When and how to get help

Getting professional help doesn't mean admitting failure or confirming that something serious is going on. It means bringing in someone to look at things alongside you. Many visits end with some brief guidance, and that is a good outcome too.

When

You don't need to be certain. Three questions can help you decide:

1. 1How long has it been going on? Something that has lasted for weeks and isn't easing up carries more weight than one bad day.
2. 2How much is it changing their life? Look at sleep, eating, school, friends and their interest in doing things.
3. 3How much are they suffering, or how much is everyone at home suffering? Suffering is reason enough, even if everything else is working.

And a fourth one, about you: if you've been turning this question over for a while, that is already a reason to talk to a professional.

If there is risk (talk of hurting themselves, violence, alcohol poisoning or an overdose, barely eating), this is not the time to wait for a regular appointment. Go to Crisis help.

Who to see

How to find someone

• Ask your health insurance plan, a community health center or your local hospital.
• Ask the pediatrician or the school for a recommendation.
• Many university training clinics and organizations offer low-cost care.
• Look for someone with experience working with teens: it's not the same as working with adults.
• Check that they are licensed to practice.
• If there is a waitlist, get on it anyway and ask what to do in the meantime.

The first appointment

It may start with the adults, with your teen or with everyone together, depending on the professional and your teen's age. They will ask what worries you, how long it has been going on and what everyday life is like. You don't need to prepare anything. It helps to bring two or three specific examples written down.

• The first sessions are for getting to know each other and understanding what is going on. There isn't always an answer in the first one.
• You can ask how they work, how often they will see your teen and how they will stay in touch with you.
• A diagnosis, if there is one, usually takes more than one session. If you are given one at the first appointment, ask what it is based on.
• If after a few sessions your teen doesn't feel comfortable, you can talk about it and, if needed, switch to a different professional. It doesn't mean starting from scratch.

What's said there stays there

For this to work, your teen needs to know that what they say doesn't make it back home. The professional will tell you how things are going, without the details. There is one exception, and it's best that you both know about it from the start: if their life or someone else's is at risk, or if someone is harming them, the professional has to act and let others know.

If your teen doesn't want to go

This is what happens most often. To them, seeing a therapist can sound like "there's something wrong with me," or like a punishment.

1. 1Pick a calm moment, not the middle of a fight.
2. 2Talk about your worry, not about what they are doing wrong.
3. 3Present it as a trial: "Let's go three times and then we'll talk about it."
4. 4Give them a say in the decision: let them weigh in on the professional and on the schedule.
5. 5If they still don't want to go, get help yourself. Parent guidance changes things at home, and sometimes it opens the door later.

"I don't think you're broken. I can see you're having a hard time, and I don't want you to carry it alone. I'd like you to talk to someone who knows about this. I'll go with you."

If there is risk, the decision is not in your teen's hands: getting help is the adults' decision.

While you wait for the appointment

• Keep routines going as much as possible: sleep, meals, school.
• Put off the fights that can wait.
• Tell your teen that you've asked for help, and when the appointment is.
• Look at the signs to get help right away in the topic you're worried about.

If you can't afford it

Mental health care shouldn't depend on money, and often it does. Ask at public or community health clinics, at the school, at university psychology training clinics and at organizations in your community. Some initial guidance from the pediatrician or family doctor counts too.

For you

Asking for help for your child stirs up things of your own: guilt, fear of what you might be told, the feeling of not having been enough. None of that makes you a worse mother or a worse father. Getting help is also a way of caring.