Does my child need counselling?

By Karla Cloete (HPCSA Registered Counsellor)

Disclaimer: The content of this blog is not intended to diagnose or treat, and all information is intended to promote psycho-education in the community. Please consult with a relevant healthcare provider before taking any mental health advice.

Whether you’re an anxious parent worriedly googling in the middle of the night or a parent who is fed up and desperate for solutions- you might have wondered: Does my child need counselling? More discipline? More empathy? Medication? An exorcist? (Just kidding- but a parent has asked me that in the past!).

As a HPCSA Registered Counsellor I hear from a lot of concerned parents and teachers who worry about kids mental health. Here is a quick guide to help you identify areas of concern that may warrant professional mental health intervention.

Signs your child might need to see a professional:

1) There has been a major life change

Big changes can increase stress for children. Children thrive when they feel emotionally safe and secure and when their environment is predictable and structured. 

When children can say:

“I know who I am, I know where I belong and what is expected of me”- that’s when they can thrive. 

Major life changes for children can include:

-starting school or daycare

-parents separating, divorcing or remarrying

-moving cities or homes

-a new sibling being born etc.

When big changes happen children can be left feeling insecure, uncertain and anxious. Negative life events are associated with higher rates of behavioural and emotional problems in children over a two year period. 

One longitudinal study from the UK suggests that moving can have potential to result in poor mental health outcomes. Children who are frequently separated from one or both parents, who witness high rates of conflict between parents and children with inconsistent mothers are all at risk for mental health problems later in life. 

2) They have experienced a traumatic event

Trauma’s can be large once off event’s where the child perceived themselves or their loved ones to be in danger such as: 

-car accidents, 

-home invasions, 

-hijackings, 

-surgery or medical crises 

-natural disasters etc. 

Then there are ongoing long term trauma’s which happen over time called ACE’s.

Adverse childhood experiences or ACEs are traumatic experiences undergone during childhood which could be anything from:

-domestic violence, 

-sexual or emotional abuse

-death or separation from a parent/family member, 

-childhood neglect 

-or a caregiver struggling with mental health issues.

In both cases it is important to address these concerns with a mental health professional and other childhood protection professionals. Untreated childhood trauma can result in substance abuse, suicidality, medical challenges and mental health disorders later in life. (Check out my blog about the health effects of trauma here)

3) Their grades are slipping or they’re not coping 

Teachers are often the first to notice warning signs since they spend so much time with our kids. Behavioural challenges at school, grades worsening and challenges with making friends are all things you can ask your child’s educator about if you have concerns. 

A child that suddenly isn’t coping with daily life can be a potential warning sign. If mornings before school are filled with tears and tantrums, bedtime is battle of the wills or they are avoiding certain people or places when this never occurred before. If they seem overwhelmed by things they could handle previously or skills they had mastered before suddenly seem to disappear. 

4) Major changes in their personality, sleep appetite etc. 

According to Mayo Clinic, some signs that children need mental health intervention can include:

-Sudden changes in appetite (over/undereating)

-Sudden changes in sleep (over/undersleeping)

-Regression in toilet training (bedwetting or soiling themselves where they mastered these skills before)

-Increased nightmares

-Children becoming shy or withdrawn when they weren’t before

-Anxiety over being separated from their parents or being ‘clingy’

-Emotional outbursts not in line with the child’s age

-Behavioural challenges and tantrums 

Seeing a mental health professional, like a social worker/psychologist/registered counsellor means a full assessment and evaluation can be done to determine what the cause of these changes could be in order to make a recommendation.

5) Your family isn’t functioning 

Maybe there is no capital-T-trauma you can point to! Maybe there’s been no huge life changes, but your family isn’t coping. You as a parent can’t manage your child’s behaviour or their big feelings, the siblings can’t stop fighting or you and your teen are constantly butting heads.

According to Mental Health America family dysfunction  can include:

-Poor communication

-Lack of intimacy and closeness 

-Lack of boundaries 

-Unpredictability and instability 

-High rates of conflict 

These can also be reasons to seek counselling- a professional, like a psychologist or registered counsellor, can help you to gain better insight into your family’s patterns, your parenting style and the unmet needs in your household. Kids don’t come with a handbook! Getting some guidance can help your family run smoother, function better and be happier!  

It doesn’t ease parental anxiety, but the truth is there is no sure fire way to know if your child needs to see a registered counsellor or a psychologist. Every child and every family is different. Even within the same family one child can be resilient and bounce back while another might struggle. If you’re not sure if counselling is right for you or your family you can reach out to a local mental health practitioner.

If you are interested I offer a 20 minute free consultation call to parents and families who are considering starting counselling in Pretoria. You can book here. 

Check out this blog on how to prepare for your child’s first session?

Sources

Berden, G. F., Althaus, M., & Verhulst, F. C. (1990). Major life events and changes in the behavioural functioning of children. Journal of Child Psychology and Psychiatry, 31(6), 949-959.

Morris, T., Manley, D., Northstone, K., & Sabel, C. E. (2017). How do moving and other major life events impact mental health? A longitudinal analysis of UK children. Health & place, 46, 257-266.

About adverse childhood experiences (no date b) Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/aces/about/ (Accessed: 27 October 2025).

For children, life changes can be overwhelming (no date) Psychology Today. Available at: https://www.psychologytoday.com/za/blog/adolescents-explained/202205/for-children-life-changes-can-be-overwhelming (Accessed: 27 October 2025).

Worried about your child’s mental health? (2024) Mayo Clinic. Available at: https://www.mayoclinic.org/healthy-lifestyle/childrens-health/in-depth/mental-illness-in-children/art-20046577 (Accessed: 27 October 2025).
Is my family dysfunctional? (2023) Mental Health America. Available at: https://screening.mhanational.org/content/my-family-dysfunctional/ (Accessed: 27 October 2025).