If you are dealing with behavior that never seems to improve, you’re in the right place.

As parents of strong-willed kids, there can be a possibility that your child is dealing with an abnormality in their functioning.  They could have inherited or developed anxiety, ADHD, depression, or autism, just to name a few.  A professional’s help is needed to get a clear diagnosis.

We often get asked: “How do I know if I need to seek professional help for my child? Where do I go if I do think they need professional help?”

We seek to answer both those questions and more in today’s episode.


Mike Fitch, CMHC


What Kind of Counselor Should I Be Looking For

It can be overwhelming because there’s a lot of different kinds of mental health professionals. There’s clinical mental health counselors, licensed marriage family therapists, licensed clinical social workers, and even family physicians. So Mike is going to talk us through where we would go next if we think that there’s something additional going on with our child.

**We strongly recommend seeing a physician first.  A child who feels poorly may behave poorly.  Talk to your physician about doing blood work to check for food allergies, nutrient deficiencies, thyroid function, etc.**

It is common to get confused and not sure where to go. So I first want to clear those little acronyms behind all of our names.

Master’s Degree Level of Licensure

  • LMFT (Licensed Marriage Family Therapist)- therapists who special in doing family therapy or doing couples therapy.
  • CMHC (Clinical Mental Health Counselor)- These therapists usually specialize in one area.  However, CMHC does not indicate to you what type of therapy.  CMHCs can specialize anywhere from early childhood to geriatrics. So you may have to seek out a little bit more information.
  • LCSW (Licensed Clinical Social Worker)- These are individuals that originally got their degree to do social work within a hospital or to do case work. Back in the early seventies because there was a lack of availability for psychiatrists and psychologists. Therefore, LCSW were allowed to start doing individual therapy as well.

All the people with the master’s level degree typically do what’s called talk therapy. They don’t do a whole lot of psychological assessments and cannot prescribe medications.

PhD Degree Level of Licensure

If you want your child to have a full psychological assessment, you have to go up to the PhD level. They can do what’s called a psychological assessment or neuro psycho neuro assessment. Normally it takes a full day to a couple of days to do that. I typically send people to psychologist when they’re having extreme problems. Most of the time you do not want to start off with a psychologist. If you’re going to start off from the counseling setting, you probably want to start off with one of the masters levels. They’re more accessible and less expensive typically. Usually parents just need some tools and some coaching.

Who Would Benefit From a Master’s Degree Level Counselor

If you feel your child might have OCD, ADHD, ODD or autism this would be a good place to start. If the counselor feels like it’s a little bit out of their comfort zone, they could refer you on to the PHD level.

Your First Visit With a Counselor

On the first visit, I usually see just the parents. Typically, the parents don’t even have a diagnosis in mind.  I like to talk to them about what the parent is worried about.  Honestly, they usually say, “My child is not listening, my child’s not doing well in school. My child is afraid or my child won’t go to sleep. Something’s off.”

After that first appointment, I’m do some assessments myself. If I do decide that it does look like autism, we would refer them to a PhD level of licensure.  The Master’s level of licensure is not allowed to diagnose autism.  However, after they’ve done the diagnosis, they typically send them back to me.

Can’t I Just Have My Pediatrician Prescribe Something?

It used to be that most pediatricians would just go ahead and give you medication for your child. However, now it’s more common that a doctor will not do that until they actually receive some sort of an assessment. The physician wants to make sure you child really does have a diagnosis.

This is important because if you give a child with anxiety ADHD medication for example, that can actually make the anxiety worse.

What If I’m Looking for a Counselor Who Specializes in a Specific Diagnosis?

Option #1: If you do go to your pediatrician to begin with, the pediatricians may have a good referral for you. For example, there are a number of doctors around here who refer children to me who are on the autistic spectrum or need social skills or struggle with anxiety.  They’ll refer them directly to me because they know that’s what I specialize in.

Option #2: There’s a website that I participate in is called Psychology Today. It’s a nationwide website and basically you can log on to that website, put in your zip code and it’ll give you a list of providers in your area. You can then go to their individual profiles and look to see what they specialize in.

Option #3:  You can call up the secretaries for places that have many counsellors, tell them what your needs are, then they can make a recommendation.

Option #4: Call your insurance company yourself, if you are a part of an insurance company. They can often tell you who specializes in what.  The only downfall is they’re just looking at a list of names. Whereas sometimes if you even just call your pediatrician, they’re going to give you a name that they trust or have heard good things about.

How to Pick a Good Counselor

  1. Check the google reviews for specific counselors.  See what people are saying before you even call.
  2. Do a phone consult or meet with a therapist first to find out if you feel like they’re a good fit for you.  Ask them what their credentials are.  Tell them about your situation and ask if they feel they’d be the best fit or if they’d recommend you to someone else. Also ask what kind of tools they use or more about their approach.
  3. If you start doing counseling and you don’t feel like it’s a good fit, don’t be afraid to change! There’s been times where a client has come in and I just didn’t feel the connection myself. I will then refer them to somebody that I trust.
  4. If you’re child’s counsellor never asks to meet with you and/or never gives YOU specific tools to use, change counsellors.  A counsellor should be talking with the parents, teach the parents, and getting feedback from the parents.**Teenagers are a little bit more difficult because teenagers do want their space.I tell parents all the time that if a teenager thinks I’m a spy for them, they’re not going to tell me . But you still should be involved every once in a while.**

What if I Can’t Find a Good Option In My Area

I have a handful of clients that have moved far enough that we’ll just do a Skype session instead. A lot more therapists are willing to do skype sessions.  Also, a lot more insurance companies are giving permission for that to happen.

How Many Sessions Should I Expect?

It’s tricky to say because there are a lot of variables.  I have some clients that if they come in with just some light issues, we can usually do a handful of sessions and we’re done. However, if there’s or specific phobias or trauma involved, it’s probably going to be longer. It depends on the degree of the trauma and the resiliency of the child. But I’ve had some clients that I’ve seen for a couple years and we’re still working. We’re still seeing progress but some issues take longer than others.

That being said, you should start to see a difference in four or five sessions.  If you’re not seeing any changes in your child at all within that time, then I think it’s really important to meet with your therapist to let them know.

At that point, you can make the choice to allow the therapist to make some modifications or to change therapists.  You are the parent and you get to choose.

What Therapists Want Parents to Know

  1. Therapists are limited in what they know.  Parents need to be transparent about what is going on.  Be open about what is working or what isn’t working at home. Feedback from the family is good and helpful because it lets us know if we need to tweak anything. I love it when parents send me a little email, saying what they happen that week (positive and negative).
  2. Also, parents need to REALLY try to use the tools their therapists suggest.  A good therapist isn’t just making things up.  Rather, they are sharing what research has proven to be effective.  But therapists can only TEACH the tools.  Parents and kids are responsible for implementing the tools.It’s hard for me when a parent is upset that their child’s behavior isn’t changing then I find out that the parent hasn’t done what I’ve asked.  Therapist’s can only do so much.  So be open-minded to what your therapist teaches and use what they teach consistently.
  3. Therapists have to be really careful honoring their client’s autonomy.  They also have to work hard to keep both the parents trust and the child’s trust.  If parents “team up” against their child with a therapist, the child will shut down.  It the child thinks the therapist is telling his parents everything from a session, the child will shut down again.  Talk with your therapist to decide the best way to share information with each other.
  4. Don’t feel embarrassed about seeking out professional help.  It’s always better to bring your child in and find out they really don’t need therapy than to not bring your child in at all. Children who receive treatment early on are typically better off when they become teenagers and when they’re adults.

For those of you who are interested in contacting Mike or the group of counsellors he works with, go to their website here.

I hope that gets you started and…

Happy Parenting!


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