How Do You Know When To Seek Professional Intervention For Your Adolescent Child?

How Do You Know When To Seek Professional Intervention For Your Adolescent Child?

As adults who were once teenagers, we can speak from experience that the teen years are fraught with discomfort and insecurity. While there is no such thing as "normal," we can honestly say that feeling awkward, highly sensitive, self-conscious, and prone to mood swings is "normal" during the teen years and, for many, can persist into the early twenties. 

So, if all these emotions are "normal," how does a parent know if and when to seek professional help for their teenager? To answer that, we need to define "professional help." This can mean anything from a school counselor to a licensed therapist or even a psychiatrist. Many parents start with the school counselor and the pediatrician, both of which can be great resources. Seeking help and knowing what kind of help is needed are two different things. When your vision is blurry, you do not make an appointment to see the orthopedist; when you have a paper cut, you do not go to urgent care. To select the most appropriate option, you must understand the problem's severity. How serious is this, and will it pass? If so, how long is it reasonable to wait for it to pass? 

Understanding the Problem and Its Severity:

Many parents of teenagers and adult children will tell you, "They need you more in the teen years than they did in the elementary years." This need for parental involvement is because their brains undergo so much change with the release of hormones that disruptions in both the endocrine and nervous systems can create havoc with thoughts and emotions. Understanding what your adolescent is going through requires you to be available at the right moments when your child is most receptive to opening up to you. These moments may not be the most convenient for you, but being aware of how significant these opportunities are, can give you the willingness to be there for them at the right time. Many kids are more apt to talk just before they sleep, so being available at bedtime or during the drive to or from school can be a good strategy. For parents working outside the home, it is imperative to create time for your adolescent to connect with you regularly. Listen to what they have to say, and avoid critiquing, lecturing, or communicating in a judgmental way during these conversations. This is how you will gain insight into the problem and how invasive it is. If your teen tells you they feel hopeless, isolated, and overwhelmed, let them know you will help them find out why and that you will work together to find the right solutions. It is important to stay calm yourself, and not to be reactive. I use the language "respond" rather than "react." To respond is to remain calm and think of all angles before suggesting any action. Whereas, to "react" can result in you saying or doing something impulsively before you really know the whole picture, which can create new problems.

Even if you think your child may be dramatizing, listen and reach out because they do not have the neurological and emotional maturity to know how to express and handle what they are going through. Hopefully, parents have a fully mature prefrontal cortex and can play the "external emotional regulator" role for their adolescents, giving them support via clarity, empathy, and limits. 

Here are some key behaviors to pay attention to:

Is my teenager exhibiting any of the following:

• Spending more and more time closed up in their room, isolating themselves from the family.

• Complaining of feeling excessively tired over more than three weeks

• Appear to have a flat affect or depressed mood that has lasted more than three weeks.

• Frequently make self-deprecating remarks.

• Have chronic trouble with sleep: either falling asleep, staying asleep, or waking too early.

• Report frequent nightmares

• Have frequent and excessive fears that are out of proportion 

• Excessive rumination over past events that seem trivial to others

• Express unrealistic expectations of self or exhibit perfectionism.

• React to stress out of proportion to the actual situation as noted by any of the following:

  • Become agitated physically

  • Burst into tears suddenly to the point of inconsolability 

  • Express feeling hopeless

  • Excessively complain of physical ailments (stomachaches, headaches, pains) to prevent involvement in daily activities or avoidance of specific tasks.

  • Refuse to participate in activities with the family or with friends.

  • Constantly worry that others are upset, dislike them, or talk behind their back.

  • Apologize excessively

  • Often seem to misperceive or misinterpret what others say or do

If their life is becoming more and more restrictive, it is time to address the situation. Seeking out qualified, knowledgeable team members with whom your child can feel comfortable is essential. This may require you to interview various professionals before you have them meet your child. If you are in tune with your child’s preferences and what makes them feel safe and comfortable, you can use this as your guideline when meeting potential providers. 

The relationship between professional and client is significant for the client to benefit from the intervention. Potential professionals on your child’s team may include some or all of the following disciplines: pediatrician, psychologist, clinical social worker (LSW), occupational therapist, and school counselor. When screening professionals before they work with your child, be sure to make a list of questions to ask, such as the following:

• What approaches do you use when working with children with concerns similar to my child's?

• Do you have extensive experience working with children with similar challenges?

• What can we expect to see, and how do you measure change?

• Do you tailor the language you use with children to accommodate their level of awareness and understanding?

• Do you discuss specific diagnoses with children or keep that information confidential?

• How do you handle challenging behaviors?

• How often do you meet with us as parents?

• Do you feel comfortable if my child wants me to participate in the session?

• Are there other people (staff or clients) in the same treatment room with my child?

• Does the treating therapist remain consistent, or can it vary?

• Do you assign home programs, and how do you monitor that?

• How long typically do children with similar issues attend, and how often?

• Do you use standardized testing or informal assessments?

• Are you available to share information with the school or other agencies?

• If you think my child needs the assistance of a different professional or service, will you refer us to the appropriate agency?

• Do you accept insurance? Do we need to submit paperwork, or does your office do that?

• Can my child return for check-ups after being discharged?

• What is your cancellation policy?

This is a sampling of questions, and you can add to the list as you need. It is best for you to meet with the professional that would be directly working with your child, before you schedule an appointment for them to do so. Ask if the clinic or office allows for Meet and Greets so you can preview their office and staff.

When in doubt, it is generally helpful to make a call and get more information, if only to settle your own anxious feelings. You can also seek multiple opinions, and be sure to listen to your gut. You likely know your child better than anyone else, and if it seems like they are struggling, you will feel better if you gather more information and speak with a professional with expertise in the area of concern