Why parents miss the signs
Children don't come to parents saying "I'm experiencing anxiety and would benefit from CBT." They act out, withdraw, develop stomachaches, refuse to go to school, or simply say "I'm fine" while clearly not being fine. Learning to recognize emotional distress through behavioral signals is one of the most valuable parenting skills there is.
Warning signs in younger children (ages 5–12)
- Significant behavioral changes — increased defiance, aggression, or regression to younger behaviors
- Persistent sadness, tearfulness, or irritability lasting more than 2 weeks
- Frequent physical complaints (stomachaches, headaches) without medical cause
- Refusal to go to school or severe separation anxiety
- Sleep problems — nightmares, bedwetting, or significant difficulty falling asleep
- Loss of interest in activities they previously enjoyed
- Withdrawal from friends and play
- Expressions of hopelessness or "wishing I wasn't here"
Warning signs in teenagers (ages 13–17)
- Significant decline in academic performance
- Withdrawal from friends, family, and activities
- Changes in eating or sleeping
- Increased risk-taking, substance use, or dangerous behaviors
- Self-harm (cutting, burning) — any self-harm warrants immediate attention
- Talking about death, dying, or "not wanting to be here"
- Dramatic mood swings or periods of grandiosity alternating with depression
Trust your instincts. If something feels off — even if you can't articulate exactly what — a consultation with a child therapist costs little and can provide significant reassurance or early intervention.
Seek help immediately if your child
- Talks about wanting to die or suicide
- Engages in self-harm
- Has a plan to hurt themselves or others
- Is experiencing psychotic symptoms (hearing voices, paranoid thinking)
How to talk to your child about getting help
Normalize therapy: "Lots of kids talk to a special helper when they're having a hard time. It's just like going to the doctor when your body hurts, but this helper helps with feelings." For teenagers, emphasize confidentiality and their autonomy: "This person is there for you, not to report back to me. You get to decide what you talk about."
What to do first
Start with your child's pediatrician — they can screen for depression and anxiety and provide referrals. Then search for child therapists on BehavioralHealthGuide.org, filtering for child and adolescent as a specialty. Call several — ask about their experience with your child's specific concerns and their approach.