One of the

questions I get more than almost any other is a question from parents

concerning whether or not their children need to see a therapist.

Parents have

observed behaviors in their children that they are worried about or they

do not see behaviors in their children that they think most "normal"

kids should be doing and they are worried. Every situation is different

and this brief newspaper column cannot answer all questions, but I hope

to give you some guidance so that you might be able to answer this question

yourself.

First of all,

with any disturbance, whether in adults or children, I first want to know

how much the problem is interrupting the person's life. If, for example,

a parent tells me her child is extremely shy and doesn't seem to make

friends easily, I want to know if the observed behavior (shyness)is interrupting

the child's ability to do the things that he or she enjoys.

If the shyness

doesn't interrupt the child's life and if the parents are able to do the

things they need to do despite the shyness in the child, then I usually

suggest that the parents not worry about it. Even if the child had a diagnosable

disorder, it makes little difference if he or she is functioning well.

On the other

hand, a parent tells me that his son has a problem getting along in school.

The child is nine years of age and has been disciplined numerous times

at school and at church. The parents have chosen to take the child out

of two different schools because the administrators and teachers, by the

parent's estimation, didn't handle the situation correctly.

This is most

certainly a problem. The child is not functioning effectively in more

than one environment and the behavior is also causing problems for the

parents. Whether or not the child has a diagnosable disorder, something

has to change.

Using this

one rule, I can often guide parents over the phone without seeing the

child. I suggest to the parent that if the situation doesn't improve or

if they would like me to see the child anyway, then I'll make an appointment

with them.

Second, there

are some problems that are almost always serious. Children who are deliberately

cruel to animals or human beings potentially are deeply troubled individuals.

It is abnormal to deliberately be cruel to living creatures.

Children who

are acting out sexually, depending on the behavior and their developmental

ages, also are displaying signs of potential disturbance or trauma. Children

who set fires deliberately and repeatedly are of concern to me as well.

I will always make an appointment to see the child in my office if these

behaviors are reported.

Finally, sometimes

the problem is actually with the parent or parents and not the child.

Many times over the years I have worked with children who were actually

the most mentally healthy people of their family.

When I suggest

therapy for the parent as a way to help the child, sometimes parents are

willing and sometimes they are not. When parents are experiencing the

stress of financial burdens, marital problems, abuse, or other significant

life stressors, it almost always affects the children in the home.

Children in

these homes may act out aggressively, they may vandalize property, or

they may withdraw. Older children may experiment with cigarettes, drugs,

and alcohol. Resolution of these problems requires treating the cause

- the distress in the parents' lives.

I would always

rather parents seek help when they don't need it than to wait too long

when their children do need help. It is easier to deal with problems early.

If you think

your child may need therapeutic intervention, I discourage using the phone

book to find a therapist. Even though there are many competent and exceptional

psychologists in the field, there are also some who are not. Seek references

from people that you trust ministers, others who have had their children

in therapy, or from people in the profession.

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