How to tell if your child needs therapy and find the right support | Canada Voices

Ask a Child Psychologist offers insights and advice on navigating youth emotional and mental well–being. It is not a substitute for professional psychological or medical advice.

I often meet families at a point of exhaustion. A parent will sit across from me and say, “This isn’t my child,” describing escalating bedtime meltdowns, refusal to go to school or sudden aggression toward siblings. The child, meanwhile, may enter the therapy room quietly, avoiding eye contact, or move quickly to the toys and begin building with blocks or colouring with intensity. Within minutes, themes often emerge – a trapped figure in a block structure, a destructive storm drawn across the page.

The parent sees behaviour; I see communication. Beneath the defiance or withdrawal is usually a child who feels overwhelmed and lacks the language to explain it.

What I see in those clinical sessions is not an isolated story. Recent data suggest that mental health challenges among children and youth in Canada are increasing. Early identification and intervention are essential to prevent concerns from becoming more entrenched or complex. When we respond during critical windows of their development, we help shape the architecture of a child’s developing brain in ways that support adaptive capacity and healthy growth. The ripple effects extend well beyond the individual child and family – strengthening communities as a whole.

Help, the teen years are coming! Four ways to lessen conflict in adolescence

If you are wondering whether your child may benefit from therapy – and what that might look like – here are some things to know.

Signs your child may be struggling

Mental health challenges in young children often show up in how they behave. Because kids are still developing the language and emotional insight needed to describe internal experiences, behaviour becomes their primary form of communication. When something feels overwhelming or unsafe, they may express it through observable changes in their actions rather than with words.

These changes may include regression – such as no longer being able to sleep through the night – as well as externalizing behaviours including dysregulation (big emotional outbursts or tantrums that may include intense crying), aggression or defiance. Other times the changes may be quieter, with withdrawal, reduced interest in play, increased irritability or physical complaints such as headaches or stomach aches. Both patterns can signal that a child is struggling.

Context, frequency, intensity and duration matter. Short-term shifts after stress or transition are common and often resolved with reassurance and support. However, when changes persist, occur across settings, increase in intensity or interfere with daily functioning, additional support may be helpful.

If a parent begins to feel out of their depth, or if previously effective strategies are no longer working, consulting a mental health professional can be an appropriate next step.

Looking for a therapist? Here’s a guide to getting started

How child therapy works

One of the first questions families often ask me is: What will therapy actually look like for my child?

Unlike adults, children do not typically sit across from a therapist and talk through their thoughts and feelings in a linear way. Therapeutic work with children is intentionally adapted to meet them at their developmental level.

Rather than relying primarily on conversation, children express themselves through the mediums that feel most natural to them – play, creativity and story. Common approaches to child therapy recognize this fact and invite children to externalize their internal world in ways that feel safe, manageable and developmentally appropriate.

Play therapy

Play therapy is a developmentally grounded approach in which play becomes the child’s primary language. For children, play helps process emotions, communicate experiences and make meaning of events or feelings. Through symbolic themes that emerge while playing, children often express feelings they cannot yet articulate directly. Within the safety of the therapeutic relationship, these themes can be gently supported and understood by the therapist.

Play also allows children to rehearse solutions, master fears and restore a sense of agency – supporting emotional regulation and increasing tolerance for difficult emotions.

Art therapy

Art therapy uses creative expression – drawing, painting, sculpture or collage – as a pathway to emotional understanding. For some children, it is easier to show a feeling with crayons or clay than to name it.

The creative process helps children externalize and organize complex emotions in a tangible way. The focus is not on artistic skill, but on meaning. Through image and symbol, children can explore their experiences at a safe distance, building insight and emotional awareness. For example, a child who feels powerless at school might draw a tiny figure standing in front of a towering storm cloud; a kid who feels left out or misunderstood might build a structure where one character is trapped inside while others stand outside.

The therapist’s role is to notice these patterns and invite reflection – perhaps by wondering aloud about the storm or asking what the trapped character might need – helping the child put words to feelings that were previously difficult to express.

Bibliotherapy

Bibliotherapy involves the intentional use of stories – including carefully selected books and individualized stories developed specifically for the child to help them understand social situations and possible responses – to support emotional growth and coping skills. Stories normalize experience, expand emotional vocabulary and model how to navigate challenges in ways that feel accessible and non-threatening.

In my own clinical work, I have often turned to stories as a bridge between insight and experience. In fact, my children’s books grew directly out of therapeutic need – I found myself writing the stories I wished I had on my shelf as a psychologist. Stories can introduce difficult topics, give language to complex emotions and open conversations that might otherwise feel too heavy or abstract.

Choosing the right support

Regardless of the approach you want to explore, it is important to ensure that the therapist you choose for your child is licensed (or appropriately registered) in your jurisdiction and has the training and experience necessary to work effectively with children.

Children are inherently resilient and with the right support, can strengthen their capacity to navigate challenges, deepen their emotional awareness, and return to a developmental pathway that feels steady, connected and hopeful for both the child and the family.

Dr. Jillian Roberts is a research professor of educational psychology at the University of Victoria. She is also a practising registered psychologist in British Columbia, Alberta, Yukon and the Northwest Territories. She specializes in child and adolescent development, family therapy and inclusive education.