Parents & Caregivers

As the person who cares for your child, you usually know your child better than anyone else. As your child develops and grows, they may have problems from time to time. If your child is acting unusual or seems to have a lot of distress for a long period of time (lasting 2+ weeks), it may be time to seek help. Other times include when your child is showing highly unusual behavior that is causing them or others harm. A good question to ask is, “Are my child’s problems getting in the way of their day-to-day functioning?” Also ask yourself, “Is my child having problems with eating, sleeping, concentrating, or doing their usual tasks such as social activities, school and family relationships?”

It is normal for all children to have times when they feel sad, angry, frustrated, shy or anxious – especially when facing new situations. But when your child is often distressed, cannot be soothed or comforted, is having worsening problems, or is having trouble with normal functioning at school or home, it is a good idea not to worry alone. Just like your child’s physical health, there are times when you may need professional help. Any time you are feeling overly concerned, have questions, or think that your child needs help or support, it is probably time to reach out to a qualified professional. Help is available and recovery and healing is possible!

It is sometimes hard to know whom to turn to when your child or teen has mental health concerns. If your child is currently experiencing a mental health crisis, you can call 211 (in Connecticut) or 988 (nationwide) to reach trained crisis counselors or access free mobile crisis services. You can also visit one of CT’s 4 urgent crisis centers for children and youth.

Otherwise, a good place to start is your child’s doctor or pediatrician. Talk to your child’s doctor about your worries and they can help you understand whether these concerns are a normal part of your child’s growth or whether they may need additional help. Some pediatricians can treat mental and behavioral health issues – especially common ones like ADHD, anxiety, and depression – while others may send you to a specialist. Your pediatrician is trained to understand child development and know what is typical for any given age or phase of development; however, they may not have specific expertise in treating mental health issues. Either way, your pediatrician can help assess the level of concern and then help refer you to a mental health specialist. Your pediatrician’s office should also be made aware of other types of help or treatment your child may be getting – just like when you see any other type of specialist for your child.

Many areas also have community mental health centers or child guidance clinics that provide support to children and offer a wide range of mental health services to children and families. To find a provider in Connecticut, you can call 211. Some parents choose to get help from a mental health professional or therapist in their area that is part of their health insurance network. A list of providers can be found by asking your health insurance carrier, or, if the child is a HUSKY member, through the CT Behavioral Health Partnership.

Other places to turn for help include your school counselor, trusted teacher, or clergy. These people can often help you find the support you need. However, in some cases, families may find that no one seems to have the answers, or that others seem to reduce their concerns. Remember that you can always call a mental health professional directly if you have concerns or would like a meeting. It is sometimes hard to know who to call and where to start. However, most communities have qualified mental health professionals who specialize in treating children.

If your child is experiencing a crisis, you should get help right away.

If there is an immediate danger, call 911.

If your child is experiencing a mental health crisis or is at risk of hurting themself or others, get crisis help:

In Connecticut, CALL 988 or 211 MOBILE CRISIS: You can call 211 (press 1 for crisis, and 1 for youth) to access Connecticut’s youth Mobile Crisis Intervention Services, which provides FREE, rapid, face-to-face crisis response for children and their families from trained counselors 24 hours a day, 7 days a week, 365 days a year. Youth mobile crisis clinicians will come to your location (home, school, etc.) in an average of less then 45 minutes.

As an alternative to visiting an emergency room, you can also bring your child to one of Connecticut’s four Urgent Crisis Centers for Youth, which are located around the state and are specifically designed for children and youth with behavioral health needs. Walk-ins welcome.

From Anywhere, CALL/TEXT/CHAT THE 988 SUICIDE & CRISIS LIFELINE: Call 988, or text 741741, for free, confidential, 24/7/365 support from the National Suicide and Crisis Lifeline. You can also Chat online at www.988lifeline.org.

Finding a mental health professional is like finding any other qualified professional to help your child. Places to start your search include:

• The 211 Infoline (in CT, dial 2-1-1)
• Your child’s doctor/pediatrician
• Ask trusted friends, teachers, school counselors, and/or clergy
• Search Google for “child therapist near me,” “child guidance clinic near me,” or similar terms to research and contact providers in your area
• Online therapist directories, such as PsychologyToday.com
• Your health insurance company / provider
• Connecticut Evidence-Based Practice Directory

If you have private insurance, you may need to choose a provider in your network. Your insurance company may have a list of providers to choose from. Families may also choose out-of-network providers or those who do not accept insurance (“private pay”), but will likely have to pay more for the service. HUSKY families can get services anywhere that accepts your plan. Families who do not have health insurance can often get services from public agencies or clinics. Referrals to mental health providers are usually not required, but check with your insurance carrier.

There are many things you should look for when choosing a therapist and questions you can ask to help choose the right fit. You might have to speak to several therapists before you find one that is a good match. You and your child should feel at ease with the therapist (although sometimes it takes a few sessions before children become engaged or build enough trust to open up). Whichever therapist you choose, ensure that they have experience working with children as well as experience in treating the main issue(s) your child is experiencing.

The Department of Children and Families has a program called Voluntary Services that provide mental health services for children in the state of CT.  The Connecticut Behavioral Health Partnership, adminstered by Carelon, offers a directory of providers. You can also search for providers trained in several specific evidence-based practices by searching the Connecticut Evidence-Based Practices Directory.

Contacting a family advocacy group, such as FAVOR or the Connecticut Family Support Network (in Connecticut), is also good way of getting support in your community, especially if you experience any barriers on your search or would find it helpful to talk with other parents going through the same experience.

There are many types of professionals that provide mental health services to children. When choosing a therapist, it is best to seek the services of a licensed mental health professional or accredited clinic or agency. Licensed professionals must complete ongoing continuing education and adhere to certain professional standards in order to maintain licensure. Ideally, you should seek services from someone who has specific training or experience in working with children. Children have their own special needs and should be treated differently than adults.

Psychiatrists are medical doctors (MDs) who have all gone to medical school and completed residency training and fellowships to specialize in psychiatry. Psychiatrists must pass a state licensing exam. Child psychiatrists have completed more specialized training (usually in the form of a fellowship) in working with children. Psychiatrists can provide evaluation, diagnosis, psychotherapy and also can prescribe and monitor medication. The ability to conduct medical evaluations and prescribe medication are two important differences that set psychiatrists apart from most other mental health professionals. Because there are not many child psychiatrists in CT or throughout the United States, they often work as part of a team or are asked to be involved when there are more serious psychiatric concerns or a need for medication. At times, your pediatrician or an APRN can also prescribe medication to treat common mental health challenges. To learn more about psychiatrists, you can visit the American Psychiatric Association website.

Psychologists are doctoral-level, trained behavioral health specialists that have expertise in providing services (psychotherapy), conducting assessments (including psychological testing), evaluation, diagnosis and research. Psychologists have completed doctoral degrees in psychology (Ph.D. or Psy.D.) and performed years of supervised training in providing psychotherapy and assessment. Psychologists must pass a state licensing exam. As part of their training, psychologists complete two years of pre-doctoral and post-doctoral training in clinical psychology. Child psychologists focus that training on working with children and families. Psychologists do not prescribe medication, but often have advanced training in assessment and behavioral treatment for children and families. To learn more about psychologists, you can visit the American Psychological Association website.

Clinical Social Workers (LCSWs or LMSWs in CT) are social workers with a specialty practice area focused on the assessment, diagnosis, treatment, and prevention of mental illness, emotional, and other behavioral disturbances. Individual, group and family therapy are common treatment modalities, and many social workers specialize in working with children and families. Clinical social workers working as therapists have earned master’s degrees or higher, completed additional clinical training with supervision, passed a state licensure exam, and must complete continuing education to maintain licensure. Clinical social workers can perform services in a variety of settings including private practices, hospitals, community mental health clinics, primary care, and agencies. To learn more, see the National Association of Social Workers website.

Licensed Marriage and Family Therapists (LMFTs) are clinicians that have master’s degrees and specific training working with families, couples, and/or children. LMFTs approach their work by looking at family systems and how they work. Often, LMFTs do two years of graduate education and can become licensed after two years of a supervised internship and ongoing professional development. To learn more visit the American Association for Marriage and Family Therapy.

Licensed Mental Health Counselors or Licensed Professional Counselors (LPCs) are  counselors who hold master’s degrees (or higher) in counseling or a related field and have completed at least two years of post-graduate supervised clinical training in working with adults, families or children. They must also pass a state or national licensure or certification exam. As with all other mental health professionals, it is important to choose a mental health counselor who has specific training and/or experience working with children and families. To learn more, visit the American Counseling Association website.

Advanced Practice Registered Nurses (APRN) – APRNs are registered nurses with a post-graduate level degree (typically a master’s) and advanced clinical education, knowledge, skills, and scope of practice. APRNs work closely with patients to achieve optimal outcomes through critical analysis, problem solving and evidence-based decision-making. Psychiatric APRNs or Psychiatric Nurse Practitioners have specialized education and training in psychiatric/mental health nursing. In addition to the basic nursing functions performed by Registered Nurses (RNs), APRNs are also qualified to assess, diagnose, and treat individuals or families with psychiatric/mental health problems and can prescribe medication. APRNs can also earn doctoral degrees (PhD, DNSc, and EdD). To learn more, visit the American Psychiatric Nurses Association website.

Therapists/Para-Professionals – In many health settings, Bachelor’s degree-level professionals also provide services to children and families, usually under the supervision of a licensed professional. Typically these services include intake, screening, referrals, case management, and other services that do not require specialized/advanced clinical training or licensure.

Non-degree and Indigenous Support Providers – In some cases, parents, advocates and other concerned adults can provide services and supports to children and families based on their needs. In many cases, these people have a special talent or skill such as speaking a specific language, coaching, group work, or mentoring. It is important that they are supervised by a licensed mental health professional or an established agency or provider who works with children and families.

Other Supports – It is important to note that many children and families benefit from services and supports other than traditional providers. Often, these services are provided with other forms of services. Research has established that many children benefit from after-school activities, athletics, and community-based and faith-based activities. When pursuing any form of mental health support for your child, it is smart to at minimum do a quick Google search of the organization, program, or treatment model to get a sense of their reputation and reviews, and ask around your community to learn about others’ experiences.

The most important question to ask a therapist is if they have training or experience working with children, especially with children who have some of the same problems or concerns that your child is facing. It is also important that the therapist makes efforts to stay current and knowledgeable about best practices in child mental health. You should also ask about billing, insurance, cancellation policies, and other logistical issues up front to avoid surprises later.

You should feel comfortable talking to your child’s therapist and not be afraid to ask questions. This is your child’s health, and no question is wrong. You should have an active role in your child’s treatment from the very start.  Get more tips on working with your child’s therapist in this article from the Child Mind Institute.

The mental health field has come a long way in knowing which treatments work best for some issues and concerns, but there are often not easy answers. If your child has an ear infection, a course of antibiotics may be prescribed to target the problem. If your child has a mental health concern, the answer might be less clear, but a well-trained mental health professional can work with you on a treatment plan that best meets your child’s needs and includes evidence-based or best practices if possible.

The first place to start in identifying the right treatment is by having a thorough evaluation. During the evaluation, the clinician will collect history about your child and family, his or her symptoms, events leading up to the distress, school performance, relationships and other issues. It often takes many sessions to collect the right information to do a comprehensive evaluation. During this time the clinician may also ask you or your child to take some simple screening tests and other assessments to better understand the nature of your child’s concerns. Some providers use certain screening and assessment measures with all patients to make sure that they get the best treatment and no hidden concerns are missed. Using objective measures is a recommended practice.

Read more about evidence-based and best practices here. To find providers of certain evidence-based treatments for children and youth in Connecticut, search the CT Evidence-Based Practice Directory.

To learn more about specific mental health conditions and their treatment, please visit the AACAP parent website.

Testing is a generic term that can be used in different places and often means that a professional, such as a teacher, pediatrician, counselor or special education consultant wants to learn more about your child. Testing can show a child’s strengths and weaknesses, and it can help diagnose a child, based on their symptoms. It can give us information about their intelligence and academics as well as behaviors that are a problem.

Screening is when several brief tests and/or instruments are used to identify children who may be at risk for certain mental health issues. For example, children in the juvenile justice system in Connecticut are screened for mental health issues to determine the types of services/supports they might need.

Assessment is a more comprehensive process that uses a series of different tests or instruments to help create a picture of your child. Assessment may look at specific areas such as your child’s educational needs, or your child’s psychological functioning. Assessments are often done by child psychologists, either individually or part of a team. Results of assessments can be used to determine the best level of care, the right services and help point to the needs of your child.

Evaluation is the most comprehensive. It may include screening testing and assessment as well as clinical interviews of you, your child, service providers and other adults in your child’s life. Evaluations often include gathering your child’s history and background and to know all the things that contribute to your child’s mental health issues. Often, a team of mental health professionals including psychiatrists, psychologists, social workers and other educational and mental health professionals will conduct evaluations. Results of an evaluation may be used by court systems, schools, state agencies and treatment providers to help find out the best services for your child. Family members should be an active part of an evaluation.

There are many types of treatment for children who have mental health issues:

• Individual outpatient treatment is where your child will see a counselor one or more times weekly (in an office setting or remotely) to help them with their difficulties. For younger children, it is helpful to have the child’s parent or caregiver involved in the treatment, and meeting in-person is often preferred due to challenges engaging younger kids in remote/video-based treatment.
• Outpatient services can also be provided to groups (often peer groups) and families.
• In-home services, such as IICAPS, are also available for treating certain conditions.
• A growing number of schools offer school-based treatment and support for individuals and groups during or immediately following the school day.
• Support for children and youth experiencing mental health crises is available across Connecticut. Mobile Crisis teams (call 211, 24/7!) and 4 Urgent Crisis Centers for Children provide specialized alternatives to calling 911 or visiting emergency rooms to de-escalate and stabilize immediate crises and connect them to treatment options.
• More intensive treatment options include partial hospitalization, inpatient hospitalization and residential treatment. Typically children and youth are referred to these levels of care from their outpatient provider/therapist, pediatrician, emergency room or urgent crisis center, or other provider, but you may also contact them directly as needed.

There are many specific treatment models for different behavioral health conditions and challenges. Evidence-based treatments and practices are those that have been shown to help children with certain conditions improve symptoms or recover more than “usual care.” You can learn about some of these evidence-based treatments here.

Some parents choose faith-based support, recreational activities, indigenous, native or local healers, or nutritional plans to help with their child’s mental health concerns. Before beginning your child on any alternative treatment plan, parents must find out whether these treatments have worked for children with similar conditions in the past and if they are safe. It is important to know that the service provider you choose has a good track record of working with children and can demonstrate successful outcomes. At a minimum, it is a good idea to do a Google search on the organization, provider, and/or treatment model you are considering. You can also ask your child’s pediatrician or around your community to learn about others’ experiences with the alternative provider or treatment.

NOTE: In Connecticut and many other states, so-called “conversion therapy,” which are typically faith-based programs that attempt to change a person’s sexual orientation or gender identity, were outlawed in 2017. According to GLAD, extensive research has shown this practice to be both ineffective and harmful to LGBTQ+ youth, and it is opposed by numerous state and national medical, mental health, and child welfare organizations. Learn about how to effectively support LGBTQ+ youth in this article from Child Mind Institute. You may also want to review these parent resources from PFLAG.

Depending on the type of condition, how serious and how long your child has had the symptoms, your pediatrician or child psychiatrist may prescribe medication for your child. Often, medication is prescribed with some type of behavioral treatment. However, in an increasing number of cases, especially in the treatment of Attention Deficit Hyperactivity Disorder (ADHD), some providers may only prescribe medication. For some conditions, including ADHD, parent training may also be recommended.

Parents and caregivers are often worried when they first learn that their child might be prescribed medication. But in most cases, parents find that medication is a helpful tool in relieving their child’s symptoms. Parents should closely monitor their child when taking medications and report any concerns about side effects, changes in mood or personality to the prescribing physician.

Typically, no. Giving your child any medication is always a concern to take seriously, but psychotropic medications (drugs used to treat mental health conditions), usually do not change your child’s personality but can significantly lessen their psychiatric or behavioral symptoms. For example, children who have depression, anxiety, and/or ADHD may get relief from these symptoms when taking certain medications. Parents should closely monitor their child when taking medications and report any concerns about side effects, changes in mood or personality to the prescribing physician.

Side effects differ with each medication. Common side effects include symptoms such as drowsiness and changes in appetite. Many side effects are mild and temporary, and will subside as your child’s body adjusts to the medication. It is best to ask your doctor and/or the pharmacist about the possible side effects for any medications your child is taking and to let them know about all other supplements or medications your child is taking to avoid drug interactions.

Medications that have been approved for use for children must go through an intense review by the Federal Food & Drug Administration (FDA). All medications have risks, so it is important to discuss these with your prescribing physician and/or pharmacist. Overall, psychiatric medications prescribed for children, when used properly, are usually safe.

However, any medication can be dangerous if not taken correctly, if combined with certain other substances or medications, or under certain other circumstances. It is important to ask a qualified physician, pharmacist or nurse practitioner about the medication’s safety and potential drug or food interactions. Ensure your provider is aware of all other supplements and medications your child is taking as well as any allergies or past reactions to other medications.

Medications differ in price from very affordable to very expensive. Most common psychiatric medications are covered by insurance plans and HUSKY/Medicaid, although co-pays can vary widely.

If your family receives HUSKY/Medicaid coverage in CT, ask the Behavioral Health Partnership (BHP) if the medicine is covered, and if not, what the estimated cost of the prescribed medication will be to you and your family.

For those with private health insurance, it is best to ask your insurance company about your estimated costs. You, your doctor or pharmacist may be able to appeal an insurance company’s denial of coverage for certain medications. They may also be able to recommend generic or more affordable alternatives. For name-brand medications that do not have generic versions, you can also try visiting the drug manufacturer’s website for the medication to see if discount coupons are available.

If you do not have health insurance, you may want to see if you (or your child) qualify for HUSKY/Medicaid, ask your doctor or pharmacist about your options, or visit Access Health CT, the state health insurance exchange, to see available health plans and tax credits. Enrolling in the GoodRx program can also help you find lower prices on prescription medications.

It depends on your child’s diagnosis and symptoms. Some conditions will require only a temporary course of medication, while others may benefit from long-term medication (if tolerated well). The prescribing clinician should assess your child on an ongoing basis to see if medications are still needed and assess the current dosage. If your child is taking a combination of psychiatric medications, it is especially important that your doctor assess the child on a regular basis.

It is common for parents to blame themselves for their children’s mental health challenges. But it’s important to know that children’s mental health is influenced by many different factors, including biological (genetic), environmental, family, societal, and individual factors. Blaming yourself for your child’s issues will not help you or your child, but taking an active role in getting them appropriate treatment and support will!

Some disorders are biologically linked, and children are more likely to have certain problems if close family members have them. If a parent has a psychiatric issue, it does increase the risk for the child to have similar difficulties. However, there are no known psychiatric disorders that are 100% hereditary. If a child’s parent has a certain mental health concern, it does not mean the child will suffer from the same difficulty, and even two people with the same diagnosis may experience different symptoms or severity. Finding professional support for yourself and your child when needed is the best way to help prevent or reduce the severity of mental health challenges.

All children and youth can experience mental health concerns, and sometimes these issues show themselves in different ways based on gender. The way in which mental health issues develop depend on many things, but gender can play a role.

Mainly because boys and girls are typically socialized in different ways, boys are more likely to show outward signs of anger, aggression, and “acting out” behaviors. Girls, on the other hand, are more likely to hold in these feelings and this can lead to more “internalized” problems, such as depression or anxiety. However, newer research has shown that the differences in the way in which girls and boys experience mental health issues is getting smaller.

Some agencies and providers offer gender-sensitive counseling and services designed for the needs of girls or boys. There are also some providers and agencies who specialize in working with transgender youth. As a parent or caregiver, you know your child best and can help point to the issues and concerns that will be most important when finding the right help.

It is common for people to worry about what others think and have concerns about the stigma or shame of mental health challenges. But stigma can sometimes get in the way of enabling your child to get the treatment he/she needs.

Different cultures have different views about mental health issues and concerns, and some cultures are less open to talking about them. However, in our society it is becoming more accepted to talk about mental health concerns. Parents often say that a safe place to talk about their issues is with other parents who have some of the same concerns or experiences.

Mental health issues should be treated like any other health concern that your child might have. However, remember that laws can protect you and your child’s privacy, and private information cannot be shared without your consent.

Like any other health problem your child may face, many mental and behavioral health issues will resolve with time and the right treatment. It is important to get treatment for your child when problems first happen to help prevent them from getting more serious. Some disorders can last a lifetime, but many children will respond well to treatment and can still improve symptoms and functioning with time and support.

Your child’s behavior or performance at school may or may not be affected by his/her mental health condition. It can be helpful to talk with your child’s school counselor or social worker to inform them of your child’s diagnosis and treatment plan so they can provide support at school. If needed, school health staff can also assist the child in managing medication during the school day. In some cases, school-based mental health services can be very helpful.

For more serious mental health concerns, or for developmental disorders such as autism or ADHD, your child may benefit from an Individualized Education Plan (IEP) that details the services, supports, and accommodations your child will be provided in school. It is important to work closely with your school to make sure your child is observed and tested so that he/she can get the right support and services if needed.

For minor mental health concerns, some parents choose not to share the information with the school and are not required to share it, as this information is considered confidential.

Learn more about mental health and school and accessing special education services and accommodations here.

Parents and caregivers often say that talking to other parents is one of the most useful forms of support. Connecticut has many family advocacy and peer support centers where trained parents can assist you and link you to services and resources. Click here to view an updated list of Family Advocacy and Support resources in the Connect4Families Toolkit on our sister site. You can also consult CT’s Community Collaboratives, which can link you to other resources.

Sometimes, parents may need their own mental health treatment and support. If you are struggling, getting support is one of the best things you can do for yourself AND your children! You can search for a therapist through your primary care physician, local community mental health center, insurance provider, or by searching PsychologyToday.com or Google for providers in your area.

It is important for parents to be honest and use words your children can understand. A good place to start is by asking your child to talk about what is worrying them or bothering them. It is important to create a safe place where your child can talk with you in the open about their issues. Some parents find that a certain time or place is best for talking to your child.

It is important to use words that your child can understand and answer their questions in a simple way so that you do not burden them with unnecessary information. Try to listen as much as you speak. Explain to your child that because of the concerns they have been having, you are going to talk to someone who can help.

Later, as your child continues getting help, it is important to keep talking with and listening to your child so that they can share their ideas or concerns. If you are having problems talking to your child, developing a better relationship and open communication can be one of the goals of treatment. A family therapist may also be able to help.

If you talk to your child’s brothers and sisters, use words that are right for their age and that they can understand. Be careful not to burden your other children with too much information, but respect their questions and concerns.

In some cases, siblings or other family members may be asked to take part in some of your child’s treatment. If the treatment is home-based or involves new skills in the home, it will be helpful if the family understands and supports your child. However, it is vital to help your child feel safe and protect their privacy even within the family setting.

In recent decades, we have learned a great deal about which services work best for children who have mental health issues. Services that have been found to work very well for children and have research supporting them are called “evidence-based practices” or “evidence-based treatments.” These evidence-based practices have been proven to work in the real world with children who have real issues and concerns.

“Best” and “promising” practices are services that we believe to be the best available services for children, but have not yet had enough rigorous research to back them up (demonstrating that they work) to be called evidence-based practices.

It is important to note that evidence-based practices have not been identified for all mental health issues that children face. Providers should involve parents and caregivers in developing a treatment plan for your child with clear goals where results can be measured over time.

In Connecticut, evidence-based practices are only available in some places, depending upon your child’s issues and concerns. Many community-based providers offer these services for children with mental health issues and you can ask your mental health professional about them when you contact them for help.

To find an evidence-based treatment provider in Connecticut, search the EBP directory here.