When should your child see a psychologist? 8 signs it's time (and what to expect at the first session)

Every child has hard weeks, and most children get through them without needing a children's psychologist. They get cranky when they are tired, anxious before a big event and upset when a friendship goes wrong. Most of the time, these moments pass with a bit of patience and a good night's sleep. Sometimes, though, a parent starts to notice that something has been going on for longer than it should, or that the usual ways of helping are not working anymore.

Deciding when to see a psychologist can be one of the harder parts of parenting. Many parents tell us they waited months before calling because they were not sure their child's difficulties were "serious enough". Children's psychologists see plenty of families whose concerns are mild, and you do not need to wait for a crisis before asking for support. This guide covers eight signs that it may help to speak with a child psychologist, and what the first appointment looks like, so the first step feels less daunting.

Is it a phase or something more?

Three questions can help you sort a passing phase from something that needs more support:

• How long has it been going on? A few days of worry before a school camp is expected. Several weeks of worry that shows no sign of easing deserves a closer look.

• How intense is it? Meltdowns that are bigger, longer or more frequent than other children the same age may point to something underneath.

• How much is it affecting daily life? When a difficulty starts to get in the way of school, friendships, sleep, eating or family life, it is a good time to ask for help.

  
  

You know your child better than anyone. If your gut is telling you something has changed, that instinct is a good reason to check in with a professional.

8 signs your child may benefit from seeing a psychologist

Every child is different, and any one of these signs on its own may mean very little. What matters most is a pattern that lasts, or a change from how your child usually is.

1. Worry or fear that is getting in the way

Anxiety is one of the most common reasons families contact us. It can show up as constant "what if" questions, avoiding situations, trouble separating from you, or tummy aches and headaches with no medical cause. Our guide to anxiety in children describes the different types and what to look for.

2. A change in mood that lasts for weeks

Sadness, irritability or flatness that sticks around, a loss of interest in things your child used to enjoy, or a teenager who is spending most of their time alone in their room can all be signs of low mood. Our post on supporting your teenager's mental health goes into this in more detail.

3. Big emotions that are hard to manage

All children have meltdowns. When outbursts are frequent, very intense, or leave your child and the rest of the family exhausted, a psychologist can help your child learn to recognise and manage their feelings. Our post on helping children manage big emotions has strategies you can try at home in the meantime.

4. Difficulties at school

A child who refuses to go to school, has a sudden drop in marks, or whose teacher raises concerns about behaviour or attention may need more support. Learning difficulties can also affect a child's confidence and mood. If school is the sticking point, our guide to school refusal is a helpful place to start.

5. Trouble with friendships

Some children find it hard to make or keep friends, often feel left out, or struggle to read social situations. A psychologist can help build social skills and confidence. Some children also enjoy learning these skills in a group setting, such as our Minecraft and LEGO® groups. A psychologist can also explore challenging social dynamics, such as bullying, and help a young person develop skills and confidence to manage these situations.

6. Changes in sleep or appetite

Ongoing trouble falling asleep, frequent nightmares, or noticeable changes in how much your child is eating can be linked to stress, anxiety or low mood. It is best to see your GP first to rule out a medical cause.

7. A difficult or stressful event

Family separation, a death in the family, a move, a frightening experience or bullying can all affect a child. Some children adjust over time with the support of family. Others may find it harder to cope, and talking with a psychologist can help them make sense of what happened.

8. Questions about attention, learning or development

If you have noticed signs that your child might have ADHD, autism or a learning difficulty, a psychological assessment can help you understand your child's strengths and challenges. We offer ADHD assessments, autism assessments and cognitive and educational assessments, each with a written report and recommendations for home and school.

When to seek help straight away

Some situations need urgent support rather than a waitlist. If your child talks about wanting to die or hurting themselves, has hurt themselves, or you are worried about their immediate safety, please seek help straight away. You can contact your GP, call Kids Helpline on 1800 55 1800, call the NSW Mental Health Line on 1800 011 511, or call 000 in an emergency.

What age can a child see a psychologist?

There is no minimum age. Psychologists work with preschoolers, primary school children and teenagers. With younger children, sessions often involve more play and more direct work with parents, because parents are usually the ones who help new skills stick at home. Teenagers usually spend more of the session one-on-one with the psychologist, with parents involved in a way that respects their growing independence.

What happens at the first session?

Many parents feel nervous before the first appointment, and children often do too. Knowing what to expect can help.

At Sydney Children's Practice, the initial consultation is 50 minutes. For children 12 and under, the initial appointment is generally held with parents/caregivers only. The psychologist will ask about what has been happening, your child's development, health, schooling, friendships and family life, and what you would most like to change. For children over 12, the initial appointment includes the young person and parents/caregivers. Depending on your child's age, some of this time may be spent with parents on their own and some with your child.

By the end of the first session or the next few, the psychologist will talk with you about their understanding of your child and suggest a plan. Ongoing sessions are usually 50 minutes, and how often and how many your child needs depends on their situation. Where it helps, we can also work with your child's school, GP, paediatrician or other allied health professionals such as occupational therapists and speech therapists.

How to prepare your child

Keep it simple and honest. For younger children, you might say they are going to meet someone whose job is to help kids with worries or big feelings, and that they might talk, draw or play. For teenagers, it helps to involve them in the decision where you can and explain that what they say is private, within safety limits. It is also a good idea to bring any school reports or previous assessment reports to the first appointment.

What does it cost, and can I claim Medicare?

You do not need a referral to book an appointment with a psychologist. If you would like to claim Medicare rebates, your child will need a Mental Health Care Plan and referral from a GP. Rebates can be processed at the practice from the first visit when you bring the referral. Some private health funds also cover part of the cost of psychology sessions, depending on your level of cover. Our reception team will let you know fees for the initial consultation and ongoing sessions when you enquire.

If you are unsure whether a psychologist is the right professional for your child, our post comparing a child psychologist, psychiatrist and paediatrician explains the differences.

Frequently asked questions

How do I know if my child needs a psychologist? 

Look at how long a difficulty has lasted, how intense it is, and how much it is affecting school, friendships, sleep and family life. If a concern has lasted several weeks and is getting in the way of daily life, it may help to speak with a child psychologist.

Is a child counsellor the same as a child psychologist? 

Not quite. Psychologists are registered with AHPRA and have completed university training in psychology and supervised practice. Counsellors may have a range of qualifications, and the title is not regulated in the same way. Medicare rebates under Better Access apply to psychologists, not counsellors.

How many sessions will my child need? 

It varies. Some children make progress in a handful of sessions, while others benefit from longer-term support. Your psychologist will talk with you about a plan and review progress along the way.

Will I be involved in my child's sessions? 

Usually, yes. Parents play an important part in helping children use new skills at home, and we work with families together wherever we can.

Getting started

If you have noticed some of these signs in your child, reaching out early can make a difference. Sydney Children's Practice works only with children, adolescents and their families, at our clinics in Glebe and Stanmore in Sydney's Inner West, with appointments from 7:30am to 8:00pm and telehealth for families who cannot easily attend in person. You can read more about our child psychologists in Sydney's Inner West, meet the team, or submit a New Client Enquiry. If you would like to talk it through first, call us on 02 9564 3758 or get in touch.

This article is general information and is not a substitute for personalised professional advice. Sydney Children's Practice is not a crisis service. If you are worried about your child's immediate safety, call 000.

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Bradley Bowen, MPsych (Clinical Psychology), BA (Hons I), BSc, AMusA, MAPS is a Board-registered Clinical Psychologist and Clinic Director of Sydney Children’s Practice. He has worked with children, adolescents, and families for over 25 years and has been practising as a Clinical Psychologist since 2011. Bradley has a particular interest in supporting neurodivergent children, including those with ADHD and Autism, and works using evidence-based approaches such as CBT, ACT, and Mindfulness.