:

• Stimulants cause intolerable side effects
• Stimulants aren’t effective
• Child has substance abuse history
• Child has anxiety (stimulants can worsen anxiety)

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Common non-stimulants:

• Strattera (atomoxetine)
• Intuniv (guanfacine)
• Kapvay (clonidine)

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How they work:

Increase norepinephrine (Strattera) or regulate blood pressure and brain activity (Intuniv, Kapvay) to improve focus and impulse control.

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Timeline:

• Takes 2-4 weeks to feel full effect
• Taken daily (not as-needed)

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Common side effects:

• Drowsiness
• Fatigue
• Decreased appetite
• Dizziness

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Pros:

• Not controlled substances
• Don’t worsen anxiety
• Can help with sleep

Cons:

• Takes longer to work than stimulants
• Often less effective than stimulants

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4. Anti-Anxiety Medications

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SSRIs (see above)

First-line treatment for anxiety disorders in kids.

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Benzodiazepines (use with caution)

Examples:

• Xanax, Ativan, Klonopin

Used for:

• Short-term anxiety relief
• Panic attacks
• Severe acute anxiety

Pros:

• Work immediately (within 30 minutes)

Cons:

• Addictive
• Build tolerance (need higher doses over time)
• Withdrawal can be dangerous
• Not recommended for long-term use in children

Typically used only short-term (weeks, not months) while SSRIs kick in.

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Buspirone

Non-addictive anti-anxiety medication. Pros:

• Not addictive
• Can be used long-term

Cons:

• Takes 2-4 weeks to work
• Less effective than SSRIs for most anxiety disorders

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5. Mood Stabilizers (for Bipolar Disorder)

Used for:

• Bipolar disorder
• Severe mood swings
• Sometimes aggression or explosive behavior

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Common mood stabilizers:

• Lithium
• Depakote (valproic acid)
• Lamictal (lamotrigine)
• Tegretol (carbamazepine)

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How they work:

Regulate mood by stabilizing electrical activity in the brain and balancing neurotransmitters.

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Important notes:

• Require regular blood work to monitor levels and organ function
• Side effects can be significant (weight gain, tremor, cognitive dulling)
• Essential for bipolar disorder (SSRIs alone can trigger mania)

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6. Antipsychotics

Used for:

• Schizophrenia
• Bipolar disorder (especially mania)
• Severe aggression or agitation
• Sometimes severe OCD or Tourette’s
• Sometimes used off-label for irritability in autism

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Common antipsychotics:

Atypical (second-generation):

• Abilify (aripiprazole)
• Risperdal (risperidone)
• Seroquel (quetiapine)
• Zyprexa (olanzapine)

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How they work:

Block dopamine receptors and sometimes serotonin receptors to reduce psychotic symptoms, stabilize mood, and reduce agitation.

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Common side effects:

• Weight gain (can be significant)
• Sedation
• Increased appetite
• Metabolic changes (increased blood sugar, cholesterol)
• Movement side effects (tremor, restlessness, muscle stiffness)

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Important notes:

• Require regular monitoring (weight, blood sugar, cholesterol, movement)
• Side effects can be serious
• Reserved for serious conditions

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The Medication Process: What to Expect

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Step 1: Evaluation

Psychiatrist or psychiatric nurse practitioner will:

• Assess symptoms
• Take full history
• Review previous treatments
• Discuss diagnosis
• Recommend medication (if appropriate)

This usually takes 45-90 minutes.

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Step 2: Informed consent

Psychiatrist should explain:

• What the medication is
• How it works
• Expected benefits
• Possible side effects
• Timeline
• Monitoring plan

Ask all your questions. Write them down beforehand so you don’t forget.

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Step 3: Starting medication

Usually start at a low dose and gradually increase. This minimizes side effects and allows the body to adjust. You’ll have a follow-up appointment in 2-4 weeks to assess effectiveness and side effects.

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Step 4: Adjustment phase

Finding the right medication and dose is trial and error.

• First medication might not work
• Dose might need adjusting
• Side effects might require switching medications

This is normal. Be patient. It can take 2-6 months to find the right medication and dose.

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Step 5: Maintenance

Once stabilized:

• Regular follow-ups (every 1-3 months)
• Monitoring for side effects
• Adjusting as needed (kids grow, symptoms change)

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Step 6: Discontinuation (if/when appropriate)

When symptoms are stable for 6-12 months, you and psychiatrist might discuss tapering off. This should be done gradually under medical supervision. Some kids can stop. Others need long-term medication. Both are okay.

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Questions to Ask the Psychiatrist

Before starting medication:

1. What are we treating? (Make sure diagnosis is clear)
2. Why this medication specifically?
3. What are the benefits and risks?
4. What side effects should I watch for?
5. How long until it works?
6. How will we know if it’s working?
7. What if it doesn’t work?
8. How long will they need to be on it?
9. What monitoring is required? (Blood work, weight checks, etc.)
10. What should I do in an emergency?

Don’t leave the appointment until you understand the plan.

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How to Support Your Child on Medication

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Do:

✓ Give medication consistently: Same time every day, don’t skip doses ✓ Monitor for side effects: Keep a journal ✓ Communicate with psychiatrist: Report concerns immediately ✓ Be patient: Finding the right medication takes time ✓ Continue therapy: Medication is not enough on its own ✓ Normalize it: “This is medicine to help your brain, just like glasses help your eyes”

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Don’t:

❌ Stop medication suddenly: Can cause withdrawal or relapse ❌ Adjust dose without psychiatrist approval ❌ Share medication with others ❌ Shame your child for needing medication ❌ Expect medication to solve everything

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Common Concerns and How to Address Them

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Concern 1: “Will they become dependent?”

Answer: Most psychiatric medications are not addictive (except benzodiazepines, which are used cautiously). Your child won’t crave them or need increasing doses to get the same effect. However, some medications need to be tapered slowly to avoid withdrawal. That’s not the same as addiction.

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Concern 2: “Will it stunt their growth?”

Answer: Stimulants can temporarily slow growth. What to do:

• Monitor height and weight regularly
• Ensure adequate nutrition
• Consider medication holidays if appropriate

Most kids catch up in growth once off medication or after puberty.

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Concern 3: “Will it make them a zombie?”

Answer: No, if properly prescribed. If your child seems “flat” or “numb,” that’s a sign:

• Dose is too high
• Wrong medication

Tell the psychiatrist immediately. This is not how medication should work.

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Concern 4: “What if they refuse to take it?”

For younger kids: You decide. Explain why it’s important, but ultimately you’re the parent. For teens: Harder to force. Try:

• Explaining the benefits
• Involving them in the decision
• Asking them to try it for 2 months and reassess
• Compromise: “Try it for 8 weeks. If you hate it, we’ll stop.”

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When to Stop Medication

Reasons to discontinue: ✓ Symptoms have been stable for 6-12 months ✓ Child has strong coping skills from therapy ✓ Functioning is excellent ✓ Psychiatrist agrees it’s appropriate OR ✓ Intolerable side effects ✓ Not effective after adequate trial ✓ Medical reasons Always taper under medical supervision. Never stop suddenly.

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What You Need to Remember

✓ Medication is treating a medical condition, not “giving up” ✓ Finding the right medication takes time—be patient ✓ Medication + therapy is most effective ✓ Side effects are often temporary ✓ Your child is not “broken”—their brain just needs support ✓ You’re not a bad parent for choosing medication—you’re getting your child help The decision to start medication is hard. But watching your child suffer is harder. If medication can reduce their suffering, help them function, and give them their life back—that’s not failure. That’s love. You’re not drugging your child. You’re treating their illness. And that’s exactly what a good parent does.

The Decision That’s Been Haunting You

You’ve been thinking about it for months. Maybe years. “Does my child need therapy?” Every time they have a meltdown, you wonder. Every time they come home from school in tears, you wonder. Every time they say they hate themselves or they wish they weren’t here, you know the answer. But actually taking the step—actually finding a therapist, making the call, bringing your child to a stranger’s office and saying “Please fix what I couldn’t fix”—that feels overwhelming. You’re worried about:

• Stigma (what will people think?)
• Cost (can we afford this?)
• Your child’s reaction (will they refuse to go?)
• Whether it will even work (what if we try and nothing changes?)
• Choosing the wrong therapist (what if we waste months with someone who doesn’t help?)

So you wait. You tell yourself maybe it’ll get better. Maybe they’ll grow out of it. Maybe you can handle this yourself. But deep down, you know: If your child had diabetes, you wouldn’t hesitate to get them treatment. Mental health is no different. This article will walk you through everything you need to know about getting your child into therapy—how to find the right therapist, what to expect, how to make it work, and what to do when it’s not working.

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When Does Your Child Need Therapy?

Not every childhood struggle requires therapy. But here are the signs it’s time:

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Seek therapy if:

✓ Symptoms persist for more than 2-4 weeks without improvement ✓ Functioning is impaired (can’t go to school, has no friends, can’t complete daily tasks) ✓ They’re expressing thoughts of self-harm or suicide ✓ Behavioral problems are escalating (aggression, defiance, running away) ✓ Anxiety or depression is interfering with daily life ✓ They’ve experienced trauma (abuse, neglect, witnessing violence, loss) ✓ Family can’t manage the situation alone (you’re overwhelmed, nothing you try is working) ✓ School is recommending it ✓ Your gut tells you something is wrong

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You don’t need to wait for a crisis.

Early intervention is more effective than waiting until things are severe. Think of it like physical health: You don’t wait until someone has a heart attack to address high blood pressure. Therapy can be preventive, not just reactive.

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Types of Therapy: What Works for Kids

Not all therapy is created equal. Different approaches work for different issues and different ages.

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1. Play Therapy

Best for: Ages 3-10 (sometimes older) What it is: Children process emotions and experiences through play instead of talking. The therapist uses toys, art, sand trays, puppets, etc., to help the child express and work through issues. Why it works for kids: Young children don’t have the language or cognitive capacity to do traditional talk therapy. Play is their language. Good for:

• Trauma
• Anxiety
• Behavioral issues
• Divorce or family changes
• Grief and loss

What it looks like: Your child plays in a therapy room with various toys. The therapist observes, reflects, and gently guides the play to help the child process emotions.

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2. Cognitive Behavioral Therapy (CBT)

Best for: Ages 7+ (though CBT can be adapted for younger kids) What it is: A structured, goal-oriented therapy that focuses on identifying and changing negative thought patterns and behaviors. Core concept: Thoughts → Feelings → Behaviors. By changing thoughts, you change feelings and behaviors. Good for:

• Anxiety disorders
• Depression
• OCD
• Phobias
• Social anxiety

What it looks like: Therapist teaches your child to identify negative thoughts (“I’m going to fail”), challenge them (“Is that true? What’s the evidence?”), and replace them with more realistic thoughts (“I’ve studied hard. I’ll probably do okay”). Includes homework assignments, worksheets, and skill practice. Evidence: One of the most researched and effective therapies for childhood anxiety and depression.

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3. Dialectical Behavior Therapy (DBT)

Best for: Teens (ages 13+), though can be adapted for younger kids What it is: A type of CBT that focuses on teaching skills in four areas:

1. Mindfulness (being present)
2. Distress tolerance (handling crisis without making it worse)
3. Emotion regulation (managing intense emotions)
4. Interpersonal effectiveness (healthy relationships and communication)

Good for:

• Self-harm
• Suicidal behavior
• Borderline Personality Disorder (in teens)
• Emotional dysregulation
• Impulsive behavior

What it looks like: Individual therapy + skills group. Focus is on building specific, practical skills. Evidence: Highly effective for teens who self-harm or have suicidal behavior.

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4. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

Best for: Ages 3-18 who have experienced trauma What it is: A specialized type of CBT designed to help children process traumatic experiences. Components:

• Psychoeducation (understanding trauma)
• Relaxation and coping skills
• Emotional regulation
• Cognitive processing (changing unhelpful thoughts about the trauma)
• Trauma narrative (gradually telling the story of what happened)
• Parent involvement

Good for:

• Physical, sexual, or emotional abuse
• Witnessing violence
• Loss of a loved one
• Natural disasters
• Serious accidents

What it looks like: Child works with therapist to gradually process the traumatic event at their own pace. Often includes play or art for younger children. Evidence: Gold standard for childhood trauma treatment.

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5. EMDR (Eye Movement Desensitization and Reprocessing)

Best for: Ages 6+ (can be adapted for younger children) What it is: A therapy that uses bilateral stimulation (eye movements, tapping, sounds) to help the brain reprocess traumatic memories. Good for:

• PTSD
• Trauma
• Phobias
• Disturbing memories

What it looks like: Child thinks about the traumatic memory while following the therapist’s hand movements with their eyes (or using tappers or sounds). This helps the brain reprocess the memory so it’s less disturbing. Sounds weird, but it works. Research shows it’s highly effective for trauma.

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6. Family Therapy

Best for: All ages when family dynamics are part of the issue What it is: Therapy that involves the whole family (or relevant family members) working together. Good for:

• Family conflict
• Communication problems
• When one child’s mental health is impacting the whole family
• Divorce or blended family issues
• Behavioral problems

What it looks like: Everyone attends sessions together. Focus is on improving communication, understanding each other, and changing family patterns.

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7. Parent-Child Interaction Therapy (PCIT)

Best for: Ages 2-7 with behavioral problems What it is: Parent training therapy where parents learn specific techniques to improve the parent-child relationship and manage behavior. Good for:

• Defiance
• Tantrums
• Aggression
• Attachment issues

What it looks like: Parent and child play together while therapist coaches the parent (often through an earpiece) on specific techniques. Evidence: Very effective for young children with behavioral issues.

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How to Find a Therapist

This is often the hardest part. Here’s a step-by-step process:

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Step 1: Determine what your child needs

Ask yourself:

• What’s the primary issue? (Anxiety, trauma, behavioral problems, depression, etc.)
• What age is my child? (Determines whether they need play therapy, talk therapy, etc.)
• What type of therapy might help? (Based on the above)

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Step 2: Check insurance

Call your insurance company: Ask:

• “What mental health providers are in-network for children?”
• “Do I need a referral from my pediatrician?”
• “What’s my copay?”
• “How many sessions are covered per year?”

Get a list of in-network providers.

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Step 3: Search for therapists

Resources: Psychology Today Therapist Directory: psychologytoday.com/us/therapists Filters:

• Age (child/teen)
• Issue (anxiety, trauma, ADHD, etc.)
• Therapy type (CBT, play therapy, EMDR)
• Insurance
• Location/telehealth

Other directories:

• TherapyDen.com
• GoodTherapy.org
• NAMI Provider Database
• Your pediatrician (ask for referrals)

Ask for referrals:

• School counselor
• Friends who have kids in therapy
• Your own therapist (if you have one)

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Step 4: Create a shortlist

Look for: ✓ Licensed (LCSW, LMFT, LPC, or psychologist) ✓ Specializes in children/teens ✓ Has experience with your child’s specific issue ✓ Takes your insurance or offers sliding scale ✓ Good availability Make a list of 5-7 therapists to contact.

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Step 5: Make initial contact

Call or email: “Hi, I’m looking for a therapist for my [age]-year-old who is struggling with [anxiety/trauma/behavioral issues]. Do you have availability? Can I schedule a brief consultation call to see if you’d be a good fit?” Many therapists offer a free 15-minute phone consultation.

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Step 6: Ask the right questions

During the consultation, ask:

1. “What’s your experience working with [specific issue]?” You want someone who specializes, not someone who “sees everyone.”
2. “What type of therapy do you use?” Make sure it’s evidence-based for your child’s issue.
3. “How do you involve parents?” Some therapists include parents in every session. Others rarely do. Find out what works for you.
4. “What does a typical session look like?” Especially for younger kids—will it be play-based? Talk-based?
5. “How long does treatment typically take?” No one can give an exact timeline, but they should be able to give a general idea.
6. “How do you measure progress?” Good therapists track progress, not just “see how it goes.”
7. “What’s your cancellation policy?” Important to know.
8. “How do you handle crises between sessions?” Do they have on-call support? Do you call 911? Know the plan.

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Step 7: Schedule an intake session

The first session is an assessment:

• Therapist meets your child
• Gathers history
• Assesses symptoms
• Discusses treatment plan

Often parents are included for at least part of this session.

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How to Prepare Your Child for Therapy

How you introduce therapy matters.

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Ages 3-6:

What to say: “We’re going to meet someone called [therapist’s name]. They’re a helper who talks and plays with kids about their feelings. They have lots of fun toys. You can play and they’ll help you feel better about [big feelings/scary dreams/being sad].” Keep it simple and positive.

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Ages 7-12:

What to say: “I’ve noticed you’ve been feeling [anxious/sad/angry] a lot lately. I want to make sure you have someone to talk to about that. We’re going to see a therapist—they’re like a feelings doctor. They help kids learn ways to handle big feelings. Lots of kids see therapists. It doesn’t mean anything is wrong with you. It just means we want to help you feel better.” Normalize it.

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Ages 13-18:

What to say: “I’ve been worried about you. I think it would help to talk to someone—not me, but someone who’s trained in helping teens with [anxiety/depression/stress]. I found a therapist and I’d like you to try it. You don’t have to tell me everything you talk about. It’s your space. But I think it could really help.” Give them some autonomy and privacy.

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What if they refuse?

Try:

• “Let’s just try one session. If you hate it, we can find someone else.”
• “I know it feels weird, but I really think it could help.”
• “You don’t have to talk about anything you don’t want to.”

If they still refuse:

• For younger kids: You make the decision. They’ll likely warm up once they meet the therapist.
• For older kids/teens: Harder to force. Consider family therapy first, or let them choose the therapist.

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What to Expect in Therapy

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First few sessions:

• Building rapport (getting to know each other)
• Assessment
• Goal-setting
• Beginning treatment

Don’t expect immediate results. It takes time to build trust.

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Ongoing sessions:

For younger kids:

• Mostly play-based
• You might not see what happens (therapist will update you)

For older kids/teens:

• Talk therapy, worksheets, skill-building
• More privacy (they may not tell you everything, and that’s okay)

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Parent involvement:

Varies by therapist and child’s age. Younger kids: Parents often involved regularly Teens: Less parent involvement (to respect their privacy) Good therapists will:

• Update you on progress (without violating confidentiality)
• Teach you strategies to support your child at home
• Include you in sessions periodically

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How to Support Your Child in Therapy

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Do:

✓ Get them there consistently: Weekly is typical. Don’t skip sessions unless absolutely necessary. ✓ Ask general questions: “How was therapy?” but don’t interrogate. ✓ Support homework: If the therapist assigns practices or worksheets, help your child complete them. ✓ Communicate with the therapist: Share relevant updates (school issues, family changes, medication changes). ✓ Be patient: Therapy takes time. ✓ Model healthy behavior: If you go to therapy, tell them. Normalize it.

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Don’t:

❌ Interrogate them after sessions: “What did you talk about? What did you say about me?” ❌ Punish them for what they share in therapy: They need to feel safe being honest. ❌ Expect instant results: Progress is slow and non-linear. ❌ Talk negatively about therapy: “I can’t believe we have to do this,” “This is so expensive.” ❌ Pull them out after two sessions: Give it at least 6-8 sessions before evaluating fit.

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How to Know If It’s Working

Signs therapy is helping: ✓ Your child is engaged (talks about their therapist, doesn’t resist going) ✓ You see gradual improvement in symptoms ✓ They’re learning and using coping skills ✓ Functioning is improving (school, friendships, home life) ✓ They seem more self-aware Timeframe: Most kids show some improvement within 6-12 weeks. Full treatment might take 6-12 months (or longer for trauma).

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When Therapy Isn’t Working

Sometimes it doesn’t work. Here’s what to do:

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Problem 1: No progress after 2-3 months

What to do:

• Talk to the therapist: “I’m not seeing progress. What’s your assessment? Should we adjust the approach?”
• Consider whether they’re the right fit: Not every therapist is right for every child.
• Consider whether the diagnosis is accurate: Maybe it’s not anxiety—maybe it’s ADHD or trauma.
• Consider whether therapy alone is enough: Maybe medication is needed.

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Problem 2: Your child hates their therapist

What to do:

• Give it a few sessions: Kids often resist initially.
• If they still hate them after 4-6 sessions: Trust your child. Fit matters. Find someone else.

How to tell the difference between:

• Normal resistance (“I don’t want to go” but they’re fine once there)
• Bad fit (“I hate them, they don’t understand me, I don’t trust them”)

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Problem 3: Therapist isn’t a good fit

Red flags:

• Therapist seems disengaged or distracted
• Therapist doesn’t specialize in your child’s issue
• No clear treatment plan or goals
• Therapist is judgmental toward you or your child
• No progress and no explanation why

What to do:

• Trust your gut. If something feels off, it probably is.
• Find a new therapist. You can say: “This doesn’t feel like the right fit. We’re going to try someone else.”

Don’t feel guilty about switching therapists. Fit is everything.

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Common Challenges and How to Handle Them

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Challenge 1: Cost

Therapy is expensive ($100-$300/session without insurance). Solutions:

• Use insurance: $0-$50 copay
• Sliding scale therapists: Many offer reduced rates based on income
• Community mental health centers: Low-cost or free
• University training clinics: Supervised students, very low cost ($10-$30)
• Online therapy: Often cheaper (BetterHelp Teen, Talkspace)
• School-based counseling: Free (though not comprehensive)

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Challenge 2: Long waitlists

Many therapists have 2-3 month waitlists. Solutions:

• Call multiple therapists at once
• Ask to be on cancellation lists
• Look for telehealth therapists (larger pool)
• Consider out-of-network therapists (if affordable)
• Start with your pediatrician (can prescribe meds while you wait for therapy)

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Challenge 3: Your child won’t go

For younger kids: You decide. They’ll adjust. For teens: Harder. Try:

• Letting them choose the therapist
• Offering incentives (not bribes, but “after therapy, we can get ice cream”)
• Framing it as “just trying it once”
• Family therapy first, then transition to individual

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Challenge 4: Confidentiality concerns

Teens need privacy. But you also need to know what’s going on. The balance:

• Therapist should keep most things confidential
• But will break confidentiality if: Child is in danger (suicidal, being abused, etc.)
• Ask for general updates: “How are they doing? Are they making progress?” without asking for details

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Therapy + Medication: Do They Need Both?

Sometimes therapy alone isn’t enough. Consider medication if:

• Symptoms are moderate to severe
• Therapy alone isn’t sufficient after 3-6 months
• Functioning is severely impaired
• Psychiatrist or pediatrician recommends it

Medication + therapy is often more effective than either alone. (See next article: “Medication Decisions: What Parents Need to Know”)

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When to Stop Therapy

Signs it’s time to end (or take a break): ✓ Goals have been met ✓ Symptoms have significantly improved ✓ Child is functioning well (school, friends, home) ✓ They have tools and skills to manage independently ✓ Therapist agrees they’re ready Don’t stop abruptly. Plan a “graduation” with the therapist to ensure your child feels ready. You can always come back if needed.

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What You Need to Remember

✓ Therapy is not a sign of failure—it’s a sign you’re taking your child’s mental health seriously ✓ Finding the right fit takes time—don’t settle for someone who isn’t right ✓ Progress is slow and non-linear—be patient ✓ Your support matters—get them there consistently and support homework ✓ Therapy works—but only if you give it time Getting your child into therapy might be one of the best decisions you ever make. It won’t fix everything overnight. But it will give your child tools, support, and a safe space to heal. You’re not giving up. You’re getting help. And that’s exactly what your child needs.