Would Your Child Be a Good Fit for Dungeons & Dragons Group Therapy?

Have you ever wondered what help is available for kids outside of individual talk therapy? Social distancing has made many of us acutely aware of how important it is for kids to be around other kids. If you’re trying to find ways for your child to stay connected to peers during another few months (or more!) of online school, I want to introduce you to a quirky new kind of therapy you may not have heard of before. In this post, I’ll be sharing a little about how Dungeons & Dragons can be used in therapy groups, and how to tell if this approach could be a good fit for your child.

What Happens in a Dungeons & Dragons Therapy Group?

Dungeons and Dragons is a little bit like a choose your own adventure book come to life. Each player in D&D creates a character with their own unique strengths, weaknesses, and magical powers. These characters work together to navigate a fantasy world, solve problems, and generally get up to mischief and adventure.

Rather than following a pre-set story or rules, D&D players are making up their own story as they go. They’re helped in this by a “Dungeon Master”, who acts like a referee and emcee in the game. The dungeon master sets the scene for the players, gives them problems to solve, and helps them to build a magical world. A roll of the dice determines how successful the player is at whatever they’re trying to do, which adds an element of surprise to the game.

Dungeons and Dragons is collaborative, not competitive, and it requires tons of creative problem solving. This makes it a great fit for therapy groups, and therapists around the country have started incorporating D&D into group therapy sessions with kids and adults. Dungeons and Dragons is a great way to meet new people, practice communication and teamwork, and experience the satisfaction that comes from learning a new skill.

Is Dungeons & Dragons OK for Kids?

The name “Dungeons and Dragons” sounds a little…sinister. It conjures up images of a game that is heavy on gore and may not be suitable for children. If this is the reaction you had when you first heard about D&D, you aren’t alone! Just like rap music and video games, there was some controversy in the 80s about whether D&D was too violent for kids.

Name aside, there is nothing inherently age-inappropriate about D&D for kids. The game is all about imaginative play, and it doesn’t even have to include dungeons or dragons: stories have been set in all sorts of cool, child-friendly fantasy worlds, from outer space to fairy forests to fantasy worlds inspired by Studio Ghibli movies. Because the game is fully customizable, it’s up to every group to decide what content is okay and what is not, and how to handle violence.

Today, we know that there are many ways in which role-playing games like D&D support child development. Game play requires both math and reading skills, encourages teamwork and turn-taking, and gets kids see the world through someone perspective, which helps to develop empathy. Dungeons and Dragons promotes all sorts of positive social skills that kids can apply not just to the game, but to their day-to-day lives.

Who Is a Good Fit for Dungeons and Dragons Groups?

So, what kind of kid might enjoy playing D&D? Is it only for children who already really into nerd culture? Is it better for extroverts or introverts? What about kids who have never played the game before—could they figure it out in a group setting?

Personally, when I started playing D&D, I was not very familiar with anime, video games, or any other aspect of “nerd culture.” I had also never played the game before, and the rules seemed a little intimidating at first. Now that I’ve played the game for a while, I think the only skills you really need to be a great D&D player are imagination, creativity, and a willingness to play.

Here are a few signs or traits that your child might be an excellent fit for a Dungeons & Dragons therapy group:

• Your child loves getting lost in fantasy worlds like Harry Potter, Lord of the Rings, or Star Wars

• Your child is a “theater kid” who enjoys acting or performing

• …or, on the flip side, your child is shy and would love to make new friends, but isn’t sure how to reach out to new people

• Your child is imaginative and was always great at pretend play

• Your child would like an opportunity to practice teamwork, verbal communication, and taking turns

• You think your child could use the self-esteem boost that comes from mastering and succeeding at a new activity

Both extroverts and introverts can excel at Dungeons & Dragons, as long as they are willing to step a bit outside of their comfort zone to play around with new friends.

How Old Do Kids Need to Be to Play Dungeons and Dragons?

I usually see 12 being recommended as the ideal age to start playing D&D. The rules can be a little complicated, and kids need to be able to think abstractly in order to enjoy playing the game. In my own D&D group, I work with middle school aged kids from ages 11-14.

The right age to start playing depends a lot on your individual child. If your elementary school-aged kid has been playing other tabletop games for years and is a fantasy story fan, she may be ready to dive into D&D. It’s also possible to simplify the rules of D&D to accommodate younger players, which can be a fun option for families with mixed-age kids who would like to play the game together.

More Information on Dungeons & Dragons Therapy Groups for Children

If you want to experience some of the therapeutic benefits of D&D for yourself, check out Young Dragonslayers. This program started as part of my therapy practice, and has grown to offer online D&D to kids across the country with the goal of practicing social-emotional skills in a friendly, inclusive environment.

For further reading, check out my earlier blog post on the mental health benefits of D&D as well as Geek & Sundry’s helpful article about D&D therapy, which focuses on how the game can be useful for kids with social anxiety.

If you have any questions or you’d like to learn more about counseling, you are always welcome to contact me.

What to Do if Your Child's Therapy Isn't Working

If you’re worried your child’s therapy isn’t working, don’t despair! There’s a lot you can do to get things back on track. Photo by SHVETS via Pexels.

Therapy can be a transformative experience for kids, helping them overcome challenges, devleop essential skills, and thrive in their daily lives. If you’ve reached this page, you’re probably a believer in the many benefits therapy can provide for children. So what do you do when…it just doesn’t seem to be working?

We all know that growth isn’t linear, change takes time, and all that good stuff. But it’s still disheartening when, after all hard work finding a therapist and attending sessions, things don’t appear to be improving for you and your child. Sometimes, despite everybody’s best efforts, progress in therapy can seem slow or nonexistent. The good news is there’s a lot you can do to get things back on track.

What Should You Realistically Expect From Therapy?

No matter what kind of therapy you choose for your child, you should expect that it will likely take some time before you see major results. In my counseling practice, the average length of a child’s therapy is about six months. Of course, some kids need a lot less time, and some need a lot more.

This lines up with what the big therapy organizations say about how long therapy takes. The Association for Play Therapy estimates that kids will need an average of 20 sessions to resolve the problems that brought them to therapy. According to the American Psychological Assocation, 50% of people in therapy will be ready to go after 15 to 20 sessions, and the rest will need more time. Even “short term” forms of therapy may take longer than you might expect: TF-CBT, a short-term trauma therapy, usually requires 18 to 24 sessions.

If you’re meeting once a week, that means you’re looking at 5 months or more of therapy before your child will be fully ready to move on. Given that estimate, I think it’s safe to start questioning whether a therapy approach is effective around the two month mark.

Here are some other points to keep in mind as you evaluate whether therapy is working out:

• Early therapy sessions focus on relationship building: your child might learn about their diagnosis and feel a lot more hopeful about therapy, but you probably won’t notice huge changes during the first few weeks.

• It’s not typical to notice big, positive changes after every session. Over time, though, you should see gradual improvement.

• Sometimes, symptoms may get worse before they get better, especially if your child is in anxiety or trauma therapy that involves exposure (facing feared situations).

• Pretty much every kind of child therapy requires some level of parent involvement. Even though kids need their privacy, you should expect to be kept in the loop by their therapist about their progress and how you can help.

If your child is new to therapy, it’s possible that you’re just too early in the process to see changes. On the other hand, if you’ve been in the therapy game for a while and progress has slowed or stopped, keep reading to learn what might be getting in the way.

What Are the Signs That Your Child’s Therapy Might Not be Working?

Stalled progress, difficulty using skills in real life, feeling uncomfortable in sessions, communication struggles, and worsening sypmtoms can all be signs of problems in therapy. Photo by Monstera via Pexels.

So, let’s say you have realistic expectations for therapy: you’ve been at it for 8 sessions or so, and you know change isn’t going to happen overnight. You’re still not seeing the differences you’d hoped for. How can you tell if you’re on the right track? Here are some indicators that something about your current therapy approach isn’t working for your child:

Lack of improvement over the long term

In therapy, progress tends to happen in fits and starts. You might have a big breakthrough one session, followed by a week or two that are relatively quiet. It’s even possible that symptoms will become more intense for a little bit, if your child is confronting tough stuff in therapy that they have avoided until now. If you zoom out and look at the big picture, though, you should notice an upward trend over time.

Skills aren’t translating into real life

Many forms of child therapy, like CBT, put an emphaisis on learning coping skills and other practical strategies a child can use to manage their feelings and handle tough situations. There’s a big difference, though, between learning these skills and putting them into action. If your child is consistently unable to use what they’re learning outside of therapy, it means something is getting in the way.

Your child feels uncomfortable in therapy

It’s pretty normal for kids to be reluctant to go to therapy some of the time. This is especially true if therapy is getting into difficult subjects, like facing anxiety fears or talking about trauma experiences. This can usually be figured out with your therapist. On the other hand, if a child consistently dreads therapy and really doesn’t want attend, this might indicate a bad fit or lack of trust in the relationship.

Communication isn’t clear

Does it feel like stuff is always getting lost in translation with your child’s therapist? Maybe it feels like your child is avoiding the big issues in sessions, and you never get a chance to meet with the counselor to bring up concerns. Or, maybe you’re not sure what’s being worked on and how you can help at home. Kids need some privacy in order to make therapy work, but as a parent you should always know what the current therapy goals are, and have a way to check in with the therapist.

Things are getting worse

Okay, this one may seem a little obvious, but it’s true! If you haven’t been warned that your child’s symptoms might flare as a part of the therapy process, and things are getting worse at home, its’s time for a talk with your child’s counselor. This is especially true if you’re noticing worsening depression, thoughts of self harm, or aggressive and destructive behavior.

It’s important to note that seeing one or more of these signs doesn’t necessarily mean you have a bad therapist or that you have completely wasted your time and money. It’s absolutely a sign, though, that you need to have a conversation with your child’s therapist and figure out how to make things better, so you don’t spend additional weeks or even months doing something that’s not working.

Please, Talk to Your Child’s Therapist!

If you are feeling frustrated and don’t think your child’s therapy is working, please don’t keep this to yourself! As awkward as it might feel, telling your therapist you are concerned is a really important part of turning things around. You aren’t going to hurt your therapist’s feelings if you tell them you’re not loving how things are going!

Speaking from experience, I always want to know when something I’m trying is not landing with a client. It’s a huge bummer to hear that something wasn’t working long after the fact. We could have changed approaches so much sooner if I’d known, and saved that kid a lot of unnecessary suffering!

Pretty much every therapist out there cares more about kids getting better than they do about their own ego. Your therapist wants to hear from you. In fact, hearing feedback from parents—the good, the bad, and the ugly—makes it much easier for us to do our jobs.

When you talk to your child’s therapist, try to be as specific as you can about what you’re seeing at home and what doesn’t seem to be improving. You can mention things like:

• How often your child is struggling, and how severe or long-lasting these episodes seem to be. For example, is your child having anxiety about school 4 out of 5 nights a week? Are tantrums lasting 30 minutes or more?

• What you’ve been trying in order to help your child at home: what strategies are you using? How are you implementing them? What doesn’t seem to work out when you do?

• Any concerns you feel haven’t been addressed yet in the therapy process

• Anything you’re confused about, like how a specific strategy works or what the current therapy goals are

One final note about having this talk with your child’s therapist: please set up a time to meet with the counselor when your child isn’t present. You want to be able to speak openly about behaviors you’re seeing at home or family dynamics that might be getting in the way of completing therapy goals at home. Kids tend to personalize these conversations and may believe that it’s their fault if therapy isn’t going well.

Common Therapy Problems, and How to Handle Them

Often, an honest conversation with your child’s therapist is enough to clear up issues that are keeping you from progressing. You may need to clarify treatment goals, rethink your child’s diagnosis, figure out what’s getting in the way of using skills at home, or consider switching approaches or therapists in order to get things working again. Photo by Cottonbro via Pexels.

Hopefully, you are able to bring these concerns to your child’s therapist, along with some specifics about what doesn’t seem to be going well. Together, you can figure out what the roadblock might be that’s preventing therapy from being effective. There are all kinds of reasons therapy might not work, but here are a few common ones to consider, along with ways you can help things improve:

Unclear Treatment Plan

I often hear from parents that they’re not sure what’s going on in their child’s therapy aside from “just playing.” This should never be the case! Start off your troubleshooting process by making sure you and your therapist are on the same page regarding your child’s therapy goals.

Every therapist is required to create and maintain a document called a treatment plan. This outlines what problems brought a child to therapy in the first place, and what goals have been set in order to make those problems better. If you’ve been in therapy a while, this document has likely been updated to show how much progress your child has made toward these goals.

If you aren’t clear on your child’s treatment plan, you can:

• Ask to meet with your child’s therapist to review the treatment plan together

• Let the therapist know that you’d like to get clear on what the current goals are, and be more direct in working toward them

• Get feedback from your therapist on what they’ve observed in sessions and how they feel your child is progressing

• Ask how you can support your child in achieving treatment plan goals at home

If your child’s therapist doesn’t have a treatment plan, can’t give clear answers about goals, or isn’t able to provide specific responses to your questions, you may not be a good fit for each other.

Treating the Wrong Problem

It’s also possible that your therapist has a clear, detailed treatment plan…and you’ve been focusing on the wrong problem. Sometimes, one mental health problem masquerades as another. Girls with autism, for example, have a harder time getting diagnosed and their symptoms might be mistaken for anxiety or another disorder at first. Trauma symptoms can look an awful lot like ADHD. Children who have OCD might take a while to get the right diagnosis, as well, because the behaviors can be hidden or hard to spot.

If you’ve been diligently working on your treatment plan, trying to follow through with things at home, and nothing seems to be moving the needle, it’s worth questioning if something else might be going on.

If you’re wondering if there’s another diagnosis at play, you can:

• Ask your child’s therapist if there are any other diagnoses (sometimes called “differential diagnoses”) they have considered for your child.

• Give a thorough review of any possible symptoms, behaviors, or difficulties you’re seeing at home,

• Reflect on your child’s history: have they lived through anything that might be considered a traumatic or highly stressful event? These are good for your therapist to know about, even if they seem unrelated to the problem at hand.

• Consider getting an evaluation from a psychologist to screen for ADHD, autism, or other developmental or learning conditions

Depending on what you learn, you may find that your goals in the therapy process need to change—or you may discover that your child is a better fit for another kind of therapy altogether.

Trouble Following Through

What happens outside the therapy room matters just as much as what goes on inside of it. This is especially true if you’re in a skills-based form of therapy, like CBT, or treating a problem like anxiety or behavior difficulties where a lot of the struggles occur at home.

Kids are still in the process of learning to regulate their emotions, and need an adult’s help to do this. Even if they’re learning skills perfectly in session, they won’t be much use if there isn’t a parent or caregiver helping with follow-through in real-world situations.

Of course, this is way easier said than done. Working on therapy skills can be time-consuming and emotionally draining. It can be really hard to find the time and emotional reserves to work on therapy when you’re managing a busy and stressful life. It’s also possible that a plan that sounded really good in the office falls apart when you get home: either your child is reluctant to do it, or you encounter some kind of issue that you can’t figure out how to navigate.

If you’re having a hard time following through on therapy goals at home, try the following:

• Be honest with your therapist about what’s going on. You aren’t getting graded, so there’s no need to lie about not doing your homework!

• Make sure you feel clear and confident about what your assignment is: you should know exaclty what you’re doing, and what to say when

• Sometimes, a plan sounds okay in the office but feels difficult, uncomfortable, or scary to a child when it’s time to follow through at home. If this is the case, you may need to adjust the goal or come up with a plan to support your child through it.

• Let your therapist know about any sticking points that you’re tripping up on when you try to practice at home

If you’re in the middle of a major life transition, experiencing trauma or loss, or feeling totally overextended by work and family obligations, you may just not have the reserves to fully participate in therapy right now. It may make more sense to focus on those life stressors first, and return to therapy once things have settled down a bit.

Child Needs Higher Level of SuPport

If you aren’t seeing improvement, and especially if things are getting worse, you may simply not be getting enough help. Some issues need more attention and support to resolve than a 50-minute sit down with a therapist once a week can provide. This is kind of the “bare minimum” of therapeutic support, and there are a lot of other options to consider when it isn’t enough.

Somtimes, families opt to try therapy on an every other week or even monthly basis. This may be due to financial concerns, time constraints, or limited availability from your therapist. While this can be a good option for kids with mild symptoms, kids who are really in the thick of it will have a hard time keeping momentum up if they’re only coming every other week.

If you feel like things are steadily worsening, and particularly if your child is struggling with suicidal thougths or self-harm, it’s worth talking to your therapist about ways to increase support. Here are some possibilities to consider:

• You child may need more frequent sessions: weekly if they’re coming every other week, or twice a week if they’ve attended weekly.

• Adding group therapy, like a DBT skills group, can add another layer of support for kids struggling with suicidal thoughts or self-harm.

• Consider meeting with a psychiatrist to see if medication could help your child make more progress in therapy: you can talk this over with your therapist and pediatrician.

• If finances make it hard to attend therapy more often, ask about a sliding scale or consider making a transition to a therapist who takes your insurance or can offer a lower rate.

• If your child is not safe at home, intensive outpatient therapy (meeting daily for part of the day) or an inpatient stay might be needed before your child is ready to “step down” to weekly therapy sessions.

It might be hard to think about adding more therapy when things are already not working: it means more time, more money, and more effort. While a higher level of care isn’t the right answer for every child, it can make a world of difference for kids who really need it.

Therapist is Not the Right Fit

Sometimes, it’s just not a good match. Maybe the style of therapy your counselor offers doesn’t work for your kid: a child who’s reluctant to attend therapy might not do well in an approach that requires a lot of self-motivation, for example. Or, maybe you’re feeling a lack of clarity about what the treatment plan is, and you can’t seem to get on the same page. If your child’s diagnosis or needs have changed over time, they may need a form of help your therapist no longer specializes in.

It’s also possible that your personalities just don’t mesh well: just like you’re not going to be friends with every person you meet, you’re not going to hit it off with every therapist you meet, either. Simply not feeling comfortable with your therapist—even if they’re a nice person—can be reason enough to make a change.

If you’re just not vibing with your child’s therapist, there are a few things you can do:

• As awkward as it may seem, you can still bring this up to your therapist, as long as you don’t have any big ethical concerns about their behavior. They may sense that it’s a poor fit, too!

• Try to get specific about what you need out of therapy that you’re not getting now. Would your child respond better to a therapist who is more animated and engaging? Do you need someone who specializes in a specific diagnosis, or does more parenting work?

• Ask yourself whether a difference in culture or background might be part of the problem. It may or may not be, but sometimes finding a therapist who shares your racial or cultural heritage can help.

• Search for therapists who meet your new criteria. You can even ask your current therapist for referrals, if you’d like!

Just like doctors have no problem with patients seeking a second opinion, most therapists genuinely just want our clients to feel better, whether that happens with us or someone else. I’m always happy when a family is able to find someone who is exactly the right fit for their situation.

Should You Switch to Another Therapist?

It’s always within your rights to switch to a new therapist, and sometimes that’s exactly what you’ll need to do if your current therapy plan isn’t working. If you’ve tried talking with your therapist and things still aren’t working out, it’s perfectly okay to transition your child to a new counselor. There are so many different styles of therapy out there that you might not find the right match on your very first try.

Just like you wouldn’t fire an employee over a minor offense, I don’t recommend leaving therapy the first time something goes wrong. In fact, you should expect that things will go wrong sometimes! Your therapist won’t always get it right. They may interpret something in a way that doesn’t sit right with you. Or, they may have a policy you don’t agree with, like charging a cancellation fee.

Minor missteps and frustrations can be worked through, and will often make your relationship with your therapist stronger. If you left therapy every time something like this happened, you’d be repeatedly starting from the begining and it would be hard to make any meaningful progress. On the other hand, unethical behavior—things like making racist or sexist comments, not protecting your private information, or saying something inappropriate in session—should never be tolerated. Get out of the situation immediately if this happens to you, and consider filing a complaint with your therapist’s board.

Most of the time, there won’t be a big, dramatic reason for ending therapy: it’ll just turn out not to be a good fit. In these situations, I strongly recommend being upfront with your therapist about what’s going on. Scheduling a final “goodbye” session for your child gives them a sense of closure before moving on.

Take Care of Yourself As a Parent

Your child’s therapy process isn’t going to look like anyone else’s, so resist the temptation to compare your child or family to others. You can’t help your child through therapy if you’re completely burned out! Photo by Albert Rafael via Pexels.

It’s easy to feel burned out when therapy isn’t working for your kid. Here you are, contributing all this time, money, and emotional energy in the hopes that things will get better…and then they don’t. You might blame yourself, worry that your child’s problem is unfixable, or start to question whether therapy will ever work.

We all know the adage about the oxygen mask in the airplane: there’s no use in bending over backwards to find help for your child if you’re feeling utterly fried by the whole process, and have no time to take care of yourself. Do whatever you need to do to prioritize your own mental health during this stressful time, even if it feels a little selfish.

Your kid’s process is not going to look like any other kid’s process: they’re a unique individual. There’s no reason to beat yourself up if so-and-so’s kid had a miraculous transformation in 3 sessions of therapy and your family is still struggling 6 weeks in. Just like kids hit their developmental milestones at their own pace, you and your child will figure this out on your own timeline, too.

When you’re really feeling stuck, it can be easy to overlook the small, everyday ways that things are getting better. It sometimes helps to refocus on those small victories. Did your child encounter a triggering situation today, but not melt down? Were they able to articulate their feelings to you this week? Have some aspects of your problem gotten better, even if other parts have stayed the same? This is all growth and progress to be celebrated.

Be patient, hang in there, and don’t neglect these little wins while you figure out how to get unstuck.

Begin Child Counseling in Charlotte, NC or Online

Finding a therapist who is the right fit for your child can make therapy more effective. If you’re looking for someone who specializes in tween anxiety and OCD, I’m available to work with children throughout NY, NC, and FL. Photo by Victoria Rain via Pexels.

If you’re still looking for the right fit for therapy for your child, I might be able to help! I can see kids in person at my Davidson, North Carolina office, or online anywhere in North Carolina, Florida, or New York.

I mainly work with tweens (rougly ages 8-13) who are struggling wtih anxiety due to OCD, difficult life circumstances, or just by virtue of having an anxious temperament. We’ll work together using practical, skills-based therapy along with a healthy portion of fun and play to learn new ways to deal with difficulties in life. I’m trained in three research-based forms of therapy: CBT (great for anxiety), TF-CBT (designed for trauma), and ERP (for OCD). I’m also a drama and play therapist, so we won’t just be learning dry skills from a book, but we won’t be playing Uno all day either :-).

If you think your child could benefit from this approach, feel free to reach out! You can also join my mailing list to get my free coping skills guide, as well as monthly information on how to help kids and tweens navigate life with anxiety.

Should Parents Be Involved In Their Child's Therapy?

Since becoming a parent myself, it’s dawned on me what a leap of faith it is to send your child to therapy. Whether you’re meeting in person or online, you’re sending your child into a room with a near-stranger without knowing exactly what’s happening behind that closed door. Does this person have your child’s best interests at heart? Do they know how to help? Are you missing out on important information? Are they just playing Uno in there?

Involving parents in a child’s therapy can be a tricky business. On one hand, kids need enough privacy to trust that they can safely share difficult thoughts and feelings. On the other, it’s fair for parents to want to be kept in the loop…and research shows therapy is more effective when they are.

Being a part of your child’s therapy process benefits everybody: you, your child, and your child’s therapist. But how you get involved will depend on your child’s age, maturity level, and the reason they’re coming to therapy.

You Are the Expert on Your Child’s Life

You know how, in documentaries, there’s always a “talking head” segment where an expert drops a bunch of knowledge and historical information about the subject of the movie? If there was a documentary about your child, you’d be that expert. You have insight about your child that your therapist doesn’t.

Child therapists have broad knowledge: they have data about a large number of kids. They know what anxiety, depression, and other mental health issues tend to look like in kids. They’ve studied child development and probably attended countless lectures and trainings on specific ways to help kids with different conditions. On top of that, they’ve met with hundreds of kids for therapy. Based on what’s helped all these other kids, your therapist can make a strong educated guess about what will be helpful for your child.

Parents have deep knowledge: you know your individual child better than anyone else. You’ve spent years learning to decode your child’s tiny facial expressions or tones of voice. You know their history and you’ve seen them at their most vulnerable. You’ve likely been with your child since the day they were born and seen them grow and change. You’re the family historian, and you can remember details about your child’s life that they cannot.

Your deep knowledge is really useful in therapy. It provides background and context. You can give your therapist feedback to help them tailor their skills to work for your specific child and family. And learning those skills alongside your child will help them to get the most out of therapy.

The Pros and Cons of Parent Involvement in Therapy

Participating in your child’s therapy is a bit of a balancing act. You want to be involved enough that you know what’s going on and how to support your child, but not so involved that your child feels like they don’t have any space to do their own thing.

There are definite benefits to parent involvement, but there are also some potential drawbacks to be aware of. Let’s take a look at both.

The Pros:

• We have a lot of research that shows that being involved in your child’s therapy is linked with better outcomes: kids do better when parents actively participate.

• Participating in therapy sends a message to your child that going to therapy isn’t a punishment for bad behavior: you’re committed to growing and changing, too.

• Coping skills are great, but kids will need help from an adult to put them into practice. You can reinforce what your child is learning at home.

• You can share important information with your child’s therapist about your family history, religion, culture, or anything else that might influence your child’s experiences.

• Children of all ages need help from their parents to handle their feelings. To create lasting change, both kids and their parents need to learn new ways of dealing with anxiety and behavior struggles.

The Cons:

• If everything a child says is immediately relayed back to the parent, it’s a betrayal of trust. Children will quickly figure this out, and stop sharing important information in therapy.

• Sometimes it’s easier for children to bring up difficult, embarassing, or scary subjects for the first time with someone who isn’t a family member: it helps to protect those important relationships. If parents are in the room all of the time, it’s hard to do this.

• Older children are more aware of cause and effect, and may worry about the consequences of sharing things in therapy as a result: if I say this to my therapist, will I get in trouble at home?

• As kids become teenagers, it’s normal and natural for parts of their lives to become more private from their parents. It’s no longer age-appropriate for them to share every detail of their personal lives.

A lot of these risks can be managed by setting clear boundaries in advance: everybody, including your child, should know what gets kept private and what doesn’t. You can talk with your therapist about the best way to participate, based on your child’s age and needs.

How Involved Should I Be in My Child’s Therapy?

There’s no “right” level of involvement in a child’s therapy. Every kid is different! Your child’s age is the biggest factor to consider when trying to figure out how to participate: the younger your child is, the more present you’ll need to be.

Your child’s reason for attending therapy matters, too. Children experiencing anxiety or OCD may need a little more privacy, safe space to begin talking about their fears. A teen having relationship struggles may not want or need to talk about all the details with a parent.

On the other hand, behavior concerns like fighting, tantrums, and not following rules usually need more parent involvement. An argument takes two people, so you really need both people to figure out how to respond differently.

Finally, the severity of your child’s symptoms might also dictate how involved you need to be. A child who is feeling stressed about homework may be able to learn ways to cope with her worries fairly independently. A child who is so anxious about their work that they’ve stopped going to school most days is going to need lots of support and guidance from parents to overcome their fears.

Participating in a Preschool Child’s Therapy

Sometimes people are surprised to hear that therapy options exist for toddlers and preschoolers. They absolutely do! If your very young child is struggling emotionally, you have options. Forms of therapy have been created specifically to help preschoolers cope with trauma, manage difficult behaviors, and explore feelings through play, rather than words. Kids in this age range need a lot of parent support in order to make therapy work.

As a parent, you’re the center of your preschooler’s universe. You’re their first playmate, their protector, and the person who sets the schedule for their day. Little children look to their parents to decide how to respond in stressful situations: they’re always checking what your reaction is. When feelings get too overwhelming, it’s hard for preschoolers to self-soothe: they need your help to do this. Because preschoolers rely on their parents for so much, you can expect to be highly involved in their therapy.

Depending on your child’s needs, parent involvement in a preschooler’s therapy could look like:

• Attending sessions alongside your child, so the therapist can guide you through play-based activities together.

• Getting coaching in real time from a therapist as you interact with your child, so the therapist can “translate” the possible meaning of your child’s behavior or offer suggestions on how you can respond.

• Learning coping skills together in session that you can help your child to practice at home.

• Meeting frequently for parent sessions with your child’s therapist to discuss their progress

• Learning parenting strategies that you can try at home to support your child and the work they’re doing in therapy

To summarize, if you have a child between the ages of 2 and 5, you should expect to be a very active participant in their therapy process. Younger preschoolers will need your support in the room for the entire session: and what you learn will be just as important as what they learn.

Older preschoolers might be able to meet alone for play therapy some of the time, but you’ll still need to be involved and open to trying new things in order for therapy to work well. If your child’s therapist meets with them alone for play therapy, you should expect (and ask!) to be included on a regular basis, either for part of each session or for regularly scheduled parent-only meetings.

Including Parents in Therapy for Elementary-Aged Kids

Elementary-aged kids have mastered the art of pretend play, which makes play therapy a wonderful option for this age group! Between the ages of 5 and 10, children are also working on their ability to verbalize their thoughts and feelings. Starting school opens up a whole new world for kids: there are new important people in their lives like teachers, coaches, and friends.

All these factors mean that unlike younger children, elementary school kids can often benefit from some alone time in the therapy room. Sometimes, practicing being apart from Mom or Dad can even be a helpful goal for kids with separation anxiety!

However, it’s not realistic to expect this age group to put what they’re learning into practice by themselves: they’re going to need help and support from you. You’re still your child’s biggest teacher, and the 50 minutes they spend in therapy once a week will never have as much impact as their time with you.

If you’re participating in your elementary schooler’s therapy, you might be asked to:

• Check in about how things are going at home at the start or end of each week’s session.

• Join your child for the last part of their appointment to learn a coping skill together—or have your child teach the skill to you!

• Help your child practice simple “homework” over the course of the week.

• Meet for parent sessions to discuss your child’s progress and talk about ways you can tweak things at home (like discipline or the way the family responds to anxiety) in order to best support your child.

In general, you can expect that a child between the ages of 5 and 10 will attend therapy sessions by themselves, but that you’ll still be needed as as major source of support. Whether it’s helping your child practice relaxation skills or encouraging them to gradually face their fears, your participation makes a huge difference in the therapy process.

How to Get Involved in Your Tween or Teen’s Therapy

It’s totally normal and age-appropriate for tweens and teens to want some privacy in therapy. They’re at an age where they no longer need to share every thought that passes through their head with their parents. As kids hit adolesence, friends become a huge source of support and a helpful sounding board…but they can also be a major source of drama. It can be a relief to talk to someone like a therapist, who isn’t a close friend or family member and who is removed from a teen’s day-to-day life.

Tweens and teens are also much more capable of considering cause and effect: what will happen to me if I share this information with my therapist? Will my parents find out? Will I get in trouble? Because of this, it’s really important for these older kids to be informed about how confidentiality works in therapy. Safety concerns (like thoughts of suicide) will always be shared with a parent, but issues that aren’t urgent or dangerous (like a fight with a sibling) might not be.

Despite all this added independence, parents still need to be kept in the loop. Teenagers still need guidance from their parents, even if it looks different now than it did when they were little. It can be stressful to raise a teenager, and parents could use some support during this time, too. Participating in your teen’s therapy also sends the message that you don’t simply see them as a “problem child”: you’re willing to put in the work to make things better, too.

Participating in your tween or teenaged child’s therapy could look like:

• Having an initial session with your child’s therapist before they meet to share your perspective and fill them in on your family’s history.

• Having an open conversation in your teen’s first therapy session about how confidentiality works and what will and won’t be shared.

• Meeting periodically with your child’s therapist to discuss the progress they’ve made toward their treatment goals—but not necessarily talking about their specific worries or problems.

• If your child is in a skills-focused form of therapy, like CBT or ERP, collaborating with your child and the therapist to come up with a plan to work on skills at home.

• Getting support for yourself and learning new ways to manage your tween or teen’s strong emotions.

Until your child turns 18, you can expect—and request—to be a part of your teenager’s therapy. Once your child turns 18, however, things change. Once your teen is a legal adult, they’re entitled to total privacy in therapy, even if they’re still living in your home and you’re the one paying for their sessions.

If your child is approaching this age, you should talk with both your teen and their therapist about how to prepare for this transition. Turning 18 doesn’t necessarily mean you can never participate in your child’s thearpy again—you’ll just need their permission to get involved.

What if I Can’t Attend My Child’s Sessions?

There are many reasons why it may not be possible for you to physically attend appointments with your child’s therapist. Maybe your child is in online therapy, and meets with their therapist while you’re still at work. Or, maybe your child’s other parent is typically the one who drives them to their sessions. Divorced parents may not live in the same town or state as their child’s therapist, which can also make it more difficult to stay in touch.

Research on children’s therapy has found there’s a difference between a parent who attends a child’s therapy sessions and a parent who participates actively in the sessions. Being physically present at the appointment is a great start, but it’s not going to be very helpful unless the parent is open to sharing, listening to feedback, and following through at home. Any parent can actively participate in therapy, whether they live 1 mile or 100 miles from the office.

If you want to be involved but you can’t make your child’s regularly scheduled appointment time, you have some options:

• Ask your therapist if it’s possible to schedule a monthly “parent only” appointment at a time that works better for you.

• Online therapy is common now, which is a great option for working or out-of-town parents. See if you can schedule periodic online check-ins to avoid a long commute.

• Many children’s therapists have much more flexibility to meet while children are in school. If you can meet remotely during your lunch break at work, this can be a good option to stay involved.

• Phone calls, emails and texts can be a good way to keep in touch when video calls aren’t possible. Your therapist can keep you updated on treatment plan goals and let you know how you can help reinforce these goals at home.

• If your child is under 18, you have a right to access their medical information. Consider asking for a copy of their treatment plan, if your therapist hasn’t shared it with you.

Regardless of how you keep in contact, your participation will have a positive effect on the therapy process. Being open to change and trying new things along with your child is a huge deal!

Therapy for Kids and Tweens in Davidson, North Carolina

Ready to get started in therapy? I’d love to help you take the next step. My child therapy office is located in Davidson, North Carolina, just north of Charlotte. I also offer online therapy for kids living anywhere in North Carolina, New York, or Florida. You can reach out to me here.

If you’re searching for a local therapist, or unsure if therapy is the right step, check out my anxiety coping skills course for kids and their parents. It can give you practical, actionable skills to try at home in the meantime to deal with overwhelming worries and panic. The course includes sections for both kids and parents, so you can support your child in learning more helpful ways to cope.

If you’re looking for more information on getting started with children’s therapy, check out my other blog posts on the subject:

What Questions Should I Ask My Child’s Therapist?
Should My Child See a Therapist, Psychologist, or Psychiatrist?
What Are the Different Types of Child Therapy?

If you’re ready to get started, email me here to inquire about therapy sessions.

How to Find a BIPOC or LGBTQ+ Therapist for Your Child or Family

It can be really challenging to find a therapist of color—and even harder to find one who specializes in working with children. I hear similar struggles from families looking for therapists who are part of the LGBTQ community: it is sometimes difficult to find affirming therapists for kids.

Usually, I write in this blog about issues that I can help kids with in my therapy office, either in-person or online. This post is a little different: I’m not a BIPOC or queer therapist, but if you need one I’d love to help you find one for your child.

Below, you’ll find a list of directories designed to help match you and your child with therapists and other helpers who understand where you’re coming from. Each of these directories has an option to search specifically for children’s therapists, and also to filter the search results for therapists who share a specific identity or background.

The Benefits of a Therapist Who Shares Your Culture

In order for therapy to be effective, your child needs to feel understood. Of course, this doesn’t mean your child has to have every life experience in common with their therapist: sometimes it can be helpful to work with someone of a different gender or background. But research shows that therapy works better when a therapist understands the client’s culture, and can tailor the therapy to line up with their client’s experiences and beliefs.

Some potential benefits of working with a therapist who shares your culture include:

• Spending less time in session having to explain yourself or your experiences

• The ability to have therapy sessions in your native language

• More informed care when dealing with issues related to racism or systemic oppression

• A stronger, more trusting relationship with your therapist

For kids, having a therapist who looks like them can also be a helpful role model or racial mirror, providing another example of a helpful, caring adult in their community who looks like them.

Directories for Finding BIPOC Therapists

The following directories were created to address the challenge of finding therapists of color. While not all directories cater to children, the ones on this list do have options to search specifically for therapists who help kids.

Therapy for Black Girls was founded by a psychologist to help Black women and girls improve their mental health. They have a large database of therapists, and their search function allows you to look for therapists who accept your insurane, as well as therapists who specifically work with children or teens.

Therapy for Black Men, according to their website, was “born from the idea that Black men and boys face unique challenges, and therefore need a dedicated space for seeking and finding mental health support.” You can find Black therapists here who specialize in helping boys, and search specifically for therapists trained to help toddlers and preschoolers, elementary-aged children, tweens, or teens.

Latinx Therapy is a bilingual database that helps people find therapists who understand the Latinx experience in the U.S., as well as Spanish-speaking therapists. Their database allows you to search specifically for help with many different problems that could bring a child or family to therapy, including some specific to the Latinx community. You can also filter your search results for therapists who work with specific ages of children, from toddlers through teens.

Asians for Mental Health is a directory for AAPI therapists. All therapists list their specific ethnic backgrounds in their profiles. You can search for issues specific to the AAPI community, including transracial adoption and immigration, as well as filter the results for therapists who speak a wide range of languages. You can also run an age-specific search to find therapists who work with specific age groups, including young children.

Llapanchik Hampinakuy is a new directory for indigenous and native healers of all kinds. Founded by two Quechua therapists, its name means “we heal each other mutually” in Quechua. Expect to find indigenous and native therapists listed here, as well as other kinds of healers who take more holistic views on health and wellness.

Directories for Queer-Affirming and Culturally Competent Therapists

While the directories above are all devoted to specific racial or ethnic groups, the ones in this section are more broadly committed to inclusivity and cultural awareness. You can find therapists who have deep knowledge of specific cultures, experiences, or religions, as well as therapists who identify as LGBTQ themselves.

Inclusive Therapists is a very large database that, according to their website, “offers a safer, simpler way to find a culturally responsive, LGBTQ+ affirming, social justice-oriented therapist.” You can search for therapists with expertise in a variety of religious beliefs, racial and cultural backgrounds, and social justice issues. You can also search for therapists who self-identify as part of the LGBTQ community or as part of a specific race, culture, or group. “Children and Tweens” and “Adolescents and Tweens” are included as searchable specialties in the database.

The LGBTQ+ Healthcare Directory can help you find therapists, doctors, and other healthcare providers who are LGBTQ-affirming and who specialize in helping members of the queer community. While not specifically focused on mental heatlh, the databse includes a good number of therapists. Therapists can also be filtered based on ethnic background, languages spoken, and whether they specialize in working with youth.

TherapyDen is another large database with an emphasis on inclusivity. It allows you to search for therapists not just by cost or location, but by gender, ethnicity, and many other factors. Their “specialized experience” drop-down menu allows you to select for therapists who have described themsevles as Queer-competent, Trans-competent, Neurodiversity-affirming, and working from a racial justice framework. You can also search fror therapists specializing in child, adolescent, or family therapy.

More Mental Health Help for Kids

If you’re looking for some support while you search for the right therapist, my online coping skills course for tweens is available to download right now. My book, A Parent’s Guide to Managing Childhood Grief, might also be a helpful resource for children and families who are recovering from a loss.

I provide counseling for kids and tweens with anxiety and OCD, both in-person in my Davidson, NC therapy office and online throughout the states of North Carolina, New York, and Florida. Want to learn more about therapy with me? Check out my FAQ or contact me with questions.

What Triggers Anxiety in a Child?

Sometimes, a child’s anxiety seems to come out of nowhere. One day, everything seems okay, and the next day, boom! You’re begging them to leave the car to go to school. Other kids may have seemed anxiety-prone since toddlerhood: they were just always more sensitive than their peers. You may even have been told that their worries were just a phase. But here you are, years later, still dealing with the same fears.

When you’re trying to tackle anxiety, it can help to know the root cause. Whether you’re dealing with an all-of-a-sudden attack or an always-been-there anxious temperament, knowing what’s triggered your child’s anxiety lets you better help them to manage it.

Genetics + Life Experiences = Your Child’s Anxiety Risk

Stress affects all of us differently. It’s not always clear why one child may struggle with anxiety after a tough experience, when another gets through the same situation seemingly no worse for wear. It’s likely that our genes and life experiences combine to give each of us a unique way of coping with anxiety and stress.

We know that anxiety runs in families. Kids who have relatives with anxiety disorders are more likely to develop one themselves. This is true even if the types of anxiety are different within the family; for example, a chid who has many family members with generalized anxiety may have a slightly higher risk of developing OCD. Depending on the genes your child inherits, they may be more or less anxiety-prone from the start.

Even if your child has inherited some anxious traits, anxiety still needs an outside event to trigger symptoms. Big events, like moves and divorces, can do this. However, more day-to-day stress plays a part, too. In general, a child who has a strong family history won’t need as big of a stress to set off anxiety. On the other hand, a child with very little family history could still become anxious after a big enough trigger.

There are plenty of things parents and families can do to support a kid with anxiety—and sometimes best intentions can accidentally cause anxiety to grow. But there are so many factors that contribute to childhood anxiety that it’s never one person’s fault.

What’s a Trigger, Exactly?

“Trigger” has become a household word…and sometimes a word used to tease people who are deemed overly sensitive. So let’s clarify what exactly we mean when we talk about anxiety triggers.

A trigger is a catchall term for anything that sets off anxiety. Triggers can be physiological, like drinking too much caffeine if you’re sensitive to it. They may be sensory, like the sound of a fire alarm going off if your child has a sensitivity to loud noises. They can also be situational, like taking a test if you struggle with perfectionism. The pandemic has served as an anxiety trigger for many kids in recent years.

Triggers are unique to an individual. What triggers one person might not be an issue for another. Sometimes it can be hard to figure out what exactly is setting off anxiety for a child. It’s helpful to discover your child’s triggers so you can figure out how to prepare for potentially difficult situations in advance. The goal isn’t to avoid triggers forever, but to find ways to gradually learn to deal with them.

Sometimes, people talk about triggers as being the thing that set off a child’s anxiety in the first place. Other times, “trigger” is used to describe the day-to-day events that cause anxiety to flare up again. We’ll talk about both types in this post.

Any Big Life Change Can Trigger Worries

Predictabilty and routine help children feel safe. Knowing what’s about to happen next gives kids a sense of control in a world that often feels big and unpredictable. Anything—good or bad—that upends routines in a major way can lead to increased anxiety for kids.

This is one reason why so many kids are struggling with anxiety after covid, even if their loved ones haven’t been seriously affected. Even without major illness, the stress of household routines collapsing in on themselves during quarantine was a lot to cope with. It’s also why starting at a new school or moving to new town can set of anxiety, even if your child is excited about the change.

Here are some big changes that can set off anxiety for kids:

• Moving to a new place

• Divorce or remarriage of a parent

• The birth of a new baby

• The death or loss of a loved one

On a more day-to-day basis, these changes in routine can cause anxiety to flare up, too:

• Unexpected changes in plans

• Changes in a parent’s work schedule that affect their time spent at home

• Vacations or travel

• New babysitters or caregivers

Family Stress Increases Anxiety Risk

Kids are really good at picking up on family stress. Sometimes, a chlid’s anxiety is almost like a release valve for pressure that’s been building up at home. If a child starts showing new symptoms of anxiety, it’s never a bad idea to do a quick assessment of how you and the rest of the family are doing managing your own stress.

If children sense that things are a little tense at home, they may respond by clinging or getting more anxious when they have to be away from a parent. Kids instinctively want to be close to a parent during uncertain times, to make sure they stay safe.

Any major stress in a family will affect children too, such as:

• Intense, frequent fights between parents

• A family member’s chronic or serious illness

• Job loss or trouble with finances

• A parent or caregiver’s own mental health struggles

• Struggles with racism or other systemic oppression

If your child is sensitive to family stress, you may notice that their anxiety gets set off by everyday scenarios such as:

• Changes in family routines or plans

• Parents leaving the house for work or date nights

• Having to separate from the family, such as for school or a sleepover

• Seemingly minor arguments, disagreements, or discipline

Friend and School Drama Are Often Triggers

The older kids get, the more important friendships become in their lives. And these friendships can be pretty turbulent! On one hand, most kids are desperate to be accepted as part of a group. On the other, they’re still figuring out the social skills they need to manage conflict without escalating disagreements into full-on drama.

Kids have to juggle all this social stuff while also dealing with academic pressure that can feel overwhelming. Homework, college admissions, and even just getting to class on time can be stressors for kids.

School and peer issues like these can contribute to the development of anxiety troubles:

• Returning to in-person school after being online during Covid

• Bullying or social isolation

• Transitioning fo a new school building, such as the move from elementary to middle shcool

• Learning difficulties, low grades, or other academic problems

Kids may notice that smaller triggers like these set off everyday anxiety at school:

• Projects that require public speaking

• Testing, especially standardized testing

• Feeling judged for their appearance, clothes, or interests

• Having to navigate a large or complicated school building

• Not sharing many classes with familiar friends

Grief: A Surprisingly Common Source of Anxiety

Grief is often associated with sadness, anger, denial, and a whole host of other feelings. But when we think of grieving children, anxiety might not be top of mind. Losing a loved one often means a loss of stability for kids. Their routines are upended, a safe person is gone, and suddenly, they’re aware of the many unexpected dangers that can happen in life.

It’s normal for grieving children to experience separation anxiety while grieving, because keeping loved ones in sight feels more safe. Health anxiety is also common, since children may worry about whether or not they or a loved one could get sick or die, too. The stress of grief can also lead to more generalized worries, trouble sleeping, and body aches and pains due to anxiety, too.

Some types of grief that can trigger anxiety include:

• The death of a family member or close friend

• Losing a loved one due to estrangement, a move, or imprisonment

• The death of a pet

• The loss of a pregnancy in the family

Triggers related to grief, death, and loss can trigger kids on a more day-to-day basis, too. Grieving kids may notice their anxiety heighten when faced with situations such as:

• Scenes of violence, illness, or death on TV or in movies

• Mentions of suicide in health class

• Assigned school readings with themes of grief and loss

• Anniversaries and holidays that remind a child of their loved one

• Being away from caregivers

Illness, Accidents, and Trauma Can Lead to Anxiety

Highly stressful and traumatic events can also shake up a child’s sense of safety. Even if nobody gets seriously hurt, the experience of an accident or a dangerous situation can leave a child with lasting worries.

At the beginning, you may notice your child is only anxious in situations that are closely linked to their stressful event. Over time, however, that anxiety can generalize. This means the anxiety pops up more often in situations that are only loosely connected to the original event. As time passes it can be harder to connect anxiety symptoms to the underlying trauma or stress that triggered them in the first place.

Traumatic or stressful events that can lead to anxiety include:

• Car accidents

• Attacks or bites from dogs or other pets

• A loved one experiencing a major illness

• Natural disasters such as fires, floods, and tornadoes

• Repeatedly hearing about crime, disasters, or other emergencies affecting people on the news

Children dealing with trauma may notice they feel nervous or overly aware of their surroundings even when there isn’t a clear trigger. They might also notice anxiety caused by:

• Sudden noises

• Sensory experiences (like sounds and smells) that remind them of their trauma

• People, places or things that are associated with the stressful event

Help Your Child Learn and Cope With Their Anxiety Triggers

Learning what triggers anxiety is the first step toward helping your child cope with worries in a healthier way. Once children know what sets their anxiety off, they can learn strategies to help them in difficult situations. They can even practice noticing their thoughts, and questioning whether the worries that bother them so much are even accurate.

These skills may seem small, but over time they add up. Coping skills can change a child’s perspective on anxiety and other big feelings. They can empower children by giving them some control when things feel totally out of hand. We can’t always change a stressful situation, but giving kids coping skills can help them deal with hard moments, both now and as they grow up.

I teach coping skills so much in my therapy practice that I’ve created an entire coping skills course for tweens on the subject. Kids ages 8-13 can learn anxiety management tools they can use right away. There’s content for parents, too, so you can learn why the skills work and how to support your child in practicing them. You’ll also learn what isn’t as helpful for anxiety, so you don’t unintentionally make worries worse.

You can learn more about the course, preview the lessons, and enroll your child here.

Do Kids Grieve Differently Than Adults?

Children’s grief doesn’t always look the way we expect it to. With kids, sometimes still waters run deep. If your child has just experienced a loss and they aren’t talking about it, are they still feeling it? Should you bring it up to them, or wait until they come to you with questions? How can you tell if your child is processing their grief in the way they need to in order to move forward and heal?

All children are capable of grief: they just show their feelings differently than adults do. In this post, we’ll take a look at the key differences between child and adult grief. We’ll also go over how children of different age groups tend to grieve, so you can keep an eye out for common signs of grief in your own child.

Children’s Grief Can Be Hard to Recognize

Back in the days of Freud, experts believed young children weren’t capable of feeling grief, because they couldn’t fully understand what death meant. Today, we know that isn’t true at all: even little babies can sense when a caregiver has left. Children don’t need a complete understanding of death to mourn the loss of a loved one.

When most of us think of grief, we imagine lots of crying, maybe even depression. We might imagine grieving people talking a lot about how much they love and miss the person who died. We might assume it will be a long time before the griever starts to feel or act like themselves again.

Kids’ grief doesn’t always fit this traditional mold. While many children will cry or feel sad after a loved one dies, others may not. Their feelings and reactions to grief might change rapidly or seem short-lived. Because their grief looks so different, it’s easy to miss. Parents may notice behavior changes or physical symptoms in their children, but not recognize them as being related to grief.

Difference 1: Delayed Reactions

When a loved one dies, children have to deal with a huge shock that they don’t fully understand. In addition to dealing with the loss, kids often have to figure out what exactly death is, and what it means for them. Most children also don’t have a lot of prior experience with grief, so they may not know how they are “supposed” to react when faced with such horrible news.

Kids can grieve even if they aren’t old enough to fully conceptualize death. However, it might take them longer to process what has happened and begin showing their feelings about it. Grievers of all ages experience shock and denial after death. For children, this might include wondering if a loved one might still be alive, or wishing they could come back to visit. Little children may ask repeated questions about the death in an attempt to understand it better.

Once time has passed and children have developed an age-appropriate understanding of death, you may notice more recognizable grief symptoms begin to show up. But if a child doesn’t appear sad right away, it doesn’t mean they aren’t grieving.

Difference 2: Grieving in Bits and Pieces

Children process their feelings differently than adults do when it comes to grief. A bereaved adult is likely to feel their grief intensely for weeks, months, or even years after a loss. They may have to work hard to give themselves breaks from grieving, so it doesn’t overwhelm them. Adult grief is ever-present, and the feelings tend to exist even when the griever is focusing on other tasks.

This isn’t how grief works for most children. Kids are much more able to jump in and out of grief. It’s normal for a child to cry and have intense feelings for a short period of time, before seemingly moving on to another activity, like playing with friends or watching a show.

This kind of back-and-forth would seem weird if an adult did it, but it’s perfectly normal for kids. Adults have a much bigger emotional capacity than kids do: they can tolerate a lot more before getting overwhelmed. If you imagine that an adult’s capacity for grief is like a big empty cup, a child’s might only be a tiny thimble. Once a child’s thimble is full, they need to step away from their grief process for a while, and return when they’re ready to handle some more.

Difference 3: Kids Feel Grief in Their Bodies

Studies have shown that kids are much more likely than adults to have physical pain and other body-based symptoms as part of their grief. This may be, in part, because it’s harder for kids to put their feelings into words. Instead, they hold on to all those feelings inside, and they show up in other ways.

It’s common for kids to complain of headaches and stomach aches as a result of the stress. They may also feel fatigued, dizzy, or have trouble focusing on things. Sleep and eating habits can change, too: bereaved children may have poor appetites or trouble falling asleep at night.

It’s always a good idea to talk to a doctor if your child isn’t feeling well. However, if your child’s symptoms don’t have a clear cause, they might be an outward sign of your child’s grief.

Different Signs of Grief in Preschoolers (3-5 Years)

Little children are in the earliest stage of understanding death. They’ve probably seen movies or cartoons in which characters die, and this might be their only basis for comparison. Children may assume death means that a person has gone away, fallen asleep, or otherwise left them in a way that is not permanent. They may also worry about whether or not their loved one is afraid or feeling pain.

Any stressful event can cause regressions for preschool-aged kids, and death is no different. You may notice your 3, 4, or 5-year old returning to earlier habits, like thumb-sucking or bedwetting. Your child may be extra clingy for a while, or have trouble sleeping alone when they were once independent.

You might also notice that themes or details from your loved one’s death show up in your child’s play. While it might be a surprise to see your child having a funeral for a Barbie doll, or re-enacting an accident with toy cars, this is usually a healthy sign. Children process feelings through play, so these types of activities help kids make sense of what has just happened in their world. If the play is prolonged, rigidly repetitive, or seems to make your child upset instead of relieved, it might be worth speaking to your child’s doctor or a children’s grief counselor.

What Grief Can Look Like for Big Kids (6-10 Years)

6, 7, 8, 9, and 10-year-olds have their own unique experiences during the grieving process, including magical thinking.

Older children have a more solid understanding of death, which is both good and bad news. On one hand, it’s easier to help kids in this age range understand what’s going on when a loved one dies. On the other, kids tend to develop their intellectual ability to understand death before they build the emotional skills they need handle the strong feelings of grief. As a result, elementary-aged kids may have the hardest time coping with loss.

Big kids may be wondering why their loved one died, and searching for explanations that make sense to them. Kids in the younger end of this age range often believe that their thoughts and feelings have a direct influence on the outside world. This can lead to children worry that something they said, did, or thought might have caused their loved one’s death. It’s important for children to have a clear explanation for their loved one’s cause of death that removes any possible blame for what happened.

Children may ask repeated “why” questions at this age. It’s likely, though, that your grade schooler will show you their feelings more than they tell them. Physical complaints are common among this age group, and so are problems with sleeping and difficulty concentrating at school. Keep an eye on how your big kid handles school and friends in general: some children may throw themselves into too many activities in an attempt to cope, while others may withdraw from friends and hobbies they once enjoyed.

How Do Tweens and Teens Grieve Differently?

Tweens and teens are able to think more abstractly, which means they’re able to grasp the concept of death in ways that younger kids can’t. They understand that death is permanent, and they may wonder about their own mortality or the afterlife when a loved one dies. Even though tweens and teens think about death in similar ways to adults, they still face their own unique emotional challenges.

As kids near the teen years, their friend group becomes increasingly central to their lives. This means tweens and teens may be more likely to turn to their friends for comfort when a loved one dies. If your child is part of a healthy, mature friend group, this can be a great source of support. However, it can be hard for peers who haven’t experienced their own loss to empathize in the way that grieving teens need.

Depending on your relationship with your tween or teen, you may notice that relying more on friends for support means you hear less about your child’s grief. Changes in grades, dropping out of school activities, and self-isolating can all be ways that older kids show they’re struggling with grief. It’s also common for kids in this age range to compare their situation to non-bereaved friends, so keep an eye out for unusual arguing or difficulties with peers. Death is unfair, and it’s easy to feel jealous or angry at a friend who complains about their family when you’ve just suffered a loss in yours.

Finally, tweens and teens are more likely than younger kids to find unhealthy or harmful ways to cope with grief. They may have access to drugs or alcohol, or may use self-harm as a way to deal with strong feelings. Any signs that a child may be considering self-harm or suicide should be taken very seriously, especially when a child is grieving.

Grief Timelines Look Different for Kids, Too

Grief can be a lifelong process, and this is especially true for children. Many kids start working through their grief before they fully understand the concept of death. This doesn’t make their grief any less valid or painful, but it does mean they’re likely to revisit their grief as they age. As children mature, they may understand their loss in new ways, and more fully grasp everything they will miss out on in the future with their loved one.

Milestones like special birthdays, graduations, and other coming of age traditions can rekindle grieving feelings for kids. These events, while happy, are also a reminder that someone is missing from the family. This is especially true for children who have lost a parent or caregiver. As kids become young adults, they may be increasingly aware of how their early loss will affect their weddings, the birth of their children, and other life milestones.

If you notice your child has a hard time around the holidays, or enters a period of intense grief when a milestone occurs, it’s okay. It doesn’t mean your child’s grief is getting worse or moving backwards. They’re just looking at their grief with a new perspective and working through it in a deeper way.

Grief Help Made Especially for Kids

I hope you reached this page either out of curiosity, or to prepare for the future, just in case. If that’s not true, and you’re here because your child is grieving, I have a resource to share with you.

I wrote an activity book, A Parent’s Guide to Managing Childhood Grief, that was created to help parents understand and support the unique ways that children grieve. The book contains 100 playful and creative activities for kids ages 5-11, divided into categories to address some of the most common needs children and families face when a loved one dies.

If you’re wondering how to help your child understand what death means, or explain difficult details about a loved one’s passing, you’ll find scripts inside to help. There are also chapters devoted to safely expressing feelings like guilt, anger, fear, and sadness that tend to show up during a child’s grieving process. Finally, you’ll find activities you and your child can complete together to encourage a sense of safety, meaning, and hope after grief.

A Parent’s Guide to Managing Childhood Grief is available at all major bookstores, including Amazon, Barnes and Noble, and independent bookstores.

Grief Counseling for Children: How to Find the Right Help

While we may think of death as a grown-up topic, the truth is that many children will be touched by grief and loss at an early age. By the time they turn 18, roughly 5.8 million children will experience the death of a parent or sibling. The number of children grieving any kind of loss, including the death of a close friend or extended family member, is much higher: 1 in 3.

Some children benefit from having a person to talk to about their grief who isn’t a family member or friend. Counseling can help children to process their feelings, and make it less likely that they’ll struggle with their emotions later in life. Some forms of therapy are a more natural fit for grief counseling than others, and finding a child therapist who is experienced with grief can make a world of difference.

Do All Grieving Children Need Counseling?

If your child is reluctant to go to therapy, there’s no need to push. While grief therapy can be very helpful, it may not be necessary for every child. Grief is painful and difficult, but it’s also a natural process and the result of the close bond your child formed with their loved one. Research shows that many kids are able to adjust and cope with their loss on their own, with fewer lasting difficulties as they grow. These children might appreciate having a listening ear to talk to, but may not want or need it.

Other children have a harder time dealing with their intense feelings of grief. They may feel “stuck” in their grieving for a long time, or their emotions might be so overwhelming that they interfere with school, family, or friends. A child’s temperament, age, gender, support system, and trauma history can all influence the way they grieve. The way that a loved one died can also have a big impact.

If these more vulnerable kids don’t get help to move through their grief, their unresolved feelings put them at risk for problems later in life. These children may struggle with tantrums, problems with school or peers, and increased anxiety or depression. As adults, they may be more likely to develop mental health problems or unhealthy ways of coping with feelings.

When to Look for Help for Your Child

How can you tell if your child is coping well, or if they will need counseling to get through their grief? Your child’s feelings and behavior, as well as the circumstances surrounding their loved one’s death, can guide your decision-making.

If any of the following are true for your child, they may be more likely to need a grief counselor:

• Your child did not have many opportunities to mourn, such by attending a funeral or memorial service

• Your child struggled with anxiety, depression, or low self-esteem before the death

• Your child has a history of other traumas or losses

Some types of losses also make it harder to grieve, such as:

• The loss of a parent

• A death that was sudden, unexpected, or violent

• A death that happened when your child was very young (under age 8)

Regardless of the circumstances, if your child is showing signs of ongoing anxiety, depression, or anger following the death, they might benefit from therapy. Some of these signs include:

• Feeling guilty or believing they did something to cause their loved one’s death

• Avoiding talking about the death or doing things that could trigger memories of their loved one

• Feelings of hopelessness

• Intense feelings that get in the way of daily life

• A lack of interest in doing things, or big changes in behavior that continue after the initial wave of grief has passed

• Nightmares or trouble sleeping

• Any mention of self-harm or a wish to die: this should always be taken seriously

Sometimes, a child who is seemingly doing just fine will ask to go to therapy. It’s possible for kids to be grieving deeply on the inside but not show it on the outside. If at all possible, find a way to set your child up with a counselor for at least a few sessions to get some support and see if ongoing therapy would be a good fit.

What Types of Therapy Can Help Grieving Kids?

If you’ve decided to pursue counseling for your child, you’re faced with a ton of options. Should you look for individual therapy or a group? Does your child need a therapist, psychologist, or psychiatrist? Let’s take a look at a few options for therapy that are a good fit for grieving kids. We’ll talk about how they work and why they can help with grief. We’ll also discuss what situations these types of therapy tend to work best for.

Play Therapy: Sitting on a couch and talking about feelings works well for older kids and adults, but it’s not always the most natural thing for young children to do. If you’re seeking therapy for a child under the age of 10, I strongly recommend finding a counselor who uses play therapy in their sessions.

Children use play to learn and make sense of the world around them. It’s why we see children repeating the same situations in play over and over until they master that concept and move on. Creative play and make-believe can help children sort through their confusion and strong feelings about death. It gives young children an opportunity to express big emotions and ideas that might be too complex to put into words.

A skilled play therapist can guide this process for children and keep an eye out for signs of trauma, self-blame, or big misunderstandings about death that could be causing additional pain. Look for somebody who describes themselves as a Registered Play Therapist to find someone highly trained in this type of work.

Trauma-Focused Cognitive Behavioral Therapy: Grief is shocking and stressful for everybody, but some children may experience their loss as a traumatic event. This is especially true if a child has lost a parent, or if their loved one’s death was very sudden or due to a violent act. Children who go through these kinds of losses may experience traumatic grief, which includes symptoms of PTSD.

Children suffering from traumatic grief might struggle with frequent nightmares, or deal with unwanted memories or images of their loved one’s death that pop up during the day. Sometimes, it might even feel like they’re living through that moment in time all over again, which is called a flashback. Traumatic grief feelings are so strong that children may avoid doing anything that they associate with their loved one or the death, so they don’t have to think about it.

These children need therapy that helps them deal with both their trauma and their grief, so they can think about their loved one without getting overwhelmed or avoiding things they used to enjoy. Trauma-Focused Cognitive Behavioral Therapy, or TF-CBT, was designed to help children learn the skills they need to manage strong feelings and gradually tell the story of what happened to them. Kids get a lot of support from their therapist and caregivers along the way.

Group Therapy and Support Groups: Many bereaved children feel isolated. Even though grief is a common experience, it’s likely they don’t have any friends who have gone through a similar loss. Peers may not know what to say to a grieving child, or how to help. Young grievers may avoid talking to their friends about what has happened for fear of upsetting them or appearing vulnerable.

It’s also common for grieving children to worry about whether or not their grief is “normal.” Grief can bring up all kinds of feelings and reactions, some of which are confusing or even contradict each other. Reading stories about grief can help children realize that these complicated emotions are normal and okay. Talking to another grieving child, however, can be even more validating.

Being around other kids who “get it” can help grieving children in a way that individual therapy can’t. Instead of learning about grief from an adult, children can hear directly from other peers about how loss has touched their lives. Children can share their stories and struggles in a safe environment where they know everyone else will understand what they are going through.

Therapy groups are led by a licensed mental health professional, while support groups usually are not. Both types can have a lot to offer grieving children. You can find a therapy or support group near you by entering your zip code into this tool from The Dougy Center.

What Do Children Do in Grief Therapy?

If you’re considering grief counseling for your child, you may be curious about what exactly happens in the therapy room. Your child might be curious, too! Every therapist is different, but here are some general ideas of activities your child’s therapist might introduce to help your child learn about and express their grief:

• Read books or play games to learn age-appropriate facts about death and grieving.

• Use art or pretend play to explore feelings of grief without having to talk about them directly.

• Draw pictures, write poetry, or use other forms of art to express feelings and memories.

• Create rituals to honor and remember your loved one’s life.

• Write a letter to your child’s loved one to express things that were left unsaid.

• Learn coping skills to manage the strong feelings of anger, sadness, and other feelings that sometimes come along with grief.

A grief therapist will never push your child to talk about things before they feel ready. While they may make suggestions, your child gets to choose the pace. It’s always okay for your child to say they aren’t ready to share.

Help Your Child While You Look for a Grief Counselor

Once you’ve decided to find a grief counselor, it may take a while before you book your first appointment. Not all children’s therapists specialize in grief, or work with every age range. The demand for children’s therapy is high in many places, which means you might need to time on a waiting list or search longer to find someone who has availability.

While you wait for your first appointment, you can help your child begin to cope with their grief at home. As a parent or caregiver, your support will be one of the most helpful resources a grieving child can have. My book, A Parent’s Guide to Managing Childhood Grief, was created to help parents and other caring adults guide children through the difficult, complex feelings that come with loss.

This book is filled with simple, easy-to-follow activities that tackle big ideas like finding meaning and imagining a hopeful future after loss. You’ll find over 100 ideas for how to use creative play, books, and games to start gentle conversations about death, express difficult emotions, and strengthen family bonds after loss.

While not a substitute for therapy, these activities are inspired by my own work as a child therapist, and borrow ideas from cognitive behavioral therapy and other approaches often used with grieving kids. The book is available for presale on Amazon, as well as other major bookstores near you.

To find a grief counselor near you, check out The Dougy Center or the National Alliance on Children’s Grief. Both have directories to help you find local children’s therapists or support groups. If you live in New York, North Carolina, or Florida and would like to learn more about counseling with me, you can contact me here.

What is Prolonged Grief Disorder, and How Does it Affect Kids?

How long is too long to grieve? We all have our own ways of dealing with loss, and there’s no right or wrong way to respond when a loved one dies. Grief never really ends, but mental health experts recently created a new diagnosis for people who grieve intensely for over a year: Prolonged Grief Disorder. Both kids and adults can receive this diagnosis, and attend therapy designed to help them move through their feelings of grief.

Is it really helpful to put a timeline on someone’s grieving process? How can you tell if you or your child is experiencing prolonged grief? Let’s talk about what Prolonged Grief Disorder is, and how you can help a child who is struggling after a loss.

Prolonged Grief Disorder is a New Diagnosis

Grief is a universal emotion, but until very recently it wasn’t considered a mental health issue. Most of us will experience grief during our lifetime. As painful as it is, grief is a healthy, natural response to losing someone we love. Many mental health problems, like anxiety, involve having a big emotional reaction that is out of proportion to the situation. It’s hard to imagine having a reaction that’s too big to the death of a loved one.

Still, grief can seriously impact a person’s life. Like trauma, it can affect a survivor’s relationships with others, their worldview, and their hopes for the future. For a small number of people, grief has a major and lasting effect on their ability to get through daily life. They may feel numb or have a hard time adjusting to the reality of what has happened. They might feel hopeless about the future, or cope with their feelings in unhealthy ways. Prolonged Grief Disorder was created to give a name to people with these kinds of struggles.

Not Everyone Agrees That Grief is a Mental Health Problem

You can find Prolonged Grief Disorder in the DSM-5, the “therapy bible” that therapists use as a guide to diagnose and treat people with mental health conditions. However, not everyone agrees that it should be there. The idea that grief should be listed alongside mental health problems like depression and OCD has been a little bit controversial.

Some critics think it’s not helpful to decide when grief “should” be over, because everyone’s process is so different. Who is to say that one year is the right or wrong amount of time to grieve? The diagnosis could make grievers feel added pressure to “get over it” or “just move on” with their lives after a death. Some grievers already feel this pressure, as phone calls and support from friends tend to fade away in the weeks or months after a funeral.

There’s also worry that putting a label on grief could make a hard time even more difficult for grievers. There is still stigma around mental illness, and being told you have a “disorder” could make a grieving person feel ashamed or as though their feelings are not valid. Many people already feel self-conscious about how they have responded to their loved one’s death—will getting this label make that feeling worse?

On the other hand, getting a diagnosis makes it much easier to get into therapy. People benefit from therapy after all kinds of life transitions, including deaths, and it doesn’t mean the feelings they’re having are wrong. Hopefully, adding Prolonged Grief Disorder as a diagnosis will help therapists and grievers find new ways to get help and heal after loss.

The Symptoms of Prolonged Grief Disorder

According to the American Psychiatric Association, prolonged grief happens when a person has been intensely mourning a loss for a long time. For adults, this means grieving for over a year. For children and teens, this means grieving for over six months. Prolonged Grief Disorder is more likely to happen after the the death of someone very close, like a parent, child, or spouse. It’s also more likely if the death was sudden or unexpected, like from an accident.

Some symptoms of Prolonged Grief Disorder include:

• Shock and disbelief

• Yearning or longing for the deceased person

• Feeling like a part of your own identity is gone

• Feeling emotionally numb, or feeling extreme emotions like sadness or anger

• Trouble returning to day-to-day activities

• A belief that life is hopeless or meaningless

• Avoiding people, places or things that remind you of the death

These symptoms don’t just happen once in a while: they’re present for most of the day, almost every day. They are so frequent and so severe that they make it hard for the griever to keep moving forward in life.

When Children Experience Prolonged Grief

Children grieve differently than adults, and this is true when it comes to prolonged grief, too. You might have noticed above that kids and teens only need to have prolonged grief symptoms for 6 months—half as long as adults—in order to get a diagnosis. Children, in general, move through grief more quickly than adults do. They also tend to work through grief a little bit at a time rather than all at once, giving them time between spurts of grieving to focus on just being a kid.

Kids who have lost a parent, sibling, or other close relative or friend are at risk of developing prolonged grief, just like adults. In addition to the symptoms listed above, a child’s grief may show up in other ways, such as:

• Difficulty believing their loved one isn’t coming back

• Tantrums and intense emotional outbursts

• Focusing on or reliving the details of the death

• Worries that they somehow caused the death with their thoughts or actions

• Anxiety about bad things happening to other family members

Many grieving kids will have some of these symptoms, but kids with prolonged grief will have them most of the time, on most days of the week. Over time, they can lead to social isolation, or added trouble with depression, anxiety, or other mental health problems.

Grieving Children Are More Emotionally Vulnerable As They Grow

Grief on its own is not a mental health problem, but it is a tremendous stress and sometimes even a traumatic event. Grief is painful no matter your age, but it can be especially tough for young children who lose an important person early in life. Bereavement affects kids both in the short term, causing problems like depression, and in the long term, leading to struggles at school, difficulty in relationships, and substance abuse.

Not all bereaved kids will develop these mental health issues. In fact, most children will find healthy ways to keep living and growing through grief. All kids need lots of help from caring adults to understand death, grief, and loss. This is especially true for kids dealing with prolonged grief.

Help for Grieving Kids and Families

As a parent, caregiver, or someone who loves a grieving child, you are your child’s biggest source of support. Many grieving children do not need to attend therapy. Simply having an adult who listens and cares reduces their chance of developing mental illnesses later in life.

You can help your child understand their feelings and find ways to remember and honor their special person together. If you need help finding ways to do this, A Parent’s Guide to Managing Childhood Grief offers over 100 activities you and your child can complete together. Using simple materials and play-based learning, you and your child can share your feelings, learn age-appropriate information about death, and regain a sense of safety after loss.

If you suspect your child may have Prolonged Grief Disorder, a child counselor can help. Therapy gives children a safe place to work through feelings at their own pace, and learn how to cope with the strong feelings that come with loss. If you’re located in North Carolina, Florida, or New York, I may be able to help with in person or online child counseling. You can also run a search for therapists near you using Psychology Today or a similar directory.

What Questions Should I Ask My Child's Therapist?

You take a seat in the therapy office—or log on to your video conferencing platform at the appointed time—to meet your child’s new potential therapist. Maybe this isn’t your first rodeo seeking therapy your child, and you’re wondering if this counselor will have the help you need. Or, maybe it is your first visit, and you’re feeling a little overwhelmed about where to start. Either way, finding a counselor for your child is a big step, and you probably have a lot of questions to ask.

It’s really important to find a therapist who is the right fit for your child. All of us—whether we’re 9 or 99—will heal the best when we’re working with a counselor we like and trust. You don’t always have to see eye to eye, but you do need to feel safe talking to them. It also helps to find someone who truly specializes in the problems bringing you to therapy. So, how do you figure out if you’ve found a good fit? Let’s go over X questions you can bring up in your initial visit with a new therapist to learn more about what to expect.

Therapists Want Your Child to Find The Right Fit—Even if It’s With Someone Else

Sometimes, your first talk or visit with a child therapist might feel a little like a job interview. And it kind of is! You’re getting to know the therapist and how they work, and the therapist is getting to know you and your needs. It might feel awkward to ask questions about your therapist’s expertise or approach: what if you decide afterward that you need to see someone else?

Please know that we want to find the right therapist for your child almost as much as you do. We aren’t going to take it personally if you ask a hard question, or decide need to move in a different direction to find your child help. It feels amazing to be able to find someone the exact kind of help they need, even if that means they need to go elsewhere. I think I speak for most therapists when I say that working with a child I’m not equipped to help is a bummer. I don’t want that for me, and I don’t want that for you!

So, go right ahead and ask the questions you need to ask. You can even ask us to recommend other therapists to you. It’s not a weird request, and most therapists will be happy to oblige.

How Do You Interview a Child Psychologist, Counselor, or Therapist?

Reach out to the therapists who interest you, and see what their protocol is. Some may be happy to offer a consultation with you over the phone, while others may invite you into the office for a full intake session. Some therapists may charge for this service, while others don’t. Whether by phone or in person, it’s helpful to have a fairly in-depth conversation with a new therapist before your child’s first session.

While doing your research, you’ll probably find therapists with all sorts of titles beside their names, including psychologists, counselors, and psychiatrists. You might also see people who specialize in particular types of therapy, like play therapists or drama therapists. You can read more about the differences between types of therapists here to see who might be the best fit for your family. You can also check out my blogs on play therapy and drama therapy to learn more about how those approaches help kids.

If possible, set up appointments to talk to at least a couple different therapists. It’s okay to shop around a little bit before making a commitment to begin therapy. Even the most amazing therapist isn’t going to be the right fit for every child or family. Interviewing multiple people makes it more likely you’ll click with someone.

5 Questions to Ask Your Child’s Therapist

Okay, so you’ve done your research, found a few contenders, and set up some times to interview possible therapists for your child. What do you ask once you get to the appointment? I’m going to share 5 questions I think are pretty universal and would benefit any family that’s considering starting therapy. If you’ve never been in counseling before, these may not have occurred to you to ask. Hopefully they’ll be helpful to you!

Of course, every child’s situation is different and you may have more specific questions you need to ask in order to find the best fit. These questions should provide a good jumping-off point for more detailed conversations about your child, family, and needs.

Question 1: How Much Experience Do You Have Working with Children Like Mine?

No matter how skilled a therapist is, it’s impossible to be an expert in everything. You are likely to have the best experience working with a therapist who has helped children navigate similar issues. They’ll already know the ropes, and have an idea of what approaches will help.

You might want to know if your therapist has in-depth training or experience working with a specific diagnosis, like ADHD or OCD. Or, it might be helpful to hear if they specialize in helping children through certain issues, like divorce or grief. Sometimes, it can be helpful to find a therapist who shares or is very knowledgeable about your cultural, racial, or religious background.

Working with children is also very different than working with adults. Just because a therapist specializes in helping adults or teens with anxiety, for example, doesn’t mean they’ll automatically know how to adapt skills to work for kids. Ideally, you want to find a therapist who specializes not just in children, but in kids in your child’s specific age group. After all, a preschooler learns, thinks, and communicates really differently than a tween!

Question 2: How Will I Be Involved In My Child’s Therapy?

Depending on the circumstances, you may hear a lot or a little about what goes on in your child’s therapy sessions. Your child’s age, their specific concerns, and your therapist’s style will have a lot to do with what is shared and what isn’t. However, what you’re told about your child’s therapy should probably be more than nothing, and less than everything.

Ask your potential therapist if they plan to meet with your child alone, or if they’d prefer to have everyone meet together. There’s no wrong answer, but it helps to know what to expect. You should also know how you’ll be kept in the loop about how therapy is going. Some therapists may send home weekly reports, while others will schedule periodic parent sessions to talk about progress and goals.

In general, the younger your child is, the more involved you need to be in their therapy in order to see good results. Young children need their parents help to regulate their feelings, so coping skills only work if you’re there to help. On the other hand, all kids need some element of privacy in order to feel comfortable sharing in therapy. The older your child is, the more personal space they are likely to need.

No matter your child’s age, you should expect to have some information about how therapy is going, what your goals are, and what you can be doing to help. Also, you can always expect to be told if your therapist suspects that your child could be in a dangerous situation or is at risk of hurting themselves or others.

Question 3: What Are Your Fees? How Do You Handle Payment and Cancellations?

It stinks to get all the way through an interview with a new therapist, only to discover you can’t make things work financially. Hopefully, you were able to get a sense of your therapist’s fees from their website before meeting. If you aren’t clear or the information wasn’t listed, please ask! Money conversations might feel a little bit awkward, it’s so important to know up-front what you are committing to.

Therapy sessions in private practice work differently than many other medical appointments. Your therapist may or may not take insurance. If they do, your copay might be different than it is for other types of medical care. If they don’t take insurance, you may still be able to get insurance to reimburse you for some of the cost, but it may be your responsibility to contact your insurance provider. It’s likely you’ll need to be prepared to pay the full fee for your session on the day of your visit.

Also, it’s good to know that many therapists have policies about when and how clients can cancel appointments. This is excellent to talk about in advance, so you can plan ahead and not end up with a charge later that you hadn’t expected. It’s common for therapists to request either 24 or 48 hours’ notice when someone needs to cancel a session for a non-urgent reason.

You can break this big question about fees down into some smaller ones to get a detailed idea of the financial investment you’ll be making if you continue therapy:

• How much is your fee per session?

• Do you charge a different amount for intake or initial sessions?

• What insurances do you take, if any?

• What is your cancellation policy?

• How do I pay for sessions: by cash, check, card, or another way?

Question 4: Can You Estimate How Long It Takes Children to Complete Therapy?

Therapy isn’t just a financial commitment, it’s a time commitment, too. It helps if you have a ballpark idea of what to expect before you get started. That “ballpark” might still be a pretty broad estimate—it can be really hard to predict how quickly a child will move through therapy. Many things—your child’s age, the reason they’re coming to therapy, any trauma history they may have—can influence how much time they will need.

Still, your counselor should be able to talk with you about whether the type of therapy they practice is short, medium, or long-term work. There are some forms of therapy that are designed to be extremely brief, so children might complete the whole sequence in 8 to 12 sessions. That still may feel longer than what you might expect from brief therapy! Therapists who do deep trauma work or use a psychodynamic therapy approach may see clients for many months or years. Many therapy styles fall somewhere in between.

Question 5: Is There Anything I Can Do at Home to Support My Child’s Progress?

I love being asked this question, because the answer is almost always yes! You and your child’s therapist will be partners in their care. Your therapist only sees your child an hour a week, while you are with them day in and day out. Your therapist may have a broad knowledge from having worked with many children your child’s age, but nobody has a deeper knowledge of your child as an individual than you. Therapy just works better when parents are following up at home.

Your therapist may have book recommendations for you and your child, or ideas for coping skills the two of you can try together. If you continue working together, they may be able to help you figure out ways to tweak how you’re handling situations at home to help your child better manage their feelings. Asking this question during your first interview helps you get a better idea of the therapist’s style, and the sort of “homework” you may be asked to do down the road.

Begin Child Therapy in New York, North Carolina, or Florida

If you’re looking for a children’s therapist and you’re in one of these three states—New York, North Carolina, or Florida—I may be able to help! I specialize in helping anxious tweens overcome worries and cope with strong feelings using a combination of play therapy and CBT. Children are welcome to visit my Davidson, North Carolina therapy office for in-person counseling, or meet me online for virtual therapy.

I also have some mental health resources that are available to all families, regardless of location. My coping skills course, Worry-Free Tweens, helps kids and parents learn new strategies they can use at home to combat anxiety. It’s a great first step to take while you’re looking for a therapist. My book, A Parent’s Guide to Childhood Grief, helps children and caregivers reconnect and talk about their loss through play-based activities.

Now that you have your first 5 questions prepared, you’re ready to go forth and interview some therapists. I’m wishing you the best of luck on your search!

6 Helpful Books on Grief for Elementary Students

By elementary school, children have developed an awareness of death. They’ve seen characters pass away in TV shows and movies, and noticed that plants and animals die in real life, too. None of this makes it any easier, however, when a loved one dies. Death brings up many difficult questions for elementary-aged kids, and reading books about grief together can set the stage for healthy conversations about loss.

We’ve already covered picture books to help children under 5 cope with a loss. Today we’ll take a look at books geared toward slightly older kids. These 5 books can help early elementary schoolers—roughly ages 5 through 8—learn about grief, death, and serious illness.

How Stories Help 5, 6, 7, and 8-Year-Olds Through Grief

Stories and picture books give 6 through 8-year-old children accurate, age-appropriate information about death, which can help reduce anxiety. Death is a big unknown for all of us, but especially for kids. Children who don’t have enough information about death may make assumptions on their own that lead to even more worry, such as wondering whether or not they did something to cause their loved one to die.

Reading a book also helps children talk and think about death without having to share their own personal experiences. It’s easier to talk about a fictional character and their grief. Stories help elementary-aged children understand grief through another person’s perspective, and hopefully realize that the feelings they’re having are normal and healthy, too.

Time spent with a parent or loving adult is one of the most helpful experiences a grieving child can have. 5,6, 7, and 8-year-olds will still need a lot of support from you to understand their grief. Sitting down to read a book together is a wonderful way to comfort your child and let them know its okay to talk about grief.

Finding Meaning in the Life Cycle: The Fall of Freddie the Leaf, by Leo Buscaglia

Recommended age range: 4-8

At first glance, the title and plot of this book might seem a little corny—at least it did to me! The story follows a leaf through the four seasons of the year, from growth in the spring to falling off the tree and dying in the fall. It’s accompanied by nature photography that shows the beauty of each season.

While the book is recommended for kids ages 4-8, I think the length and wordiness of the story might challenge the attention spans of some younger readers. The story also raises some big philosophical questions that might be better suited to older kids, like “What’s our purpose in life?” Finding meaning in life and death is an important part of grieving, and few children’s books talk about it. If your child is starting to ask deeper questions, this book is a gentle way to think about how life and death are both natural parts of life.

One small word of caution: at the very end of the book, there’s one brief mention of death feeling like falling asleep. Younger children may take this literally and worry about falling asleep at night. I’d recommend changing the words when you get to that page!

Talking About Causes of Death: When Dinosaurs Die, by Laurie Krasny Brown and Marc Brown

Recommended age range: 4-8

Death is never easy to talk about, but it can be even harder to broach the subject when a loved one’s cause of death was difficult or sensitive. This heavily illustrated book is divided into panels, like a comic strip. The pictures are expressive, colorful, and full of small details for children to notice and study. The pictures alone can prompt a lot of discussion, but this child-friendly book also shares some hard truths about death.

When Dinosaurs Die offers brief, age-appropriate explanations of death caused by violence, racial prejudice, suicide, and substance abuse. It also helps children understand that while most people live to a very old age, it is sometimes possible for very young children and even babies to die. These specifics may be too much information for families looking for a more general introduction to the subject of death. If your little one has experienced one of these causes of death, however, reading about them in print can be extremely reassuring.

Flip through this book in advance to ensure that the content is right for your child’s needs. It’s okay to pick and choose sections to share. This is one of the books I find myself turning to again and again in my child therapy practice to help children make sense of more difficult grief experiences.

Saying Goodbye After an Illness: Ida, Always by Caron Lewis

Recommended age range: 4-8

Ida Always doesn’t feel like an educational or therapy book—it’s just a good story. Like many of my favorite books for kids, this one teaches by showing, not by telling. Readers meet Ida and Gus, two polar bears at the Central Park Zoo (who really existed!) who are best friends. One day, Ida becomes very sick and can’t get better. Over the course of the book, Ida and Gus grieve and prepare for Ida’s death together.

This book offers a child-friendly explanation of death, as well as a good example of what to expect when someone has a terminal illness. Ida sleeps more often, has good and bad days, and sometimes need a moment alone while she is sick. Gus goes through some very human feelings, too: disbelief, anger, humor, and acceptance are all a part of the story.

Gus—and readers—learn that you can continue a friendship during and after terminal illness, and that you don’t need to see someone in order to stay connected to them.

A Spiritual Look at Death: The Endless Story, by Melissa Kircher

Recommended age range: 5-10

This lesser-known book explores the entire life cycle, from birth to death as well as what might happen after. It’s great for children who are asking deeper questions about what gives life meaning, or where people go after they die. The Endless Story explores many ideas different people and cultures have about the afterlife. The book uses simple, open-minded language and doesn’t comment on whether anyone is right or wrong, which makes it appropriate for kids of all beliefs and backgrounds.

The Endless Story describes the life cycle as something universal—it happens to all of us. It’s a gentle and even beautiful way of looking at life and death that works for kids of all ages, but really lends itself to elementary-aged kids. The author, a professional artist, has added beautiful illustrations throughout that will encourage children to read this book again and again.

A Recipe for Getting Through Grief: Tear Soup, by Pat Schweibert

Recommended age range: 8+

This quirky, longer picture book uses the metaphor of creating a recipe to describe the many layered “ingredients” that make up the grieving process. Because it’s more abstract, it’s best for older kids who can easily tell the difference between fantasy and reality. Amazon recommends this book for kids 8 and up, but I think it could work for slightly younger children who are avid readers, too. It’s a little on the long side, so you may want to break the story up into a few reading sessions.

In fact, many adults who have reviewed this books say it’s been helpful for them, too. The story’s main character goes through many feelings associated with grief, including a few that are harder to talk about, like jealousy and hopelessness. Children and adults can learn about how grief isn’t a linear process, and it’s okay to focus on your grief for a little while and then take a step back when it becomes too intense. Finally, the book stresses the importance of finding supportive people who understand and can share your grief with you.

Help Your Elementary Schooler Cope with Grief Through Art and Play

These picture books are a great start to helping your young child understand grief, death, and loss. However, grief is a lifelong process: it will take more than one story to help your child work through their feelings. Losing a loved one is a huge, overwhelming experience, and it’s okay to take things one step at a time.

If you need ideas for more small steps you and your child can take to process grief, my book may be right for you. A Parent’s Guide to Managing Childhood Grief takes you step by step through activities you can use at home to help your child safely express big feelings, understand their loss, and begin to adjust to a “new normal” after a loved one has died.

All activities are geared toward children ages 5-11. You can pick and choose the ones that seem right for your child. The book is available on Amazon, Barnes & Noble, or at an independent bookstore near you.

Picture Books About Death, Grief, and Loss: Five Stories for Kids Five and Under

Preschoolers and kindergarteners are just beginning to understand the basics of what it means when a living thing dies. This makes it challenging to talk about grief and loss with little kids: even though it’s important to do, it can be hard to figure out where to begin. Picture books take these big subjects and break them down into smaller, more manageable pieces. That’s why several of the exercises for younger children in my grief activity book begin with reading a story together.

Picture books are an opportunity for you to sit down with your child and provide some much-needed one-on-one support after a loss. Stories help kids to approach grief in a gentle way, and helps kids to express their fears and feelings without having to speak directly about their own grief. Perhaps most importantly, stories reassure children that the feelings of grief are universal. Picture books take all the big, overwhelming feelings that come after loss and make them just a little bit easier to understand.

Let’s take a look at 10 picture books that can help your young child learn about grief, death, and loss. We’ll focus on stories geared toward children from preschool and kindergarten through the early elementary years.

What to Look for in a Picture Book for Kids About Grief

As a children’s therapist, I am always on the lookout for good books for my play therapy office. Something that’s important to me is that books about tough subjects don’t feel too “therapy-ish.” Really good stories for children don’t feel like after school specials or counseling in disguise, even when the topic is heavy.

Good storytelling—likable characters, strong writing, and beautiful illustrations—hold a child’s interest and help them connect emotionally with what they’re learning. I think even little children can sense the difference between a book focused on storytelling and a book that isn’t.

You may also want to pay attention to how stories describe what happens after someone dies. Some books include religious beliefs, while others don’t. None of the books on this list follow any particular belief system, so they should work for most families. Still, it’s worth paging through your picture books in advance to make sure there aren’t any messages that could be confusing to your child. Some books may use phrases like “went away” or “went to sleep” to describe death, and this kind of abstract language can be hard for young children to grasp.

A Grief Book for the Youngest Children: The Goodbye Book, by Todd Parr

Recommended age range: 3 and up

Preschoolers and kindergarteners may already be familiar with Todd Parr’s popular book series. The bright style of his illustrations is easy to recognize. The Goodbye Book is short and sweet, with basic vocabulary and only one sentence per page, making it ideal for very young readers. The language is simple, but the ideas are pretty grown-up.

Each page describes a different feeling or symptom a person may experience after a loved one dies, such as pretending the death never happened or not wanting to do fun things anymore. Young children will get reassurance that all these grief responses are normal and okay, and that they become easier to manage as time passes. The book never specifically mentions death, only goodbyes.

A Simple Story About Death: The Dead Bird, By Margaret Wise Brown

Recommended age range: 4 and up

Many children’s first encounter with death will be the death of an animal. Whether it’s a pet or simply an animal found outdoors, talking about nature and animal deaths can be a good introduction to conversations about grief and loss. The Dead Bird doesn’t go out of its way to teach young readers specifics about grief or death. It’s just a story about preschool children who discover a dead bird while outside, and hold a funeral for it.

If you’ve ever been in a similar situation with your preschooler, you might have been surprised by the seemingly morbid curiosity little kids can display when they find a dead animal. It may seem weird to adults, but it’s totally natural for children to wonder about what physically happens when a living thing dies. Similarly, this story has some descriptions of death that might seem jarring at first: it describes how the bird’s body starts off as warm, and then becomes cool and stiff. Learning this kind of information can help children begin to differentiate between living and dead, and understand that death is permanent.

This is a classic, older book that’s been updated with new illustrations showing a diverse group of kids. It’s a good option for a first conversation about death, or to help children better understand funerals and mourning.

A Children’s Book About the Death of a Grandparent: Nana Upstairs & Nana Downstairs, by Tomie dePaola

Recommended age range: 3 and up

The death of a grandparent or great-grandparent is another common way children are introduced to grief and loss. This story for young children touches on themes of aging, dementia, and the special relationship that little children and their older relatives can share. Like The Dead Bird, this book focuses more on telling a story than teaching specific concepts about death or grief. It’s an entertaining story for children in its own right that could also lead to some helpful discussions about what happens as grandparents and other loved ones grow old.

This true story, based on author Tomie dePaola’s childhood, explores the relationship between a little boy, his grandmother, and his great-grandmother, who live together in a nearby house. It gently refers to death as a part of life, and something that happens to everyone. While dementia or Alzheimer’s aren’t specifically mentioned, talking about great-grandmother’s behavior in the story might be a helpful jumping-off point for conversations about these illnesses in real life.

An Informational Book for Preschoolers and Kindergarteners: I Miss You, by Pat Thomas

Recommended age range: 4 and up

If someone in your family or circle of friends has recently died, you may need to speak a little more directly about death with your young child. The death of a loved one can bring up a lot of questions and curiosity for preschoolers and kindergarteners. Children may wonder what happens to the body when someone dies, why people die, or what happens at a funeral. It’s also common for young children to worry that they might have done something to cause their loved one’s death, or to believe that death is a punishment for being bad.

I Miss You: A First Look at Death answers these questions in a way that’s detailed but easy to understand. It’s aimed at a similar age group as The Goodbye Book, listed above, but it’s a longer and more complex read. In addition to answering common questions and dispelling misconceptions a child might have about death, it normalizes many of the complicated feelings a grieving child might have, such as guilt, regret, and anger. It also reviews a few simple beliefs different cultures have about what happens after death. There is a lot here for kids to think about and revisit over time.

Staying Connected Through Love: The Invisible String, by Patrice Karst

Recommended age range: 4 and up

Of all the books in this list, this is the one that feels the most “therapy-ish” to me. It’s a very simple, straightforward book without a lot of story to it. However, the idea of the invisible string is easy for children to understand: it’s a metaphor for the love that connects family, friends, and other special people. This image can be a big comfort when a loved one dies, leaves, or moves far away.

The book briefly mentions death and heaven, but isn’t solely focused on grief. Instead, it talks about how the bond between two people remains no matter where they are, how they’re feeling, or what they’re doing. The book points out that love doesn’t go away even when a person is angry, which can be a really important message for grieving children to hear.

Children (and adults) have to find ways to continue to love and remember the person who has died as part of the grieving process. This book can be a great opener to having conversations with very young kids about how they can continue to maintain a connection to their loved one.

A Book for Caregivers: A Parent’s Guide to Managing Childhood Grief

Caregivers need support navigating the grieving process, too. If you’re the parent of a young child who is grieving a loss, My new book, A Parent’s Guide to Managing Childhood Grief, can help you move on to deeper conversations after reading picture books like these.

The book combines guidance and grief education with hands-on activities you and your child can work on together. You’ll find ways to learn about grief and loss, express feelings, and strengthen your parent-child bond.

It’s available for on Amazon, at Barnes & Noble, and at your local independent bookstore.

Talking to Kids About Death: Finding the Right Words in Difficult Conversations

You’ve probably imagined many difficult conversations you’ll need to have with your kids in the years to come: talks about bullying, puberty, and real-life issues like racism and violence. For some reason, talking to kids about death wasn’t at the top of my mind. Maybe that’s because we aren’t very comfortable talking about mortality as adults either.

Even though the subject of death may not get as much attention, it’s important to think about. Losses, both big and small, are a natural part of childhood. Many children encounter death for the first time through the loss of an animal, such as their classroom goldfish or the family dog. Kids who are fortunate enough to have close relationships with grandparents and extended family may also learn about grief as their loved ones age.

Whether you’re anticipating a loss in your child’s future, or just want to introduce the concept of death in a healthy way, it can be hard to find the right words. So, let’s talk about how we talk about death. We’ll go over how to tailor information to your child’s age, words to use (and words to avoid), and how you can make conversations about death a part of your day-to-day life.

At What Age Should You Tell a Child About Death?

Death is a huge concept, and it takes a long time for children to really understand what it means. However, even the youngest children feel grief when a loved one dies, even if they don’t grasp exactly what has happened. If you’ve recently lost a loved one, any child who is old enough to express their feelings through talking and playing is ready for a very simple explanation of death.

Usually, children begin to understand that plants, pets, and sometimes even people die by around age 4 or 5. However, it will be a long time before your child is fully aware that death is permanent and happens to every living thing. If you’re not mourning a loss and just want to broach the subject of mortality with your child, you can let their own curiosity about life and death guide your conversations.

Young children are famous for asking lots of questions—remember the “why” phase? You don’t need to volunteer lots of information about death and dying, but if your child asks you a question, it’s okay to give a short, honest answer. In general, if your child is old enough to ask, they’re developmentally ready to hear your response.

Tailor Your Talk to Your Child’s Age and Maturity Level

Talks with kids about death are not one size fits all. The information your child needs will depend on their age, where they are in their development, and your child’s individual personality. Your child is unique, so use your best judgment and your knowledge of your child when considering what to share. Let’s take a look about how kids tend to think about death, according to their age.

Preschoolers are just starting to develop a concept of death: before this age, the word doesn’t really hold any meaning at all. Little children may worry that death can be a punishment for bad behavior, or that the things they think and do might cause someone else to die. Keep your explanation of death very simple and concrete, and help your preschooler to understand that the things they do can’t make others get sick or hurt. Be prepared to answer lots of repeated questions, and to remind your child that death is permanent.

Elementary school-aged kids have a better understanding of death as a permanent event. As they realize that death happens to all living things, they may start to think about their own mortality. This can lead to worries about their own health and safety, or the safety of loved ones. It can help to remind your child that most people live to a very old age, and discuss who would take care of your child in the event of an emergency. School-aged kids are ready for a more detailed explanation of death and any religious beliefs your family holds. You can let their questions guide how deep your conversation goes.

Tweens and teens are more capable of the abstract thinking, which allows them to appreciate spirituality and the permanence of death in a deeper way. Kids this age are figuring out who they are and what they believe about life. They may enjoy reflecting on their own spirituality and what they think about religion. Teens may be ready for harder conversations about death, and may ask uncomfortable questions without simple answers. Honesty is the best policy, especially with this age group, even if the answer you have is “I don’t know.”

Simple Language Is Best for Kids

At this point, it’s common advice to use straightforward words when talking to kids about death. Euphemisms that sound comforting to us can be confusing for kids, because they’re abstract. Children may fill in the gaps in their understanding with their own assumptions, which are often scarier than the truth.

We understand what it means when someone “passes away,” but a young child doesn’t. Where did they pass to?, a child might wonder. Is it like passing out? If a family pet has been put to sleep, a child might fear going to bed at night, in case something bad happens to them, too. Even phrases like “she’s gone to a better place” can cause children to wonder if a loved one chose to leave them to go somewhere else.

Using basic language cuts down on confusion and reduces the chances that a child will experience unnecessary worries. The words “dead” and ‘died” might sound harsh to adult ears, but they’re often easier for children to hear. If your child is too young to fully understand what “dead” means, you can give simple examples of what’s physically different after someone dies. For example, the heart stops beating, the lungs stop breathing, the body stops moving, and a dead person no longer feels hunger, pain, or fear.

Build Conversations About Death Into Everyday Life

It can be intimidating to talk about death with children. It’s a sad, hard, uncomfortable thing to think about. It’s even more daunting if we envision having a serious, sit-down talk where we lay out everything our child needs to know about death and dying. Conversations about death don’t always have to be a big deal. Small events in your day-to-day life can be great learning opportunities for kids.

The natural world offers lots of chances to talk about life, aging, illness, and death. Whether you’re going on a nature walk or tending to a garden, examples of the life cycle are all around you. Talk with your kids about what you see when you’re outside. Can they notice how plants are changing when fall turns to winter? Can they spot any dead worms on the sidewalk after it rains?

Many kids are naturally curious about dead things, which can be awkward for adults. When possible, let your child express their curiosity and ask questions. If you drive by roadkill or spot a bird that has flown into a window, it’s an opportunity for you to show your child that it’s okay to talk about—and have feelings about—death.

Books can be a great starting point for conversations about death, too. The Dead Bird is a short and simple picture book for preschoolers that tells the story of a group of children who discover a dead bird outside. It’s a great way to help very young children think about death and nature. Elementary-aged kids may enjoy Lifetimes, a beautifully-illustrated book that describes the life cycles of different animals.

Leave Space for Questions and Feelings

One of the most helpful messages you can give your child is that any feelings they have about grief and loss are okay. If your child expresses sadness or worry about death, you might feel an urge to help the feel better right away. It’s tempting to rush in and fix things, but sometimes putting a name to your child’s feelings is the most helpful thing you can do. This lets your child know that it’s okay to have negative feelings, too.

It will take children a long time to work through their thoughts and feelings about death. Kids learn through repetition, and you may notice your child asking similar questions about death and dying over and over again. Sometimes, the questions might even seem a little odd! It might feel strange to wonder with your child about where dead pets go to the bathroom, or to answer the same question multiple times in a day. However, by answering honestly and consistently, you’re helping your child make sense of a big, scary topic. You’re helping your child feel more secure, and teaching them that it’s okay to ask you more questions in the future.

If your child stumps you with a question, it’s perfectly fine to say “I don’t know.” Sometimes that’s the most honest answer we can give. If you’re not sure how to respond in a child-friendly way, it’s also okay to tell your child you need to think about their question, and you’ll get back to them later with an answer.

Incorporating Religion Into Talks About Death

So far, we’ve covered the concept of death in a very practical, body-focused way. We haven’t talked about more spiritual aspects of death, like what happens to a person’s soul. If your family is religious, you may be wondering how to incorporate your beliefs into conversations with kids about death.

First, some good news: research shows that learning facts about death doesn’t get in the way of a child’s religious development. Especially as kids grow older, they can hold both the scientific and spiritual aspects of death in mind at the same time. What’s more, a basic understanding of what physically happens when somebody dies can make abstract concepts like the afterlife a little less confusing.

Find ways to tie together what happens when a person dies to your family’s beliefs about what comes after death. For younger children, its best to keep this conversation very simple. For example, “When a person dies, their body stops working and doesn’t start working again. Their body doesn’t eat, feel, think, or move. A person’s soul, which we can’t see, goes to Heaven when they die.” Because young kids are concrete thinkers, you may need to clarify that Heaven is not a place that we can visit, and that loved ones can return from in their physical form.

Older children may be ready for more in-depth conversations about your family’s belief system about death and the afterlife. It’s helpful for older kids to know that not everyone they meet will share the same ideas about what happens after we die. You can also explain to your older child that some aspects of death and what comes after are a mystery to all of us, regardless of our religion.

As always, leave space in your talks about death and religion for questions from your child. "I’m not sure,” “I don’t know,” and “Let me think about that and get back to you” are perfectly okay responses when there isn’t an easy answer.

More Ways to Help Children Understand Death and Loss

Helping a child understand death is an ongoing process. There’s no need to find the perfect words or to have one perfect conversation: you’ll have many opportunities to talk about death, grief, and loss as your child grows. Your child probably won’t remember the exact phrases you used, anyway. What they will remember is that you showed up for them, you were honest, and you cared enough to talk about difficult things.

If you’re anticipating a loss or someone you love has recently died, you may be wondering how to support your child in the weeks and months to come. How can you keep healthy conversations about death and grief flowing? How do you create a safe space for them to let out their feelings without pushing too hard?

If you’d like more step-by-step guidance, A Parents’ Guide to Managing Childhood Grief may be helpful to you. I wrote this activity book especially for parents and caregivers of school-aged kids who are going through grief. Inside, you’ll find deeper advice on how children grieve differently than adults, what to say (and avoid saying) to a bereaved child, and 10 chapters of play-based activities you and your child can try at home to explore many aspects of grief and loss.

You can order the book now on Amazon, at Barnes & Noble, or find a local Indie bookstore to support through IndieBound.

What to Say to a Grieving Child: 5 Messages Kids Need to Hear

Wondering what you should say to a child who is grieving? Your actions and words can both speak volumes.

My Child Just Lost a Loved One. What Do I Say?

It’s so hard to know what to say to someone who has just experienced a loss. Even when we’re talking to other adults, death can feel so overwhelming and huge. How do you figure out what a child needs to hear at a time like this? Go-to phrases like “I’m so sorry this happened” and “I’m here to help” fall a little flat when we are trying to support young people.

Whether you’re a parent, a caregiver, or another important adult in a grieving child’s life, this post is for you. Children understand and process death differently than adults, so the words they need to hear from people around them are a little different, too. We’ll talk about 5 messages that children need to hear from the adults in their lives as they begin to process a loss. Whether you say these phrases out loud, put them into your own words, or show them through your actions, they will help your child feel safe, loved, and understood.

First Things First: Talk Honestly About Death

Before you talk about anything else, it’s important to have an open conversation with your child about death. Younger kids need help to understand the concept of death as something that is permanent and irreversible. Kids of all ages need at least some information about what caused their loved one to die.

We’ll go into detail about how to tell a child a loved one has died in another post, but honesty is the best policy when it comes to talks about death and dying. That means avoiding euphemisms like “passed away,” and describing death as something that makes the body and brain permanently stop working. In general, if your child is old enough to ask a question, they’re old enough to hear an age-appropriate answer. It’s always okay if that answer is “I don’t know.”

Grief Message 1: “It’s Not Your Fault.”

Have you ever noticed that kids tend to believe the world revolves around them? It can be a little exasperating at times, but it’s totally normal and healthy for young children to have this mindset. Kids are the main characters in their life stories, and they’re still figuring out the impact they have on the world around them.

Up until about age 7, kids are still learning that their internal thoughts and feelings don’t affect the outside world. For example, thinking a mean thought about a sibling can’t cause them to actually get hurt in real life. Wishing a person would just go away doesn’t mean they will disappear.

When somebody dies, it’s very common for children to blame themselves. They might over-estimate the power they had to change a situation. They may also worry that their thoughts somehow caused their loved one’s death. This kind of guilt can happen even in situations where the death was nobody’s fault, such as a death from cancer or old age. As you can probably imagine, it’s a terrible feeling, and a tough one for many kids to talk about.

Make it clear to your child that nothing they said, did, thought, or felt caused their loved one to die. You can let them know that many people—adults and kids—feel guilty when someone dies. It’s a normal feeling, but it doesn’t mean the death was your fault. We can’t control another person’s life, health, or decisions, and we usually can’t prevent accidents from happening, either.

Grief Message 2: “All Your Feelings Are Okay.”

Talking about feelings can help children after someone has died. Photo via Pexels by Ketut Subuyanto.

When we think about a grieving person, we probably imagine someone who is very sad or crying. In fact, this is usually how grief is portrayed in the media, too. While it’s true that sadness is a big part of grief, there’s a whole range of other emotions involved, too.

Adults may be aware that grief is complicated, but kids usually aren’t. Most kids don’t have very much personal experience with grieving. They look to books, TV, and movies to figure out how they’re supposed to feel.

Actually, there’s one other place kids are looking to figure out how to feel: you.

Children turn to parents and caregivers to see how they are responding to grief, and to decide whether their own feelings seem “normal” or okay. You can be a role model for your child, and help them to accept and cope with the many confusing, conflicting feelings they might experience.

You can help your child understand that there’s no right or wrong way to grieve. Any feelings they have are okay. Whether those feelings are big or small, scary or sad, angry or happy, it’s all normal. It’s even alright if they aren’t feeling much of anything at all, especially right after the death when many people are still in shock.

You can affirm your child’s feelings in two ways: by talking about them directly, and by showing your own emotions in front of your child. It’s okay to share when you’re feeling sad or frustrated or worried. When your child sees you dealing with your own grief, they learn that feelings aren’t something they need to hide.

Grief Message 3: “There Will Always Be Someone to Take Care of You.”

Human brains are hardwired for survival. We’re good at looking for signs of danger—in fact, sometimes we’re a little too good at it, and we end up with anxiety. Kids understand that, in order to survive, they need to stay close to grownups who can take care of them.

The death of a loved one is a scary reminder to kids that bad things can happen to the grownups in their lives. It can leave children feeling vulnerable and unsafe. What’s more, the things that kids usually turn to for safety—routine, predictability, and time with caregivers—may all be disrupted for a while as the family deals with their loss.

Remember earlier when we talked about how kids are the main characters of their own life stories? That comes into play here, too. When children hear about a loved one’s death, they often wonder “What does this mean for me? Who will be there to take care of me?”

You can help your child feel safe by reminding them that, no matter what, there will always be someone looking out for them. Even if something unexpected happened, you have plans for who would step in to help. You can name the many adults in your child’s life who provide for them, either physically or emotionally. Keep your child in the loop about who will be taking them to school or tucking them into bed at night, so they know what to expect.

Grief Message 4: "We Can Talk About Anything, Even the Hard Stuff.”

Parents and caregivers sometimes worry that bringing up a deceased loved one in conversation could upset their child. It can be painful to bring up old memories, and the child has already suffered so much pain. If a child isn’t talking about the death, should adults around them bring it up?

We never want to force children to talk when they aren’t feeling up to it. On the other hand, if adults never talk about their grief, it can give children the mistaken idea that it’s not okay for them to talk about it, either. Kids often worry about their caregivers a lot following a death, and pay close attention to their responses to grief. They may interpret silence as a sign that you aren’t ready to talk, or that hearing about your child’s grief would be too much for you to bear.

It’s okay to take the lead on conversations about grief. It’s not too forward to ask your child how they have been feeling. If they say they’ve been fine or haven’t been thinking about their loved one lately, that’s just fine—there’s no need to push. You can always try again another time.

Sharing your own thoughts and feelings about grief can be really helpful, too. It can help make painful emotions feel less taboo to talk about. By bringing up your own positive and negative emotions, you’re letting your child know that you can handle hearing about theirs.

Grief Message 5: “I Remember Your Loved One, Too.”

Remembering a loved one is another way you can talk about grief with kids.

It’s normal for grieving people of any age to think about their loved ones more on special days. Anniversaries, milestones, and holidays can bring up difficult feelings at times of the year when we’re “supposed” to be happy. The mixed feelings can be a lot for a young person to handle.

Grieving kids have another layer of complexity to deal with, too: the older they get, the more they understand their loss. With each passing month or year, a grieving child becomes older and wiser. The realization that death is permanent really starts to sink in. Celebrations and anniversaries are a reminder of everything a child has lost: not just their loved one, but all the memories they could have made together in the future.

With your words or with your actions, you can let your child know they’re not alone in thinking about their loved one. Share a funny story about them, light a candle, or just let your child know they’ve been on your mind. There isn’t a timeline on grief, and sharing your own thoughts takes pressure off your child to just get over it and move on.

No Matter What You Say, Keep the Conversation Going

The stakes can feel really high when we’re talking to kids about grief. This sensitive, vulnerable little person is depending on us to help them figure out a life-altering event. There’s a lot of pressure to not mess up. What if you say something wrong, and end up doing more harm than good?

We’ve probably all heard the Maya Angelou quote about how people will forget what we say and do, but they’ll always remember how we made them feel. It’s a little cliché, but in this case it’s true. Children may not hang on to your every word for the rest of their lives, but they’ll remember the ways that you helped them to feel safe and supported.

It’s okay if your response to your child is honest, but awkwardly worded. It’s okay if a conversation falls a little flat. It’s even okay if you misspeak, and need to come back later and make things right. What’s most important is that you’re keeping lines of communication open with your child. If you miss an opportunity, don’t worry—you’ll get another one. You are letting your child know that you care, and that you’ll be there for them when they’re ready.

Need More Ways to Talk About Grief With Your Child?

Talking about grief with kids is an ongoing process. Children will need repeated opportunities to work through their feelings about a loved one’s death. That repetition is part of what helps children to learn and make sense of information. These conversations don’t all have to be heart-to-heart chats, although those are wonderful: playing, making art, and spending time together can all help your child grieve.

A Parent’s Guide to Managing Childhood Grief is an activity book for parents, caregivers, and any adult who wants to support a bereaved child. I wrote it with children ages 5-11 in mind. It includes 100 activities that you and your child can do together to talk about death and dying, cope with hard feelings, and honor the memory of your loved one. If you’d like more ideas and advice for helping grieving children, it’s available on Amazon, at Barnes and Noble, and in local bookstores.

Thank you for supporting your child! As always, if you have any questions or would like to learn more about children’s counseling, you’re welcome to send me a message.

My Child is Afraid of Halloween! What Do I Do?

Maybe it’s just me, but I love a good baby Halloween costume. I started researching them long before I became a parent, and I’m excited to have at least a year or two of freedom to dress my baby up without objections from him about my style decisions. Eventually, though, all good things must come to an end.

As children grow up and begin to develop their own (strong) opinions about things, including Halloween. What if your child’s views are not so enthusiastic? What if they are downright scared of Halloween? You may be wondering if it’s okay to push them to face their fears so they don’t miss out on any fun—or keep their siblings from having a good time. On the other hand, you don’t want to overwhelm your poor kiddo by subjecting them to an evening of skeletons and eyeballs.

What’s a parent to do? Let’s take a look at a few strategies to help children who are afraid of Halloween feel secure enough to (gently) try out some spooky fun.

Is it Normal for Kids to Be Afraid of Halloween?

If everyone else’s children are eagerly jumping into their Pennywise costumes or laughing with glee at the scary chainsaw man on the haunted hayride, you may wonder if it’s normal for your child to feel so scared.

When you stop to think about it, many Halloween traditions are very weird and unlike our normal day-to-day life. It’s a day deliberately intended to scare people. On Halloween, kids get to do a lot of things they aren’t allowed to do any other night of the year, like walk around the neighborhood in the dark and take candy from strangers. No wonder some kids have a hard time adapting.

I wonder if the abundance of scary games, movies, and other content geared towards children has led to more kids fearing Halloween. I can’t tell you how many kids have come into my therapy office deathly afraid of characters like Pennywise, Annabelle, or the cast of Five Nights at Freddy’s. Even creepy memes can have a lasting effect on kids. Remember Momo? She was a major subject in my office for about 6 months in 2019.

I do think it’s worth mentioning that while mild anxiety is totally normal and understandable, extreme anxiety may be a different story. A child who is creeped out by Halloween decorations or who is hesitant to go trick or treating is experiencing pretty typical fears. On the other hand, if your child is so paralyzed by fear that they have nightmares the entire month of October, or refuse to go to public places because they might have decorations up, she may be dealing with a more severe phobia that could use some outside help.

How to Help a Child Who is Scared of Halloween

We all want to protect our children from harm and help them avoid upsetting experiences when we can. That said, please don’t wrap your child in psychological bubble wrap and avoid all things Halloween-themed. While this might help your child (and you) feel less anxious in the short term, it is likely to make your child’s fears stronger and more persistent over the long term.

Anxiety makes us want to avoid the things that scare us. We get the sense that something terrible will happen if we don’t. The problem is that every time we avoid something scary, we reinforce the idea that it is worth being afraid of. The longer a child avoids a scary situation, the harder it will be to return to it when the time comes. This is why it can be so hard to go back to school after summer vacation, and why so many kids developed separation anxiety after months of togetherness during quarantine.

To help an anxious child, we want to:

• Let them know their feelings are normal and okay

• Talk, read, and play about feelings and scary things

• Clear up any misunderstandings that might make anxiety worse

• Support them in gently and gradually facing their fears

Let’s see how we can apply those ideas to help a child who is afraid of Halloween.

Practice in Advance of the Big Day

The best time to start addressing Halloween anxiety is not October 30th. I say this knowing full well that this blog post will go up on October 30th, the night before Halloween. But, I am assuming that you are likely reading this blog post at some future time. Hopefully, Future You has decided to Google this issue in September or early October, which gives you plenty of time to prepare.

Kids learn and make sense of things around them through repetition and play. Ever seen your child act out the same game over and over for a week and then move on to something else? They’re learning! Children also thrive on routine, which helps the world feel more predictable and safe. Repeated conversations about Halloween traditions helps children learn what to expect, and takes away the element of surprise that can be so frightening.

Reading books about Halloween together is a great way to facilitate conversation. As an added bonus, books are a gentle form of exposure for anxiety. You are gently showing your child that he can handle talking and thinking about scary subjects, and you’ll be right there to support him.

Talk About the Difference Between Real and Pretend

Little kids have a hard time distinguishing between fantasy and reality. Their imaginations and ability to “make believe” can add a lot of magic to childhood. On the flip side, it can also add a lot of fear!

Older kids and adults can delight in scary movies because they know that there’s no chance of Godzilla lurking around the corner when they leave the theater. Pretend scary stories let us experience the adrenaline rush of a good scare at a time when we know that nothing bad can actually happen. Imagine how it must feel if you aren’t so sure the Godzilla won’t be there!

You can use TV shows and movies as an opportunity to show your child that the stories are pretend, and the actors are playing make-believe. Mister Rogers once invited the actress who played the Wicked Witch of the West onto his show to teach this exact concept. Onscreen, the actress showed how she put on her costume and makeup, and used a pretend scary voice to play the part. In reality, she was a really nice lady! You can talk with your child about how actors use makeup and costumes to look scary, when really they are normal people—there’s plenty of videos of actors in and out of costume to back up your point.

Use Exposure to Make Scary Items Feel Familiar

Exposure is a big part of the kind of therapy I practice for kids with anxiety, called Cognitive Behavioral Therapy. In exposure, we help a child face unhelpful fears, but we do it in a gradual way. This helps kids build up their confidence, and learn to tolerate anxious feelings without becoming totally overwhelmed.

You can practice exposure at home by giving kids a chance to look at and handle scary Halloween props in small doses. This could mean taking the scary mask from a sibling’s costume out for your younger child to handle and play with. It could also mean walking on the opposite side of the street from a Halloween display to view it from a safe distance before getting closer. It often helps to make these exposure situations funny: try talking with your child in a goofy witch voice, or encourage them to make fun of a monster that frightens them. It’s hard for things to be both funny and scary at the same time.

Involve Your Child in Halloween Prep

Helping your child participate in Halloween traditions in an age-appropriate way gives them another opportunity for exposure. It’s also another chance to highlight the difference between real and pretend by showing kids how things are made. A glowing jack-o-lantern seems a lot less intimidating when you saw the pumpkin that was scooped and carved to make it.

Giving your child a role in the Halloween festivities allows them to feel a sense of control over the situation. You can let your child pick out your decorations, play their choice of music, and decide what snacks to enjoy or what candy to give out to trick-or-treaters. Feeling in control can ease anxiety, and getting to pick out all the details might give children an added motivation to participate.

Fun is Most Important!

Okay, so I’ve gone on and on in this post about the importance of exposure and facing your fears. All of that is true! But also…Halloween is a holiday, and it’s one day a year. While I encourage you to gently help your child overcome Halloween anxieties, there’s no need to push them so far out of their comfort zone that the holiday stops being fun.

We’re looking for progress, not perfection. Maybe this isn’t the year that you go trick-or-treating in the neighborhood that goes all out for Halloween with super gory decorations. Maybe your young child would be more into a casual daytime party with friends rather than a nighttime trek with the big kids. Some aspects of Halloween may just be too intense for young or sensitive kids to handle, and that’s perfectly okay.

What’s most important is communicating to your child that having anxiety is okay, and that we don’t always have to do what it tells us to do. By staying calm and finding small opportunities for exposure, you are showing your child that you can handle their big feelings. They may be terrified of the ghost hanging on the neighbor’s house, but you aren’t!

Help for Anxious Kids in Davidson, NC

Do your child’s anxieties extend past Halloween? If you’ve got a sensitive kid who is prone to big feelings, it might feel like there’s a minefield of situations you have to tread carefully around to avoid triggering a meltdown. If anxiety is getting in the way of your child living their best life, counseling can help make things more manageable.

I am a former-anxious-kid-turned-therapist who loves working with children and tweens. I see kids in person for CBT and play therapy at my office in Davidson, North Carolina, just outside of Charlotte. If you aren’t close by, we may still be able to work together! I see kids throughout North Carolina, New York, and Florida for online therapy. If you’re not sure you’re ready to start therapy, or need some basic help right away, check out my coping skills course for anxious kids and tweens.

If you’re ready to start child anxiety therapy, drop me a line. I’m always happy to hear from you.

Is My Child Having a Panic Attack or an Anxiety Attack?

Your child’s mind is racing. Her stomach is flip-flopping. She’s having a hard time falling asleep at night, and an even harder time getting up for school in the morning. You know something is going on, but you’re not sure what to call it when you describe it to people. Is your child having a panic attack or an anxiety attack? What’s the difference? Today I’m going to break down the difference between panic and anxiety, so you know the next steps to take to help your kiddo.

Panic Attacks and Anxiety Attacks Are Basically The Same Thing

I guess I’m giving away the big reveal in this blog post right up top, huh? Kids and parents often ask me if the symptoms they’re describing sound more like an anxiety attack or a panic attack. The truth is, most people use both terms to describe the same thing, so you can pretty much use them interchangeably. Mentioning either term to a therapist will give them a good idea of what you’re going through.

“Panic attack” is the official name for a sudden bout of intense fear, bodily reactions, and a feeling of impending doom. This is the term used by the DSM-5, the phone book-sized manual therapists use to diagnose mental health problems. The phrase “anxiety attack” isn’t usually used by therapists because it doesn’t appear in the book and isn’t “official.”

Parents might use the phrase “anxiety attack” to describe another intense emotional experience, like a tantrum or extreme worrying, but that’s rarely the case. It makes sense to describe panic as an attack of anxiety, and pretty much everyone will understand what you mean if you do.

What Does Anxiety Look Like in a Child?

The big difference between anxiety and panic is that anxiety is more general and long-lasting, while panic is specific and sudden. Anxiety can be mild or severe, and it can ebb and flow over time. Some kids may only feel nervous in specific situations, such as meeting new people or sleeping in bed alone, while others may have more generalized anxiety that happens most days.

If your child has anxiety, you might see signs like:

• Frequent worries that seem like more than a phase

• Avoiding specific people, places, or things to keep from feeling afraid

• Difficulty falling asleep, or trouble sleeping alone

• Muscle tension, headaches, and stomach aches that don’t have a clear medical cause

• Clinginess and difficulty tolerating being alone

• Repeatedly asking for reassurance

• Irritability or seeming on edge

• Being easily startled by loud sounds or surprises

• Focusing on things that went wrong in the past or that might go wrong in the future

Every child is different, but these are some of the most common signs I hear about from families in therapy.

Signs Your Child Is Having Panic

Panic comes on suddenly, and it can be debilitating. It’s possible for a child to go about her day with anxiety, but a panic attack will stop her in her tracks. While anxiety gradually waxes and wanes, panic is like a light switch flipping on and off. The good news is that although panic attacks are intense, they don’t usually last very long. If your child has a panic attack, it will most likely be over in 15 minutes.

If your child is having a panic attack, you may notice things like:

• Shaking hands or full-body shivering

• Increased sweating

• Hot flashes or chills

• A racing, pounding heartbeat

• Hyperventilating, or feeling like it is hard to breathe

• Dizziness or weakness

• Tingling feelings in the fingers or hands

• A sense of losing control

• Intense terror, as if something bad is about to happen

Your child may or may not be worried about something in particular when a panic attack occurs. Sometimes, panic attacks seem to appear out of the blue, when a child isn’t thinking about anything in particular. Over time, though, your child may start feeling worried about the panic attacks themselves. If she’s already had a few, she may dread the possibility of having another one.

Can a Child Have Both Anxiety and Panic?

Yep! A child can have both anxiety and panic attacks. In fact, it’s pretty common. Being anxiety-prone or sensitive to stress may put a child at risk for experiencing panic attacks. Sometimes, panic attacks happen on their own, and this is called Panic Disorder. It’s also very common for panic attacks to go hand-in-hand with other forms of anxiety, like Social Anxiety, Generalized Anxiety, and Agoraphobia.

If a child is struggling with both anxiety and panic attacks, she probably has lower-level anxiety on an ongoing basis that gets punctuated by brief moments of intense fear. For example, a child may struggle with perfectionism and worries about not doing a good enough job on school assignments. This could lead to problems like avoiding turning in homework, stomach aches on school days, and fitful sleep. Before a test, however, this child might experience a full-blown panic attack with rapid breathing and dizziness.

Anxiety and panic are both tough. Dealing with them both is even harder. The good news is, there are great therapy options to help kids with anxiety, panic, or a mix of both. It’s possible to get worries under control and learn to soothe panic responses in the body, so your child can get back to enjoying life.

Help For Kids With Anxiety and Panic Attacks in Davidson, NC

Anxiety doesn’t have to run your child’s life and call the shots in your house. If you feel like you’re bending over backwards to avoid things that set off your child’s worries, therapy can help. Kids can learn coping skills to feel more in control of anxiety and panic, like the ones I teach in Worry-Free Tweens, my online class for kids.

Child-friendly styles of therapy like Play Therapy and Cognitive Behavioral Therapy have been proven to help anxious kids feel better in a relatively short period of time. With a little practice, your child won’t have to dread their next panic attack, because she’ll know exactly what to do if she feels one coming on.

I love helping anxious kids and tweens in my Davidson, NC child therapy office. I also provide play therapy and CBT online to kids throughout North Carolina, New York, and Florida. I use these approaches because I’ve seen them work, and I know they’re effective. Whether you work with me or another counselor, I hope your family finds therapy helpful, too.

Questions? Ready to schedule an appointment? Reach out to me here.

Signs of Social Anxiety Disorder in Children

How can you tell whether your child is just shy, or if there’s something more going on? If you’ve noticed your child lingering on the edges of the playground or appearing uncomfortable during playdates, you might wonder if social anxiety is to blame. Social anxiety affects about 7% of Americans, and it often starts during late childhood or the teen years.

This post will cover the common symptoms of social anxiety and how they show up in younger kids. You’ll learn what to keep an eye out for, and how to spot the difference between true social anxiety and run-of-the-mill shyness.

How to Tell If Your Child Is Shy…

Kids who are shy have trouble meeting new people. While their shyness may pop up with close friends and family, it’s usually the most noticeable when talking to an unfamiliar person. Shy kids may have a hard time initiating conversations, or responding when an adult says hello. However, after spending some time with a new person, many shy kids are able to warm up and interact more comfortably.

Kids who are shy may appear soft-spoken or socially awkward at times, but their troubles are usually mild or fleeting. Shyness doesn’t usually cause major problems in a child’s life, or keep them from making at least a few good friends. Over time, many children may outgrow their shyness altogether.

…And How to Tell If Your Child Has Social Anxiety

On the flip side, kids who have social anxiety fear judgment from others. They worry about embarrassing themselves or making a mistake in front of friends, teachers, and even strangers. You may hear a socially anxious child worrying aloud about doing something wrong. This fear can be paralyzing, and it doesn’t usually get better on its own.

Because socially anxious kids fear judgment, they can definitely have a hard time talking to friends or meeting new people. However, they can have a hard time with other public activities, too. The “social” in social anxiety refers not just to friendships, but any activities that involve being observed by others. This can include things like reading out loud in class, participating in gym class, or even eating in restaurants or using public restrooms.

Signs and Symptoms of Social Anxiety Disorder

Therapists use a manual called the DSM-5 to diagnose children with Social Anxiety Disorder and other mental health problems. It tells us how many symptoms a child needs to have, and gives us a handy bullet point list of what exactly those symptoms are. It also tells us how long those symptoms need to last in order to be considered social anxiety.

Here are the “official” symptoms of Social Anxiety Disorder, according to the manual:

• Intense and ongoing anxiety about social situations due to a fear of being judged or humiliated

• Avoiding situations that trigger this anxiety, or tolerating them with distress

• The fear is exaggerated or out of proportion to the actual situation

• The anxiety gets in the way of completing day-to-day activities

In order to qualify as social anxiety, the symptoms need last for at least 6 months. There also can’t be a better reason for the anxiety, such as a physical problem or the side effect of a medication.

What Social Anxiety Looks Like in Kids

Okay, now that we know the “official” symptoms of social anxiety, let’s talk about how they actually show up in children. Some kids with social anxiety might be very vocal about their worries, which makes it easier to figure out what’s going on. Others might have a harder time putting feelings into words—or they may feel too embarrassed to talk about it.

Here are a few common scenarios that illustrate what Social Anxiety Disorder may look like in children:

• Your child loves school and learning, but absolutely dreads class presentations. He gets flushed and visibly anxious when he has to read aloud, and stumbles over his words. You have noticed he avoids these projects at all costs, even in classes where he excels. In fact, he always seems to get sick on presentation days.

• You’ve noticed your child is extremely worried about what others may think of her. She feels like all eyes are on her, even in situations where most of her peers probably have other things on their minds. Her thoughts tend to jump to the worst-case scenario, and assume other people are critical of how she dresses, what she says, or how she acts.

• Your child avoids trying out for sports or the school play, even though you have a feeling he’d love to join. Being “in the spotlight” is just too overwhelming for him, and he’d rather be able to participate without anybody looking at him. You’re worried he might be missing out on a lot of fun.

• It’s hard for your kid to order food at a restaurant or answer the phone. You’ve offered a lot of encouragement, but it’s still seems like it’s way harder for her than it should be. You’ve noticed other kids the same age don’t have the same struggle.

• Your younger child throws tantrums when it’s time to go to a birthday party or other social event. It’s hard for him to articulate why, but he dreads going. He complains of headaches and stomach aches, and starts feeling on edge the night before it’s time to go.

Do any of these sound like your child? If so, chatting with a children’s therapist can help you confirm whether or not your child is dealing with Social Anxiety Disorder.

Counseling for Kids with Social Anxiety

Counseling can help your child to overcome her worries, so she can participate more fully in life without a fear of being judged. Therapy approaches like cognitive behavioral therapy can help kids learn how social anxiety affects their thoughts. It can be a big relief for socially anxious kids to realize that, most of the time, other people are focused on their own lives and not thinking negatively about us at all!

Younger children with social anxiety can benefit from play therapy, too. Even if it’s too hard (or embarrassing) to talk about worries out loud, children naturally express their anxieties through their play. A play therapist can help kids work through these feelings in a non-threatening way, and even use play and storytelling to help kids learn coping skills to manage their worries.

If coping skills sound like the way to go for your child, you can also check out my online coping skills courses. My anxiety skills course, Worry-Free Kids, is a good fit for older kids with social anxiety.

I’m a CBT and play therapist in Davidson, North Carolina. I love helping kids with anxiety to learn that they don’t always have to listen to the worries that anxiety gives them. I get to see kids build their self-confidence and face their fears every day in my office, which is part of why I love my job. Even if you don’t live in the Lake Norman area, I may be able to help: I offer throughout North Carolina, New York, and Florida.

If you are ready to take the next step with counseling for childhood social anxiety, you can reach out to me here to set up an appointment.

How Do I Talk to My Child About Counseling?

You know your child better than anyone, and lately, things just don’t seem right. Maybe you have noticed your child seems to be more worried than other kids her age. Or, you’ve been waiting to see if your child’s tantrums were just a phase, but they’ve stuck around long past the toddler years. After consulting with friends, the pediatrician, or “Dr. Google”, you’ve decided that child counseling could help. How do you tell your child you’d like her to see a therapist? It’s not a conversation most families have every day, which can make it feel awkward. In this post, I’ll share some tips from my experience as a children’s therapist on how to introduce therapy to your child in a positive way.

Common Concerns When Discussing Counseling

The most common concern I hear from parents is that their child will think something is wrong with them if they see a counselor. Views on mental health are changing quickly, but there can still be a stigma attached to getting therapy. The last thing a child struggling with anxiety, depression, or low self-esteem needs is another reason to feel different or “bad”!

Parents of younger children often worry about separation anxiety during sessions, especially if this is one of the issues bringing a child to therapy in the first place. Will it be too frightening for their child to meet with a therapist alone? What be done to help soothe their child’s fears?

When the child is a preteen or teen, there’s sometimes a worry that kids will “shut down” or not be receptive to attending therapy if it wasn’t originally their idea. Any suggestions from Mom or Dad might be viewed with suspicion by a teen or tween. How can we explain therapy in a way that encourages kids to keep an open mind?

If any of these worries sound familiar to you, congratulations! Your concerns are totally normal and you’re in the right place. Keep reading for some tips on how to handle this important talk with your child.

Don’t Bring Up Therapy in the Middle of a Fight!

There isn’t one right way to bring up the subject of therapy. However, there are a few that are…not so great! This is one to avoid. As frustrating as arguments with your child can be—especially if this is your millionth meltdown this week—don’t let this be the way your child learns about therapy.

Telling your child you’re sending them to a therapist between screams or from behind a slammed door virtually guarantees they’ll view therapy as a punishment. It increases a child’s feelings of shame and embarrassment, which won’t help them get better. What’s more, it can turn children off to the whole idea of therapy. They enter their first therapy session feeling resentful and not trusting the therapist to be on their side. That is a hard place to start.

Instead, wait until everyone is feeling good to start a conversation about therapy. This way, your child won’t connect going to a therapist with bad behavior. Avoid times of the day when you know you or your child will be stressed, tired, or hungry. A quiet evening after dinner or snack time after a good day at school is a great time for this discussion.

Describe the Problem as Belonging to Everybody

It’s often easiest to start the “counseling talk” by identifying the problem at hand. Even if your child is showing the most symptoms, it helps to acknowledge that parents have a role to play in therapy, too. This way, the child doesn’t feel like she’s a problem that needs to be fixed: everyone is in this together.

Try to describe the problems you’re seeing in a matter-of-fact, non-judgmental way. It helps to empathize with the emotions your child is feeling, even if the behaviors may be tough. Avoid making assumptions about why the problem is happening, if you aren’t totally sure, and stick to the what instead. If you think a child’s struggles were set off by a particular event, you can always “wonder aloud” about the possible connection.

For example, if your child is having anxiety about going to school, you could try saying: “I have noticed you have had a lot of stomach aches and worries lately, and they usually happen right before it’s time to get on the bus for school. It must be terrible to feel so nervous every day! I wonder if starting in your new school has been scary. I don’t always know the best way to help you with your worries.”

Once you’ve outlined the problem and how it’s affecting your family, you can move on to talking about therapy itself.

Explain What a Counselor Is to Your Child

Children need to know that a counselor is someone who can help them—and you—deal with their big feelings. They need to know that therapy is common and not something to feel ashamed of. In fact, we could all use counseling at some point in our lives!

When I meet younger children, I often describe myself as a “feelings doctor” even though I don’t have a doctorate degree. Most little kids are very familiar with going to their pediatrician’s office, so it’s a good comparison to make. If you have a cold or hurt your arm, a doctor can help you feel better. If your worries, sadness, or anger are bothering you, a feelings doctor can do the same thing. It’s important to explain that feelings doctors can’t give shots!

I tell older children that a therapist is an adult whose job is to be there to listen to them. A therapist is different than a teacher or parent, because they can’t give out punishments or make the rules. They are also different from a friend, because you don’t have to worry about offending your therapist or giving them a turn to speak in conversation. Therapists also keep what you say private, which is helpful and reassuring for older kids to know.

Talk About How Child Counseling Works

When describing child therapy, it helps to keep things simple. Sometimes, over-describing the situation only adds to the anxiety. You might consider something like this: “When you see your therapist, you can talk or play about anything you want. She’ll help you with your strong feelings and will keep the things you say private. She’ll also meet with me to help me understand you better.”

You can also prepare your child for what the therapy session will look like. If you’ll be meeting the therapist in person, describe where the office is and how it looks. Young children are often excited to know that there will be a playroom filled with toys! Tell your child where you’ll be during their session, for example, that you’ll stay in the waiting room nearby.

If you’ll be meeting online, explain how that will work to your child. Most kids are intimately familiar with Zoom these days, but they may still have questions about how much privacy they’ll have or who exactly will be on the call with them. You can pick out a quiet, private location for video calls with your child, and practice logging into the therapy platform together. Younger children may want to pick out a few toys or art materials to “show” their therapist on the first day.

Looking for a Child Counselor in Davidson, NC?

I live and work in the Lake Norman area, just north of Charlotte, North Carolina. If you’re in my neck of the woods, I specialize in working with preteen anxiety and trauma at my Davidson child therapy office. If you aren’t local to Charlotte, I also work with kids throughout New York, North Carolina, and Florida using online CBT and play therapy. And no matter where you live, my coping skills courses are available to access and use at home.

Want to see if we might be a good fit? Feel free to drop me a line to ask questions about what to expect in therapy, or to schedule an intake appointment.

Should My Child Have Social Media?

Depending on who you ask, social media is either the best or worst thing to ever happen to kids. Is it the way of the future, giving kids endless entertainment and a connection to peers all over the world? Or is it an unsupervised no-man’s-land that exposes children to danger and risks their mental health? I’m not here to tell you what to do—every kid and family is different. But, as a children’s counselor, I can go over the pros and cons of social media for children from an emotional perspective. Hopefully, this post gives you a more balanced perspective so you can make the right choice for your child.

What’s The Right Age to Get Instagram, TikTok, or Other Social Media?

If you ask pretty much any social media company, the answer is easy: 13. Instagram, TikTok, Discord, Snapchat, YouTube, and Facebook all require users to be 13 or older to join. This seems straightforward enough—end of blog post, right? If only life were so simple. Sure, Instagram says you have to be 13 to join, but Instagram doesn’t have a tween daughter begging for an account, claiming she’s the last person in her class who is without one.

As far as I can tell, the 13 year old age limit has very little to do with kids’ readiness to be on social media. Nobody consulted with a child psychologist or child development expert to come up with this magic number. Instead, it has more to do with big media companies not being allowed to collect data on little kids. One of the reasons social media apps remain free is because they’re collecting data on us all the time, so that they can target advertisements to us. I guess that, somehow, it’s deemed okay to do this once a child turns 13.

What does this mean for parents? I think we should all be taking this age guideline with a grain of salt, because it’s a little bit arbitrary. Depending on their maturity level, some kids may be ready for social media at 13. Many others may need to hold off until they are older, or have a lot of parental supervision to make sure they stay safe. Personally, I would not feel comfortable with any child age 13 or under having an unsupervised social media account of any kind.

How Social Media Hurts Kids’ Mental Health

Have you seen The Social Dilemma yet? If not, go watch it and come back…I’ll wait. It does a much better job than I could possibly do of explaining how social media puts children at risk of developing anxiety and depression. Imagine your 13-year-old past self for a moment. Think about how important your friends’ approval was to you. Remember how awful it felt when someone made a snarky comment about you? Multiply that by ten, one hundred, even a thousand, and that’s what tweens and teens are exposed to on social media.

Our brains were not designed to deal with social acceptance or rejection on such a large scale. Getting “likes” activates the pleasure centers of the brain and can become addictive. Kids on social media aren’t just comparing themselves to other students at school, but to professionally styled, heavily filtered influencers on TikTok and Instagram. This can really do a number on a child’s self-esteem. Research shows that depression, anxiety, and suicidal thoughts are all more common among teens who frequently use social media.

The Safety Risks of Social Media for Children

We have all heard horror stories about internet predators at this point. Fear-mongering news stories aside, it’s absolutely true that there are people out there who try to victimize kids online. Even if you’re in a “child-friendly” corner of the internet, or talking to someone who appears to be a fellow teen, you never really know who you’re dealing with.

Even though most kids are very aware of “stranger danger”, predators know what to say and do to earn trust. This is called “grooming”, and it lowers a child’s defenses and makes them more vulnerable to being financially or sexually exploited. Because being online feels so anonymous, it’s really easy to accidentally overshare personal information. Younger children tend to be impulsive, and they have a hard time considering the long-term consequences of their decisions. This can (incorrectly) make it feel less dangerous to send photos through apps like Snapchat, where they’re seemingly only available for a short period of time.

Are There Any Benefits to Social Media For Kids? (Actually, Yes)

Okay, so this all sounds pretty grim. Even though it’s super common, it’s undeniably risky for kids’ mental health and safety to have unrestricted social media access. But here I am, the children’s therapist, writing this blog post with Instagram pulled up on my phone and Facebook in the next tab on my browser. You may be surprised to learn that I think social media—when used in moderation—can be beneficial to kids’ mental health.

Social Media Is a Child-Friendly Creative Outlet

Social media can be an amazing creative outlet for kids. Many of my child clients primarily use social media to share fanfiction and fan art that they’ve created based on their favorite TV shows. Aspiring makeup artists, photographers, and fashion designers can also find an outlet for their passion online. I could write a whole blog post on the possible mental health benefits of this kind of creative expression. It’s meaningful, positive social interaction that helps kids build real-life skills. Especially during times when kids are stuck at home, positive and creative experiences like these can reduce their risk of depression.

Social Media Encourages Diversity

I also think social media can open a child’s eyes to a bigger, more diverse world. If you live in an area where everybody looks the same, this is an opportunity to provide racial windows for your child that give her a peek into another culture or way of life. Did you know there’s a big Indigenous and Native American community on TikTok performing dances and teaching about their culture? I didn’t until this year, and now I love watching their content.

I also think social media is a godsend for anyone living with a disability or chronic illness. A child who lives with a medical condition may be the only person at their school with that diagnosis. However, social media can connect him to tons of other people who get exactly what he’s going through. It can be a source of moral support, positive role models, and even advice. Being different can be isolating, and social media can make a child feel less alone.

Need More Help? Try These Resources for Tweens and Teens

It’s tough to figure out how to navigate the internet when you have young children. Unless you are planning to move off the grid, internet access is a necessary evil for today’s kids. My age-by-age guide to internet safety can help you figure out what activities are appropriate for kids from preschool through late elementary school.

If you have older children, my guide on internet and phone safety for preteens and teens may help. It talks about the specific risks older kids face online. You’ll also find advice to consider if you’re deciding whether your tween is ready for their own phone.

As you may have gleaned from this post, I’m a children’s counselor in Davidson, North Carolina. I especially love working with preteens who are dealing with anxiety and trauma symptoms. I’m able to work with families in North Carolina, New York, and Florida thanks to online counseling. If you’re in one of those states and would like to learn more about starting therapy, you can reach out to me here.

5 Books on Transracial Adoption for White Parents of Black Children

If you’re a parent considering transracial adoption, you’re probably experiencing a whirlwind of emotions. On one hand, there’s the joy of growing your family—possibly after struggling with infertility or other setbacks. Expecting a child is hopeful and exciting! On the other hand, you may be feeling sorrow for your child’s first family and anxiety about how to effectively parent a child of another race. How can you help your child navigate a racist world? How can you teach your child about a culture that isn’t yours?

One benefit of adoption is that adoptive parents often have a lot of time to prepare for parenthood. It can be a long wait! If you’re waiting to meet your child, you can use that time to read up on the subject of transracial adoption. Today, I’ll be sharing 5 books that I’ve personally read and enjoyed as I learn more about adopting a baby of another race.

Who is This Book Recommendation List For?

This list focuses on books for white parents adopting Black infants or children. Most of the adoptions described are domestic infant adoptions, although a few books touch upon international or older child adoption. Although most books are geared toward adoptive parents, grandparents, relatives, and interested friends will find something of value in them, too.

I’ll share the pros and cons of each book (from my perspective) as well as who might benefit from giving it a try. I’ll also present these books in the order that I wish I’d read them—if you’re interested in learning more about transracial adoption, you can start with my first recommendation and move your way down the list.

#1. So You Want to Talk About Race, by Ijeoma Oluo

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Although not an adoption book, this is a great start for any white person wanting to learn the stuff about race and racism that wasn’t covered in school. Ijeoma Oluo, a Nigerian-American author, talks about her experiences as a Black woman in a way that sounds almost as casual as a friend talking over coffee. Each chapter of the book is devoted to exploring a different issue, such as white privilege, cultural appropriation, or affirmative action.

The Pros: I wish this book were taught in schools. It’s a great introduction to concepts that might feel overwhelming or intimidating to talk about. Whereas other books about race and racism can feel very dry and academic, this one is easy to read. Oluo shares personal stories that bring the concepts to life, and there’s a lot of humor despite the heavy subject matter. One big takeaway of this book is to expect to make mistakes: trying to speak up and putting your foot in your mouth is better than never speaking up at all.

The Cons: If you have already done some work learning about race and racism, this book may be too introductory for you. I was hoping for a little more depth. Most of the discussions of race focus on interactions between white and Black people, which may not be as helpful if you’re wanting to learn about the experiences of other races. I would also have loved some more actionable advice on how to start conversations with my family, friends, and acquaintances.

#2. In Their Own Voices: Transracial Adoptees Tell Their Stories, by Rita J. Simon and Rhonda M. Roorda

If you are a hopeful adoptive parent, start here. This isn’t so much a book as it is a collection of interviews with adult transracial adoptees. If you don’t know adoptees in your personal life, it can be hard to find these kinds of first-hand experiences, which makes the book really valuable. The young adults interviewed for the book were also part of a study on what it’s like for kids to grow up with a family of a different race. The results of that study are shared and unpacked in the book. The book includes an even number of male and female interviewees, all of whom are Black or biracial and grew up with white parents.

The Pros: There are a lot of transracial adoption books out there, but most of them are written by white adoptive moms. It’s harder to find books that share other perspectives. Rhonda Roorda is a transracial adoptee herself. She writes not just as a researcher but as someone who personally knows what it’s like to grow up as a Black child in a white family. The adoptees she interviews come from all different types of families, so their experiences are different and interesting to read.

The Cons: This is not the most reader-friendly book. It has an academic writing style that makes it feel like a book you’d be assigned in a college class. The interviews were all conducted in the mid-90s, and the book hasn’t been updated since. The book shows its age in some places: all the adoptees were in closed adoptions, which is no longer the norm, and there’s a lot of ‘90s slang. I’d love to see a follow-up with more modern adoption stories!

#3. Dim Sum, Bagels, and Grits: A Sourcebook for Multicultural Families, by Myra Alperson

This is a good book for adoptive parents, but I think it might be an even better fit for grandparents or other family members who may not be doing as much research as a new mom or dad. Myra Alperson is a white, single mom to a daughter adopted from China. She shares stories from her own family’s experience trying to blend multiple cultures under one roof, and brings in quotes from other families, as well. There’s a lot of direct advice about how to honor a child’s birth culture in your day-to-day life.

The Pros: This is a quick and easy read, which is one reason why I think it’s a great option for non-parents who are curious about someone else’s adoption. I really enjoyed the passages from other adoptive families and adult adoptees. It was helpful to learn that adoptees may have different levels of interest in their birth culture throughout their lives, and that’s ok! There’s no need to force a child into cultural activities just because that’s what adoptive parents “should” do.

The Cons: Because the author adopted her daughter from China, this book isn’t quite as relevant for white families adopting Black children in the U.S. This book could also really benefit from an updated second edition. There are some really impressive, very detailed resource lists at the back for stores, websites, and book series that look amazing—but many of them no longer exist.

#4. Secret Thoughts of an Adoptive Mother, by Jana Wolff

As you can guess by the title, this is a memoir that offers a peek into the private thoughts of a transracial adoptive mom. I think this is most helpful for people considering transracial adoption and wondering what the emotional experience will be like for them. Very close friends or relatives might also enjoy it. Jana Wolff is the mother of a biracial son, and details her adoption process from infertility through her son’s early childhood. She also touches on some of the discoveries she made about subtle racism after her son was born.

The Pros: This book does a good job of covering the full range of emotions a person might feel when considering adoption: both the good and the not-so-good. If you’ve had any worries about bonding with your baby or any other aspect of adoption, you’ll probably feel validated by this story. It’s a quick read—I finished it in an afternoon. Moms may find this book especially helpful, because Wolff talks about the pressure society puts on women to get pregnant.

The Cons: I’ve seen some controversial reviews of this book online. Some people feel that Wolff is too cynical or harsh in the way she describes her adoption experience. I’ve even seen a few concerns that her son might read this someday, and feel uncomfortable with his mom’s less positive thoughts. Ultimately, this is one person’s very personal and individual story. You might see parts of yourself in it, but you probably won’t connect with the whole thing.

#5. In Their Voices: Black Americans on Transracial Adoption, by Rhonda M. Roorda

This is another book by Rhonda Roorda with a very similar title to book #2 on this list, so don’t get them confused! In this later book, Roorda interviews Black Americans who are somehow involved with or touched by transracial adoption. They aren’t adoptees, but they may be lawyers, social workers, teachers, or the adoptive parents or siblings of a Black child who was adopted by white parents. The interviews are organized based on age, and gives a lot of context for what was happening in Civil Rights as these interviewees grew up. Because it’s more in-depth, I’d recommend it for parents as opposed to other family.

The Pros: This might be the most informative book on this list. It manages to teach about racism, give perspective on the positives and negatives of adoption, and provide concrete “to-dos” for adoptive parents all in one book. Even though Roorda doesn’t shy away from the hard parts of adoption, she’s advocating for you, too. The final chapter of the book includes specific tips to connect your child to his or her culture, plus a list of further reading. Honestly, that last chapter is worth buying the book all by itself!

The Cons: Like the other books in this series, In Their Voices is very dry and a slow read. It’s written like an academic textbook, and not the kind of book you’ll breeze through in one sitting. Because this book isn’t from the perspective of an adoptee or a parent, it might feel a little less relevant if you’re just starting off in your adoption journey. But come back to it later—it’s worth it!

Mental Health Resources for Kids and Parents

No matter how your children join your family, sometimes kids need emotional support. There’s some research to suggest that adopted kids are more at risk for certain kinds of mental health struggles. If your child is dealing with anxiety or trauma symptoms, counseling can help both of you to navigate your child’s big feelings with less stress.

I’m a children’s therapist who works with children and tweens in the states of North Carolina, New York, and Florida. If you’re close to Davidson, North Carolina, you can stop by my office for a face-to-face session. Otherwise, I’m available for online therapy using a video conferencing platform.

Have any questions? Did you read one of the books on this list? I’d love to hear your thoughts. You can always reach out to me here, either to schedule an appointment or let me know what’s on your mind.

5 Things I've Learned From Playing DnD With Middle Schoolers

If you’d told me in 2019 that I’d spend 2020 hosting Dungeons & Dragons groups for middle schoolers, I would have been…very surprised, to say the least. But 2020 was a weird year! As the pandemic and quarantine moved our social lives online, my therapy practice moved online, too. Online D&D groups are a big part of my life now—and, honestly, a highlight of my week.

When I first moved to North Carolina from New York, I joined a “DnD” group on a whim as a way to make friends. I learned that DnD is perfect for this: it’s an easy, low-stress way to socialize, especially if you are someone who doesn’t love small talk. There’s enough structure to the game that you aren’t left staring at someone, wondering what to say next. It’s creative, a little goofy, and sometimes surprisingly heartfelt. Because you are playing as a character, it’s hard to feel like you’re making a fool of yourself: any mistakes are the character’s fault, not yours.

When quarantine started, I realized that so many of the tweens I knew could use a structured, creative outlet like DnD to help them feel connected while social distancing. It’s been so fun to watch kids who have never played before take to the game easily, and use it as a way to support each other through a tough time.

Playing DnD with middle schoolers has taught me a lot about the game, the value of online friendships, and it’s even debunked some myths about middle school. Here’s what I’ve learned after 6 months of DnD with tweens.

“Mean Girls” Are a Myth

I have to admit that as a tween therapist I have perpetuated the myth of the “Mean Girl” many times. I grew up with the movie, and I remember how miserable 6th grade was for many of us. You couldn’t pay me to go back to 6th grade! While it’s true that middle school friendships can be filled with drama, there’s nothing inherently “mean” about girls this age. In fact, middle school girls really want to support each other.

It can be hard to be kind and supportive 100% of the time in a stressful school environment, where everyone is competing with each other and you’re worried about grabbing a spot at the “good” lunch table. In our groups, though, players know they are working toward a common goal: they’re here to make friends, and they take that responsibility seriously.

Far from “mean girls”, tween girls are some of the most welcoming and inclusive people I know. We’ve had girls from all walks of life join these groups, and their differences have not just been accepted, but celebrated. When they are set up for success, middle schoolers are an accepting bunch. Adults could learn a thing or two from watching them play.

Having Fun is Good Therapy

It’s easy to get hung up on the serious side of therapy—making sure you are working in a way that’s effective, and backed by solid research. I can geek out on this stuff all day: I love approaches like Cognitive-Behavioral Therapy that use scientifically proven techniques to help kids cope with anxiety and trauma.

Creativity, joy, and fun are as important for our mental health as any coping skill. In fact, it’s pretty hard to do any kind of therapy with kids if it’s not fun. Children learn through play. We can talk about social skills until I’m blue in the face, but talking will never be as effective for learning as playing is.

For kids who are struggling with depression, fun may be just what the doctor ordered. Depression is caused not just by the presence of bad things in life, but an absence of good things. We all need opportunities to learn new skills, flex our creative muscles, and just plain enjoy life. We call these opportunities “positively reinforcing activities” in therapy, because they leave us with a sense of accomplishment or fulfillment.

In quarantine, kids are getting fewer positively reinforcing activities than they should. DnD is an opportunity to be playful, make a terrible pun or inside joke reference, and generally act like a goofball for 90 minutes with a circle of friends. That’s good therapy in and of itself.

“Online” Doesn’t Have to Mean “Impersonal”

I worried a little about getting girls together across multiple states for these groups. They’d never met in person: heck, I had not met a lot of them in person. How would the group gel, having only met online? I think adults from my generation (elder millennials) and up still think of online hangouts as being more distant and removed from the real thing.

Gen Z doesn’t have the same feelings about online friendships. They’re digital natives; video chatting is just a part of daily life. It was a little humbling the first time a tween girl taught me something about how to use the Zoom platform, but I’ve embraced it now. Having structure to follow and a clear reason for meeting together online helps the sessions feel very personal and “real”.

…In Fact, It Can Help Anxious Kids Connect

Online school has been a dream come true for some of my tween clients with social anxiety. At last, they can learn without feeling like all eyes are on them! While I want my anxious clients to learn how to face their fears and handle face-to-face school with confidence, online hangouts are a great way to practice socializing with less fear.

Meeting online means we can gradually ease anxious kids into socializing without feeling put on the spot. Not ready to turn your camera on? That’s okay, this isn’t school. Nervous about talking on mic because your voice is shaky? No problem, lean on the chat function until you’re feeling more comfortable. While I always want players participating as fully as possible, tech gives us an option to turn down the intensity while new players build up confidence.

You’re Not Alone (Even If It Feels Like You Are)

At least once a week, a tween client tells me through tears that they feel totally alone. Nobody likes the stuff they do, nobody listens to their music or watches their favorite anime. Everybody has already found their clique, and nobody’s looking for new friends. It’s terrible to feel like you’re missing out, and even worse to feel like you’re the only person who is so isolated.

If these groups have taught me anything, it’s that you’re never alone. There’s somebody out there who is passionate about the same things you are. Somewhere, somebody is staring at their phone, too, wishing it would light up. In fact, there are probably multiple somebodies, and they’re probably closer to you than you think. Kids who attend the same schools or who live in the same towns have “discovered” each other through DnD groups, never knowing they had so much in common.

This has to be true for adults, too, right? Online groups mean that we can all find the people who like the same weird, goofy stuff we do—even something as weird and goofy as DnD.

Interested In DnD For Your Tween?

I’ve got you covered! As I write this, we’re about to embark on a new group adventure, and we have additional 6-week sessions starting periodically. We have groups available specifically for middle school girls, as well as groups that are open to all genders. Games are currently open to kids in New York, North Carolina, and Florida.

You can learn more about the groups I currently offer, fees, and other FAQs on my Dungeons & Dragons Therapy page. If you’d like to chat more or ask about enrolling your child, email me here.

Looking for something a little different? Consider joining us at Young Dragonslayers, which uses D&D for fun and friendship-building rather than counseling. These games are not facilitated by therapists, and are open to kids in all 50 states.