After serving the Shanghai community for over four years, I've witnessed an ongoing trend in mental health for many local and international children with therapeutic needs. Typically, these children are referred to therapy by a parent or school provider in the early months of the academic year, when learning and behavioral problems begin to surface. After meeting for the initial consultations, some parents will elect to discontinue the treatment for a variety of reasons. This is most often because one of the many school holidays is on the horizon and the timing of the treatment does not feel ideal. The holiday passes, at which point the parents question whether resuming treatment will be necessary or not. By the time they have made their decision, perhaps another school holiday is upon us, and again it no longer feels like an opportune time to resume.
Meanwhile, the child's symptoms have intensified to the point where ongoing treatment is no longer an option, but rather a medical necessity. By now it's spring, and with all the holidays behind them, the parents recontinue their child's treatment. After trying therapy again for a couple of sessions, the summer holiday arrives, the family leaves for two months, and the cycle starts all over again the following year.
Does this situation sound familiar to you?
In this edition, I'm going to provide a guide for parents and other caregiving adults on how to identify earlier the warning signs and symptoms of mental health-related concerns in your child. I will also cover how to discuss these concerns with your child, and highlight how ongoing, consistent adherence to mental health treatment can make all the difference in a child's ability to effectively manage their symptoms.
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Assessing Mental Health Concerns in Your Child
Listed below are four separate, but related domains of mental health signs and symptoms in children. While all children will experience symptoms in each of these categories from time to time, if you start to witness an elevation of symptoms across multiple domains, then it's likely the right time to schedule a visit with a mental health professional.
1. Physical
- A headache
- Stomachache/nausea
- Restlessness
- Over/under-reactivity
- Feeling 'on edge'
2. Cognitive
- Difficulties concentrating
- Confusion
- Indecisiveness
- Forgetfulness
- Reduced academic performance
3. Emotional
- Fluctuations in mood
- Low frustration tolerance
- Crying and sadness
- Anger and irritability
- Flat affect (lack of reaction to emotional stimuli)
4. Behavioral and Interpersonal
- Frequent disagreements with adults/peers
- Changes in daily routine
- Changes in eating and sleeping habits
- Increased school absences
- Withdrawing and isolating from others
Tips for Responding Proactively to a Child's Mental Health Needs
1. Give the therapy process time
Similar to going to the gym, going to the therapist to work out your mind takes consistency and time. While each case will differ, I often encourage my patients and their families to allow for eight-10 consistent, weekly sessions before they see positive changes in mood and daily functioning take shape.
2. Help your child to differentiate
between stress and distress Each of us operates along a continuum of stress; in fact, it’s those mild to moderate doses of life stress that help get us out of bed and motivate us to accomplish tasks throughout the day. With that said, the amount of stress we endure has its point of diminishing returns, where once healthy, motivating stress can progress to the point of
overwhelming and debilitating distress. Have a conversation with your children about what stress means, how it can be healthy, how to recognize their stress limits and when it's time to reach out for support.
3. If you see something, say something
Children often refrain from disclosing their mental health concerns for fear their parents won't understand or they will be disappointed in them. As a result, the responsibility will fall on you as the concerned adult to raise these sensitive topics with your child, particularly if you've noticed them exhibiting some of the signs and symptoms listed above.
[Cover image via Pexels]
Dr. Balfanz is the Senior Clinical Psychologist at American Medical Center, a comprehensive medical and mental health service clinic for children, adolescents, adults and families living in Shanghai. For more information on clinic services, contact Dr. Balfanz at: nate.balfanz@amc-shanghai.cn or visit his website at: www.drnatebalfanz.com
