How to Know When Your Child Needs Therapy: A Therapist’s Guide for Parents

Child sitting with a parent during a calm moment, representing emotional support and child therapy.

As a parent, it can be hard to know when your child is going through a normal phase—and when their behavior is a sign they may need extra support. Many families wait months hoping things improve on their own. The truth is, early support can make a huge difference in emotional regulation, confidence, and overall wellbeing.

As a child and family therapist in Virginia who specializes in EMDR, IFS, Theraplay, SMART Moves, and PCIT, here’s what I tell parents who ask, “How do I know if my child needs therapy?”

1. Big Emotions That Don’t Match the Situation

All kids have meltdowns and hard moments. But therapy can help when:

• The intensity seems disproportionate

• They go from 0–100 quickly

• They stay dysregulated for a long time

• They can’t calm down without help

If you’re noticing hyperarousal or emotional outbursts that interfere with daily life, the Child Mind Institute has a helpful overview of emotional regulation in kids:https://childmind.org/article/helping-children-regulate-their-emotions/

2. Sudden Behavior Changes

Behavior is communication. Warning signs may include:

• Withdrawing or isolating

• Increased irritability or anger

• Drop in academic performance

• Clinginess or separation anxiety

• Sudden impulsivity or risk-taking

The American Academy of Pediatrics (AAP) identifies behavior changes as key indicators a child may need behavioral or emotional support:https://www.aap.org/en/patient-care/mental-health-in-children/

3. Ongoing Family Stress or Parenting Exhaustion

Kids absorb the stress around them. Situations like co-parenting conflict, custody transitions, new siblings, or household tension can impact emotional health.

The CDC notes that children exposed to ongoing stress can experience changes in mood, sleep, and behavior:https://www.cdc.gov/childrensmentalhealth/

Therapy supports both the child and the parent—especially when family dynamics feel heavy.

4. Trauma, Loss, or Difficult Experiences

Children respond to stressful events in many ways, including:

• Sleep changes

• Regression

• Nightmares

• Sudden fears

The National Institute of Mental Health outlines how trauma can show up differently in children than adults:https://www.nimh.nih.gov/health/topics/child-and-adolescent-mental-health

Approaches like EMDR and play-based therapy are developmentally appropriate and highly effective.

5. Your Gut Says Something Feels Off

You know your child best. If something feels different, concerning, or “not quite right,” that intuition matters.

The American Psychological Association notes that early intervention often leads to better outcomes:https://www.apa.org/topics/children-teens/mental-health

You don’t need a crisis to reach out.

What Therapy Actually Looks Like

Child therapy is gentle, relational, and play-based. In my work, I draw from:

• PCIT (Parent-Child Interaction Therapy): Evidence-based for behavior challenges — learn more from PCIT International:https://www.pcit.org/what-is-pcit.html

• EMDR: Effective for trauma and stress — overview from EMDRIA:https://www.emdria.org/about-emdr-therapy/

• IFS-informed therapy: Helps children understand their internal “parts” — information from the IFS Institute:https://ifs-institute.com/

• Theraplay: Builds secure parent-child bonds, strengthens emotional regulation, boosts self-esteem, and helps children heal from trauma or navigate developmental challenges by fostering joy, trust, and connection through caregiver-led activities https://theraplay.org/what-is-theraplay/

Therapy isn’t about “fixing” your child. It’s about helping them feel safe, regulated, and understood.

When to Reach Out

If your child’s emotional or behavioral patterns are interfering with daily life — and if you’re feeling overwhelmed as a parent — therapy can provide relief and direction.

If you’re in Virginia and looking for compassionate, down-to-earth support, I offer online therapy for moms, kids, and families. You can reach me at wthc@willowtreehealingcenter.org or schedule through my Psychology Today profile.

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Mary Willoughby Prentiss is a licensed professional counselor in the state of Virginia who provides online therapy for Willow Tree Healing Center. She enjoys transforming the lives of women, college students, kids, tweens/teens, and families through providing communication strategies, coping skills that work, allowing a safe space to be heard, and actively working towards helping you with your challenges. She is certified in Parent-Child Interaction Therapy (ages 2-7) and Trauma-Focused Cognitive Behavioral Therapy, counsels substance abuse in teens and adults, and practices Eye Movement Desensitization Reprocessing (EMDR) Therapy.