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Episode Two: Does my Child Need Therapy?
81 Plays1 year ago
Mental health treatment for children is on the rise. Now more than ever, kids struggle with strong emotions and undiagnosed issues.
Dr. Caroline Danda, a clinical child psychologist with over 20 years of experience specializing in childhood anxiety, depression, ADHD, and behavioral issues, discusses the signs to look out for if your child needs therapy. Listen to learn how you can best support your child's mental health.
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Transcript
Podcast Introduction
00:00:07
Speaker
Welcome to the Guardians of Hope podcast, where we bring together parents, nonprofits, and legal experts dedicated to positively impacting children's lives. I'm Cynthia, your host.
00:00:19
Speaker
Before we begin, it's important to note this content should not be used as legal advice. The purpose of this podcast is to inform and unite. So please seek advice from your attorney or your therapist to address specific needs. The thoughts and opinions of my guests are not necessarily my own. This is a platform for sharing.
Meet Dr. Caroline Danda
00:00:40
Speaker
I'd like to welcome my guest, Dr. Caroline Danda. Dr. Danda is a licensed clinical psychologist specializing in cognitive behavioral therapy for children and adolescents. She serves the greater Kansas City and Johnson County areas. Welcome, Dr. Danda. Thank you so much for joining me today. Thank you for having me. I'm excited and look forward to diving into our topics today.
00:01:08
Speaker
Awesome.
Why is Children's Mental Health a Growing Concern?
00:01:09
Speaker
So Dr. Danda is here to discuss a relevant and very timely topic so many parents I know are navigating, and that's whether or not their child needs therapy. According to new data from the Centers for Disease Control and Prevention, nearly 15% of children received mental health treatment in 2021, and these are American children.
00:01:33
Speaker
The stats show that 5.8 American children have anxiety and about 2.7 million battle depression. Let's dig into this, Dr. Danda. What are some of the biggest factors contributing to the rise in children's mental health treatment over the last few years?
00:01:52
Speaker
There's really two reasons, and we can dig into each one of them separately, but the first reason is there's actually increased anxiety and depression and ADHD, particularly since the pandemic. There was a rise in those mental health issues prior to the pandemic, but the pandemic certainly exacerbated what was already there.
00:02:12
Speaker
And the second part would be is the Surgeon General even did an advisory on the youth mental health crisis and the crisis of loneliness in 2023 more recently. And it's brought much more attention to the challenges of youth mental health, which has also then decreased the stigma of seeking mental health. In thinking more about that, I would also add that
00:02:41
Speaker
It's still a challenge for many to receive treatment. One of the questions usually I get when people call me is, are you taking patients? Are you accepting new appointments? One in three youth are still not receiving treatment for therapy. So I think that it may have been increased, but it can still be a little bit of a challenge to that.
00:03:05
Speaker
One of the other things that has helped with access though to mental health has been the increase in use of telehealth services where some communities may not have access or have practical considerations like transportation, dealing with work schedules and being able to obtain therapy. Telemedicine has made it easier to be able to do that. It's very interesting that
00:03:32
Speaker
Many of the teens and kids that I know and in the communities that one of the things that's also given rise to increased therapy is actually kids and teens are actually so much more comfortable talking about their emotions and talking about their feelings.
Children's Emotional Openness vs. Coping Skills
00:03:49
Speaker
And that's a fantastic thing that they're much more aware
00:03:53
Speaker
The second part is that a lot of adults are not necessarily aware of what to do with some of those feelings, and neither are the kids. So we're better at identifying talking through feelings, but we're still working on how do we manage the emotions that we have? How do we navigate our struggles? And how do we develop effective coping skills to help us navigate challenging situations? Essentially, how are we gonna develop resilience?
00:04:20
Speaker
Now, this is something that I talk to you a lot about fellow parents. How do I even know
When to Seek Therapy for Children
00:04:27
Speaker
where to begin? How do I even know my child needs therapy or not? What should I look for? When we're thinking about anxiety, depression, behavior problems, emotions, really what we're looking at is a continuum. We all have some of those challenges to some degree.
00:04:45
Speaker
And so the concepts that I consider are frequency, intensity and duration as primary things. So for example, if you are somebody who's worrying and it's happening very often or it's getting to the point where the anxiety is just there and it's very intense reactions and it's lasting longer than what we might expect.
00:05:11
Speaker
For example, we might generally have some anxiety about going into a new situation, which is a good thing. We need to be aware. We need to be thinking about those things. But when that anxiety becomes too intense or is happening too often and even then creating impairment, that's the last characteristic we want to think about. If it's creating impairment and now kids maybe aren't going to the things that they actually enjoy doing their activities or there might not be going with friends, they might be having trouble going to school.
00:05:40
Speaker
So we're looking at frequency, intensity, duration, and then just how much impairment there is. And when I look at impairment, sometimes we'll say, well, this person's really functioning pretty well on the surface, but sometimes there's a level of distress internally that also is part of what I would consider impairment or how much it may be disrupting family relationships or social relationships.
00:06:06
Speaker
Typically, we're going to see some disruption in their functioning across settings in terms of school, home, social, and even on their selves. Like a lot of times we might look at maybe ADHD and
00:06:21
Speaker
Sometimes when it's undiagnosed, kids may become very sad and start to develop low self-esteem because they feel like they can't keep up or they can't do the things they need to be doing or they're getting in trouble a lot because they're not able to manage their behavior effectively.
00:06:38
Speaker
because of the ADHD. So when we see things tanking in terms of their self-esteem and the effect it's having on other things is when we want to think about trying to obtain therapy. Right.
Common Diagnoses and Early Intervention
00:06:53
Speaker
And you touched upon some of the diagnoses like ADHD, anxiety, but what are some of the most common diagnoses in children now? And another question to add on to that, what do I do if my child is diagnosed?
00:07:09
Speaker
So anxiety, depression, and ADHD would be the most common problems that we see. In younger kids, I would say that there's a lot of big emotions, just meaning that sometimes they're having a lot of difficulty regulating their emotions, and sometimes they're
00:07:28
Speaker
reactions or tantrums, again, maybe more frequent, intense, and last longer than what we might expect. And at those young ages, sometimes it can be hard to tease apart what exactly, whether it's a full disorder and meet criteria, say, for anxiety, depression, or
00:07:45
Speaker
say ADHD or even autism or other things. Sometimes it can be difficult to completely tease that apart, but it can still be worth addressing because it's creating impairment and having that early intervention is important. And typically the diagnosis is going to occur after you seek treatment. And so if you do have a diagnosis, the most important thing is that
00:08:07
Speaker
you continue to seek out therapy and you can consult with your pediatrician or family physician about whether medication may be the right tool to use as well. What I really think about a lot of mental health issues are ongoing, just like something like asthma. So sometimes when there's more of an urgent need, we can get in and we can figure out, well, what is going on? What can we do about it? But kids are always growing and changing.
00:08:36
Speaker
And so they may need to come back in over time because circumstances change both physically, emotionally, environmentally, things change. And so sometimes just like an asthma, maybe we have a spike or something like that. Exactly. So, you know, at what age or how early is too early for a child to be assessed?
00:09:00
Speaker
If you're concerned, I think you ask the question. When in doubt, ask the question. Usually you can start with your pediatrician or family physician or even your school counselor or even your preschool. So they can sometimes help you understand developmentally.
00:09:17
Speaker
Where is this child? Because part of what happens too is that sometimes, for example, tantrums are normal in two to three-year-olds. But if they're happening at four, five, six, seven, eight, and beyond what we might expect, then all of a sudden it becomes more problematic.
00:09:33
Speaker
or separation anxiety is more normal and like a two-year-old. And even sometimes it is a five-year-old when they're starting kindergarten, but if it starts to progress or it becomes more intense, then we're going to want to go ahead and seek some treatment. Even if it's not a full diagnosis or they meet full criteria, there may be still worthy of attention so that we can monitor and do some early intervention.
00:09:59
Speaker
Okay.
Family and School's Role in Therapy
00:10:00
Speaker
So what are some of the things that parents should keep in mind when seeking help for their children, maybe whether it's insurance or virtual visits versus in-person or anything else, you know, that you might have to offer to a parent?
00:10:17
Speaker
One of the things that's important, kind of also going back to the question you just asked about how early is too early, I think thinking about young kids, chances are parents are going to be highly involved in that. And because kids don't live in a bubble. So I'm a firm believer in having a lot of collaboration.
00:10:36
Speaker
between working with the kids, working with the parents. For example, a lot of times I will have kids and parents both in the room so they can all learn some of the same information about what's going on with their emotions, what our emotions mean, why we might use some different coping strategies. So getting everybody on the same page is really important as well as maybe contacting the school and coordinating with the school if the school is having some issues.
00:11:02
Speaker
So, that's one thing to be aware of is that it's not necessarily, oh, I'm going to drop my kid off and then they're going to lay on the couch and talk about things. You know, it really should involve both the child and the parents. And in that way too, it helps the child not feel like there's something necessarily wrong with them and you're collaborating together because they both realize there's something that's not going well. Because kids usually know if something's not going well.
00:11:31
Speaker
Yes, absolutely. And so I usually will just call it out. A lot of parents have questions too about how do I even approach talking to my kids about therapy? And I usually go with the approach of be matter of fact about it. You know how sometimes you get really upset and it's hard for you to calm down. I know you don't like to feel that way.
00:11:52
Speaker
And I don't like that you feel that way. And I know somebody that's actually got a really good ideas for dealing with emotions and helping both of us figure out what to do. Because I don't have all the answers either, which is also great modeling as a parent to be like, I don't have all the answers. So we can go get some extra help and somebody can give us some tips about how to work on our emotions. And so we just kind of call it out for what it is. It's not really good or bad. You're just making a statement of this is what we're observing.
00:12:26
Speaker
Back to your question about, you know, well, how do I even begin to find someone to see? Because there is a somewhat shortage of providers in mental health right now. And so sometimes it can be hard to find someone where you can get in at a reasonable time. And that's, we're still working on that as a field of trying to increase the availability and increase the access to that.
00:12:47
Speaker
and we're all in it together.
00:12:53
Speaker
The best place to start usually is with your pediatrician, your family physician, the school or school counselor, the mental health center. And even sometimes if you're in an urgent, you know, you have urgent concerns, even calling 988, the National Suicide and Crisis Prevention Text Line, sometimes they can get you to some resources from what's out there.
00:13:16
Speaker
The other option would be to look at, your insurance panel may recommend some people to you and you can look and see what is on your insurance and contact them. And that is also helpful if you're wanting to make sure to use your insurance for mental health treatment. And word of mouth is always great too.
00:13:37
Speaker
is if you know somebody and you know, like, well, their kids maybe have done some things or similar or just talking about it a little bit, it reduces the stigma and make sure you're not alone as well. Because even though a lot of parents think it's only my kid, well, it's happening a lot out there, even though we don't always talk about it. So the more we can talk about it, the more we can support each other, but you also might be able to get ideas of who would be a good fit.
00:14:07
Speaker
Right.
Virtual vs. In-Person Therapy for Teens
00:14:09
Speaker
And just narrowing in on virtual versus in-person, I imagine it might be hard to build a relationship with a child via virtual or Zoom meetings. What are your thoughts on that and helping, you know, anyone get access and making it as seamless as possible for a child to build that relationship?
00:14:31
Speaker
In an ideal world, I would love to have all kids, especially younger ones, be seen in person because I think it is easier to have that relationship. And with younger kids, you're going to employ a little bit more of kind of play-based type of therapy. Even if it's not play therapy per se, you're going to incorporate elements of play in things that are childlike.
00:14:52
Speaker
to explain concepts and to talk about strategies and to process emotions and other things. And it seems like it's easier in person than it is on telehealth. That being said, it's not always feasible or practical.
00:15:07
Speaker
to do that. And also, if there is going to be the telehealth, you're going to need to have somebody who's a trusted or safe parent or caregiver or adult that will also be able to maybe facilitate that Zoom meeting. So that's another important aspect is you may not be able to just turn on the Zoom and then have the kids stay there. And again, it depends on what the presenting issues are as well.
00:15:32
Speaker
So if you can, I think it's best if you can do in person, but I know it's not a perfect world, especially if you don't have access. Maybe you're in a rural area, maybe you're in an urban area, and maybe you don't have access to be able to get somewhere to see somebody. So something is better than nothing. And honestly, there are probably some providers that are actually really good at doing some of the in-person and engaging kids online. And so I think that's a good question parents can ask of how do you handle that situation when they're online?
00:16:01
Speaker
The other thing in my practice, I do a lot of virtual visits with parents only. That seems to be a little bit easier than working with the kids because again, kids don't live in isolation, they don't live in a bubble. So I do a lot of parenting work and we'll do that over video and that seems to be more workable for them.
00:16:22
Speaker
and more connected to them. Occasionally though, the video visits are actually better because some particularly maybe teenagers may feel more uncomfortable actually in person. So sometimes being the telehealth and the televideo can actually provide easier access for people that are uncomfortable because it kind of removes a little bit of that feeling they might have in that real one-on-one situation.
00:16:50
Speaker
Exactly. I totally understand what you're saying there. Yeah. So just to put you on the spot, final questions, comments.
Understanding Mental Health as a Chronic Condition
00:16:59
Speaker
There's a lot of stigma around mental health. And I know that a lot of parents wonder if something's wrong with their child because they need therapy. How do we relieve some of the stigma and make this more of a positive experience for everyone looking for treatment?
00:17:19
Speaker
Well, I would look at it the same way we might look at, say, for example, asthma or diabetes, we don't typically be like, well, what did you do to give your kid asthma, right? Now, that being said, if your kid is diagnosed with asthma, that means you might need to do some extra vacuuming and doing some extra behavioral things to kind of
00:17:39
Speaker
address that so that if like for example dust is something that exacerbates it then there are things that you can do for it so i think by and large kids bring their own personalities and their own brain wiring to the table so to speak and then parents are.
00:17:59
Speaker
as much as we would like to feel like oh well i can just parent each kid separately i've got three kids and i can tell you and i and all of my practice like your parenting each kid differently based on what they bring to the table so some of it is really just the kids wiring and i would say a lot of what i do sometimes is just helping parents
00:18:19
Speaker
parent in a way that meets their child. So a lot of times the parents aren't doing anything quote unquote wrong, but it may not necessarily be a good fit for kind of what the child is bringing to the table. I get this a lot with perfectionistic kids too. They're like, where do they get it? We don't really try to put a lot of pressure on them. And it's very true. A lot of times they will put their own pressure on themselves. Right. And I will also say the world is a lot today.
00:18:49
Speaker
It really is a lot today. And I think it's important that we take that into account between the pandemic and all of the unrest in the world and racism and you know, climate change, you know, kids are
00:19:05
Speaker
have so much more access to that information and are so much more aware, which, you know, sometimes that can be positive, but it's also sometimes too much too fast too soon. And so I think understanding that our environment really also has an impact, even outside of the family.
00:19:24
Speaker
Exactly. Dr. Danda, thank you so much. You provided so much helpful information for parents just getting started or even on their journey. So I appreciate you helping us today. Thank you. Fantastic. It was my pleasure.
Dr. Danda's Resources and Services
00:19:40
Speaker
Dr. Danda has training and experience with various issues related to children's and adolescents' emotional, behavioral, and physical health.
00:19:48
Speaker
She provides assessment therapy and parent coaching. Learn more about her services and her book From Surviving to Vibing on CarolineDanda.com. Thank you.