When to seek mental health help for your child after a traumatic event

Most children display resilience after experiencing trauma, but some will need additional support from a mental health professional. Here’s how to tell if it’s time to make an appointment for your child.

After being exposed to a traumatic event such as a mass shooting or natural disaster, children’s trauma responses may be different, ranging from resilience and recovery to changes in their daily functioning and intense distress. All such behaviors can be considered completely normal, said Michelle Reising, PhD, a pediatric psychologist at Monroe Carell Jr. Children’s Hospital at Vanderbilt.

With such a wide range of “normal” trauma responses, how do parents know when to consider seeking help from a mental health provider for their child after a traumatic event?

“For children, we’d want to consider if they are able to go to school, stay at school all day and pay attention in class. Are they engaging with their peers, participating in their typical activities, going to baseball or scouts?”

“There’s no hard and fast line, but there are things parents should consider,” Reising said. “Symptoms of acute stress after a traumatic event are very normal in the first few months. After that, we would expect to see symptoms begin to improve.”

Still, time isn’t the only factor to consider.

“Parents  to also need to consider the proximity to the traumatic event – whether directly or indirectly experienced – and impact of the child’s distress on daily life and functioning,” Reising said.

For example, if a child is still participating in daily activities but is experiencing trauma responses such as frequent stomachaches, headaches, problems with sleep, or difficulties with focus/concentration in the classroom, it might be time to talk to a mental health provider. On the other hand, it’s also completely normal for young children to need additional reassurance or cling to a parent/guardian following a traumatic event.

“It’s also important to consider the child’s wishes. Certainly if a child asks for mental health supports, parents should honor this request. If an older child is not interested in mental health supports, parents are encouraged to take this into consideration as well.”

“A pretty common way we consider a person’s mental health functioning – and this goes for people of all ages, not just kids – is how they’re able to live their day-to-day life and do the tasks that are meaningful and important to them,” Reising said. “So for children, we’d want to consider if they are able to go to school, stay at school all day and pay attention in class. Are they engaging with their peers, participating in their typical activities, going to baseball or scouts? Are they interacting with their family? If not, that’s when it might be helpful for parents to seek some additional support.”

Allie Wroblewski, a pediatric psychologist with Monroe Carrell, agreed.

“Of course, it’s also important to consider the child’s wishes,” Wroblewski said. “Certainly if a child asks for mental health supports, parents should honor this request. If an older child is not interested in mental health supports, parents are encouraged to take this into consideration as well. For example, therapy is much for effective when a teenager is motivated for help.”

Where to find mental health help

Once you’ve decided to reach out for help on your child’s behalf, the next step is to locate a mental health provider, which isn’t always easy given the current mental health crisis and provider shortage. There are several places you can begin your search:

• Ask your child’s pediatrician for a local referral.
• Ask for a referral from the school guidance counselor or school psychologist.
• Search for a provider on your health insurance plan’s website.
• Contact your employee assistance program, if available.
• Search the Psychology Today provider directory.

When considering providers, be sure to look for someone who has background and training in trauma-informed care and experience working with kids your child’s age. You’ll also want to ask what types of therapy a provider uses. The National Child Traumatic Stress Network explains the various evidence-based therapies for childhood trauma on its website.