Child Mental Health, Child Therapy, CAMHS, UK Families, Parent Wellbeing
Child Mental Health, Child Therapy, CAMHS, UK Families, Parent Wellbeing
Signs My Child Needs Therapy: A UK Parent's Guide
Signs My Child Needs Therapy: A UK Parent's Guide
You noticed something. You cannot name it exactly, but something has shifted in your child and you feel it in your bones. Here is what to do with that feeling, and where to go next.
You noticed something. You cannot name it exactly, but something has shifted in your child and you feel it in your bones. Here is what to do with that feeling, and where to go next.
Sound Familiar
Sound Familiar
You noticed something. That is not a small thing. That is everything.
You noticed something. That is not a small thing. That is everything.
You noticed something. That is not a small thing. That is everything.
Josh Ezekiel
Josh Ezekiel
First, How Are You Doing?
Before we get to your child, let us talk about you for a moment. Because the parents who end up seeking therapy for their children have almost always been carrying something themselves for quite some time. The worry. The guilt. The second-guessing. The nights lying awake running through conversations and incidents and wondering what you missed or what you could have done differently.
That weight is real and it deserves to be named.
Parental mental health and child mental health are deeply connected. Research consistently shows that when a parent is struggling, children feel it, even when parents do their absolute best to shield them. This is not a blame statement. It is a compassion statement. You are not a machine. You are a human being raising another human being through a world that is genuinely difficult, with services that are stretched thin and a culture that does not always make it easy to ask for help.
If you have been feeling anxious, low, overwhelmed, or like you are just white-knuckling your way through the days, please hold that alongside everything else in this guide. Because sometimes the most powerful thing a parent can do for their child is get support for themselves. If you need somewhere to start, your GP is the right first call. You can also self-refer to NHS talking therapies in England at nhs.uk without a referral from your doctor.
And if parental guilt is part of what you are sitting with right now, you might find it useful to read this piece on why parental guilt happens and what it is actually telling you.
What Are the Signs That a Child Might Need Therapy?
There is no single sign. There is rarely a dramatic moment where everything becomes obvious. What most parents describe is a gradual accumulation of things that individually might seem explainable but together start to feel like a pattern.
Here are the things to pay attention to.
Changes in behaviour that have lasted more than a few weeks
Children have bad patches. A difficult term at school, a falling out with a friend, a disruption at home. These things cause temporary shifts in mood and behaviour and that is entirely normal. What is worth paying more attention to is when the shift does not lift. When a child who was generally happy starts to seem flat and stays that way. When a child who managed their feelings reasonably well starts to fall apart regularly. When something that began as a difficult patch starts to look like a new baseline.
The duration matters. A week of difficulty is very different from three months of difficulty.
Big feelings that seem impossible to manage
All children have big feelings. But there is a difference between a four year old melting down over a snack and a nine year old who cannot regulate at all, or a teenager who goes from zero to explosive with no middle ground, or a child of any age whose emotional responses feel consistently disproportionate to what is happening.
If you find yourself walking on eggshells around your child, managing the environment constantly to prevent eruptions, or feeling frightened of your child's reactions, that is important information. It does not mean your child is bad. It means they are carrying something they do not yet have the tools to manage, and that support could genuinely help. You can read more about why big feelings at home sometimes look very different from how children present at school in this piece on why children behave differently at home.
Withdrawal from the things they used to love
When a child stops wanting to see friends, drops hobbies they were passionate about, disengages from family life, or spends increasing amounts of time alone in their room, it is worth taking notice. Some withdrawal in adolescence is developmentally normal. But a sustained retreat from life, especially when combined with other changes, can be a sign that a child is struggling in ways they cannot yet articulate.
Children and young people are not always able to say I am not okay. Sometimes they say it through absence.
Physical symptoms without a medical cause
Stomach aches before school. Headaches that come and go. Feeling sick in situations that feel overwhelming. The body and the mind are not separate, and children who are anxious or distressed will very often express that distress physically. If your child has been seen by a GP and no physical cause has been found, and the symptoms keep returning in particular situations, it is worth considering whether something emotional is underneath them.
Sleep disturbances and changes in appetite
Difficulty falling asleep, waking repeatedly, nightmares, refusing to sleep alone, or sleeping far more than usual can all be connected to anxiety, depression, or trauma responses. The same is true of significant changes in appetite in either direction. These are not definitive signs on their own but they are worth tracking as part of a wider picture. If your child is having night terrors specifically you can read more about what causes them and what to do in this piece on night terrors.
Regression to earlier behaviours
A child who was dry at night starting to wet the bed again. A child who spoke confidently going quiet. An older child wanting to be carried, or needing a comforter they had grown out of, or becoming clingy in ways that feel out of step with their age. Regression is the mind and body's way of going back to a place that felt safe when the present feels too hard. It is not manipulation. It is communication.
Talking about not wanting to be here, or hurting themselves
If your child has said anything, even in passing, about not wanting to be alive, about wishing they were not here, or about hurting themselves, please take it seriously. Children do sometimes say things like this impulsively and without deep intent, but it always warrants a calm, open conversation rather than dismissal. If you are worried your child is at immediate risk, contact your GP urgently, go to your nearest A&E, or call 999. You can also contact Samaritans on 116 123, available 24 hours a day. For young people directly, YoungMinds has an excellent crisis text line and parent helpline.
What Brings Parents to This Point
Most parents do not arrive at this question quickly. They arrive at it after months of trying everything they can think of. More patience. Firmer boundaries. Gentler boundaries. Books. Podcasts. Conversations with partners, with teachers, with friends who may or may not have been helpful. By the time a parent is actively searching for whether their child needs therapy, they have usually already done an enormous amount of work.
What often tips the balance is one of a few things. A teacher raises a concern. A child says something that stops a parent cold. A behaviour escalates to a point that can no longer be explained away. Or simply the exhaustion of carrying the worry alone becomes too heavy and something has to give.
Whatever brought you here, you are not too late. There is no threshold of severity you need to reach before your child deserves support. Early help is always better than waiting until things become a crisis. The families who seek support before things become critical tend to find the process easier and the outcomes better. That is not a judgment on anyone who waited. It is simply an encouragement not to wait any longer than you already have.
Who Should You Talk to First?
This is where it can feel confusing because there is not one single front door to support in the UK. There are several, and which one you use often depends on what is happening and how urgently.
Your Child's School
School is often the best first conversation. Not because teachers are therapists, but because they see your child for a significant portion of every weekday and they hold important information about how your child is functioning outside the home. A good conversation with your child's class teacher or form tutor can help you build a fuller picture of what is going on.
Every school in England is required to have a designated safeguarding lead and most have a SENCo, which stands for Special Educational Needs Coordinator. The SENCo can be a valuable point of contact if you have concerns about your child's emotional wellbeing. Many schools also have access to a school counsellor, a mental health lead, or links to an early help team. Ask directly what pastoral support is available and do not be afraid to push if the first response feels insufficient.
If your child is struggling to attend school, you can read more about what that can mean and what to do in the context of our piece on school and home behaviour.
Your GP
Your family GP is the gateway to NHS mental health support for children. If you are concerned about your child, booking a GP appointment and describing what you have been noticing is a completely appropriate and important step. Be specific and be honest. Bring notes if it helps. GPs are not always specialists in child mental health but they can refer your child to CAMHS, which is the NHS Child and Adolescent Mental Health Service, and they can also refer you to support if your own mental health is being affected.
It is worth knowing that GP referrals to CAMHS do not always result in immediate appointments. You can read more about how those services work and how they are rated across the UK in this piece on children's mental health services in the UK.
CAMHS: what it is and how it works
CAMHS stands for Child and Adolescent Mental Health Services. It is the NHS's specialist mental health service for children and young people up to the age of 18 in England. Referrals can come from GPs, schools, social workers, or other health professionals depending on the area.
Once referred, your child will typically receive an initial assessment appointment. This is not therapy. It is a meeting, usually with a clinician, to understand what is happening, gather a full picture of your child's history and current difficulties, and decide what level of support is appropriate. Parents are usually involved in this process, particularly for younger children.
After assessment, children may be offered therapy, medication, or a combination, or they may be signposted to a lower tier of support if their needs do not meet the threshold for full CAMHS involvement. Thresholds vary by area and this is a source of significant frustration for many families.
The honest reality about CAMHS right now is that waiting times are long. As of 2024, tens of thousands of children in England were waiting over a year for treatment to begin. This is not acceptable and it is not your fault and it does not mean you should not pursue the referral. But it does mean that waiting for CAMHS alone is rarely enough, and that exploring what you can do in the meantime matters enormously. We wrote a whole piece on exactly that which you can read here: What to Do While You Are Waiting for CAMHS.
Organisations and helplines that can help right now
YoungMinds Parents Helpline is free to call on 0808 802 5544, Monday to Friday 9:30am to 4pm. They offer confidential advice and support for any adult concerned about a child or young person's mental health.
Place2Be works with schools across the UK to provide counselling and mental health support and has a useful resource section for parents.
Mind and the Mental Health Foundation both have parent-facing resources and can help you understand what your child might be experiencing.
Hub of Hope is a national database where you can search by postcode to find local mental health support for children and families.
What About Private Therapy?
Because NHS waiting lists are so long, many families explore private therapy. This is not about privilege. It is about not being able to watch your child struggle for eighteen months while waiting for a service that is overwhelmed through no fault of its own.
Private child therapy can feel daunting because it involves cost and because the landscape of practitioners is varied. Child psychotherapists, child psychologists, play therapists, CBT therapists, and counsellors all work with children but they have different training, different approaches, and different specialisms. Understanding what each offers is worth doing before you begin your search.
What a consultation is and why it matters
Before most private therapists offer ongoing sessions, they will offer an initial consultation. This is different from a session. It is a conversation, usually between the therapist and the parents, sometimes with the child present and sometimes without, where you discuss what has been happening, ask questions, and get a sense of whether this person and their approach feels right for your child.
A good consultation should feel like a conversation, not an interview. You should come away with a clearer sense of what the therapist thinks might be going on, what approach they would take, how they would involve you as a parent, and what the process would look like. You should also come away knowing whether your gut says yes to this person, because that matters enormously in therapeutic work.
Consultations typically last between 45 minutes and an hour. Some therapists offer them free of charge. Others charge their standard session rate. Always ask upfront.
How long are therapy sessions?
Standard child therapy sessions in the UK typically run for 50 minutes, though some practitioners offer 45 or 60 minute slots depending on the child's age and the type of therapy being offered. Play therapy sessions with very young children are sometimes shorter. Sessions are usually weekly, at the same time each week. Consistency matters in therapeutic work because children need to be able to rely on the session being there.
How long the overall work lasts varies enormously. Some children need a focused block of 8 to 12 sessions to work through a specific difficulty. Others benefit from longer-term work that might run for a year or more. A good therapist will review progress with you regularly and be honest about how things are going.
How to find the right therapist for your child in the UK
The most important thing to look for is proper qualification and registration with a recognised professional body. In the UK, child psychotherapists are trained through the Association of Child Psychotherapists and you can search their directory for qualified practitioners. Play therapists can be found through the British Association of Play Therapists. For counsellors and psychotherapists more broadly, the BACP directory and the UKCP directory are both searchable by location and specialism.
When you contact a potential therapist, you are allowed to ask questions. Ask about their training and how long they have been working with children. Ask what age range they work with. Ask what their approach is. Ask how they involve parents. Ask about their fees and cancellation policy. A therapist who is right for your child will welcome these questions.
Trust your instincts. The research on what makes therapy effective consistently shows that the quality of the relationship between the therapist and the client is one of the most significant factors. If something does not feel right, it is okay to keep looking.
You Are Doing Something Important Right Now
Seeking help for a child is one of the most loving things a parent can do and one of the hardest. It requires you to sit with uncertainty, to navigate systems that can feel impenetrable, and to hold your child's pain alongside your own.
You are already doing it. You read this far. That tells you everything you need to know about the kind of parent you are.
If you are not sure where to start, start with one conversation. Your child's teacher. Your GP. The YoungMinds helpline. You do not have to figure out the whole path tonight. You just have to take the next step.
And if you want to keep reading, here are some other pieces that might help you right now:
First, How Are You Doing?
Before we get to your child, let us talk about you for a moment. Because the parents who end up seeking therapy for their children have almost always been carrying something themselves for quite some time. The worry. The guilt. The second-guessing. The nights lying awake running through conversations and incidents and wondering what you missed or what you could have done differently.
That weight is real and it deserves to be named.
Parental mental health and child mental health are deeply connected. Research consistently shows that when a parent is struggling, children feel it, even when parents do their absolute best to shield them. This is not a blame statement. It is a compassion statement. You are not a machine. You are a human being raising another human being through a world that is genuinely difficult, with services that are stretched thin and a culture that does not always make it easy to ask for help.
If you have been feeling anxious, low, overwhelmed, or like you are just white-knuckling your way through the days, please hold that alongside everything else in this guide. Because sometimes the most powerful thing a parent can do for their child is get support for themselves. If you need somewhere to start, your GP is the right first call. You can also self-refer to NHS talking therapies in England at nhs.uk without a referral from your doctor.
And if parental guilt is part of what you are sitting with right now, you might find it useful to read this piece on why parental guilt happens and what it is actually telling you.
What Are the Signs That a Child Might Need Therapy?
There is no single sign. There is rarely a dramatic moment where everything becomes obvious. What most parents describe is a gradual accumulation of things that individually might seem explainable but together start to feel like a pattern.
Here are the things to pay attention to.
Changes in behaviour that have lasted more than a few weeks
Children have bad patches. A difficult term at school, a falling out with a friend, a disruption at home. These things cause temporary shifts in mood and behaviour and that is entirely normal. What is worth paying more attention to is when the shift does not lift. When a child who was generally happy starts to seem flat and stays that way. When a child who managed their feelings reasonably well starts to fall apart regularly. When something that began as a difficult patch starts to look like a new baseline.
The duration matters. A week of difficulty is very different from three months of difficulty.
Big feelings that seem impossible to manage
All children have big feelings. But there is a difference between a four year old melting down over a snack and a nine year old who cannot regulate at all, or a teenager who goes from zero to explosive with no middle ground, or a child of any age whose emotional responses feel consistently disproportionate to what is happening.
If you find yourself walking on eggshells around your child, managing the environment constantly to prevent eruptions, or feeling frightened of your child's reactions, that is important information. It does not mean your child is bad. It means they are carrying something they do not yet have the tools to manage, and that support could genuinely help. You can read more about why big feelings at home sometimes look very different from how children present at school in this piece on why children behave differently at home.
Withdrawal from the things they used to love
When a child stops wanting to see friends, drops hobbies they were passionate about, disengages from family life, or spends increasing amounts of time alone in their room, it is worth taking notice. Some withdrawal in adolescence is developmentally normal. But a sustained retreat from life, especially when combined with other changes, can be a sign that a child is struggling in ways they cannot yet articulate.
Children and young people are not always able to say I am not okay. Sometimes they say it through absence.
Physical symptoms without a medical cause
Stomach aches before school. Headaches that come and go. Feeling sick in situations that feel overwhelming. The body and the mind are not separate, and children who are anxious or distressed will very often express that distress physically. If your child has been seen by a GP and no physical cause has been found, and the symptoms keep returning in particular situations, it is worth considering whether something emotional is underneath them.
Sleep disturbances and changes in appetite
Difficulty falling asleep, waking repeatedly, nightmares, refusing to sleep alone, or sleeping far more than usual can all be connected to anxiety, depression, or trauma responses. The same is true of significant changes in appetite in either direction. These are not definitive signs on their own but they are worth tracking as part of a wider picture. If your child is having night terrors specifically you can read more about what causes them and what to do in this piece on night terrors.
Regression to earlier behaviours
A child who was dry at night starting to wet the bed again. A child who spoke confidently going quiet. An older child wanting to be carried, or needing a comforter they had grown out of, or becoming clingy in ways that feel out of step with their age. Regression is the mind and body's way of going back to a place that felt safe when the present feels too hard. It is not manipulation. It is communication.
Talking about not wanting to be here, or hurting themselves
If your child has said anything, even in passing, about not wanting to be alive, about wishing they were not here, or about hurting themselves, please take it seriously. Children do sometimes say things like this impulsively and without deep intent, but it always warrants a calm, open conversation rather than dismissal. If you are worried your child is at immediate risk, contact your GP urgently, go to your nearest A&E, or call 999. You can also contact Samaritans on 116 123, available 24 hours a day. For young people directly, YoungMinds has an excellent crisis text line and parent helpline.
What Brings Parents to This Point
Most parents do not arrive at this question quickly. They arrive at it after months of trying everything they can think of. More patience. Firmer boundaries. Gentler boundaries. Books. Podcasts. Conversations with partners, with teachers, with friends who may or may not have been helpful. By the time a parent is actively searching for whether their child needs therapy, they have usually already done an enormous amount of work.
What often tips the balance is one of a few things. A teacher raises a concern. A child says something that stops a parent cold. A behaviour escalates to a point that can no longer be explained away. Or simply the exhaustion of carrying the worry alone becomes too heavy and something has to give.
Whatever brought you here, you are not too late. There is no threshold of severity you need to reach before your child deserves support. Early help is always better than waiting until things become a crisis. The families who seek support before things become critical tend to find the process easier and the outcomes better. That is not a judgment on anyone who waited. It is simply an encouragement not to wait any longer than you already have.
Who Should You Talk to First?
This is where it can feel confusing because there is not one single front door to support in the UK. There are several, and which one you use often depends on what is happening and how urgently.
Your Child's School
School is often the best first conversation. Not because teachers are therapists, but because they see your child for a significant portion of every weekday and they hold important information about how your child is functioning outside the home. A good conversation with your child's class teacher or form tutor can help you build a fuller picture of what is going on.
Every school in England is required to have a designated safeguarding lead and most have a SENCo, which stands for Special Educational Needs Coordinator. The SENCo can be a valuable point of contact if you have concerns about your child's emotional wellbeing. Many schools also have access to a school counsellor, a mental health lead, or links to an early help team. Ask directly what pastoral support is available and do not be afraid to push if the first response feels insufficient.
If your child is struggling to attend school, you can read more about what that can mean and what to do in the context of our piece on school and home behaviour.
Your GP
Your family GP is the gateway to NHS mental health support for children. If you are concerned about your child, booking a GP appointment and describing what you have been noticing is a completely appropriate and important step. Be specific and be honest. Bring notes if it helps. GPs are not always specialists in child mental health but they can refer your child to CAMHS, which is the NHS Child and Adolescent Mental Health Service, and they can also refer you to support if your own mental health is being affected.
It is worth knowing that GP referrals to CAMHS do not always result in immediate appointments. You can read more about how those services work and how they are rated across the UK in this piece on children's mental health services in the UK.
CAMHS: what it is and how it works
CAMHS stands for Child and Adolescent Mental Health Services. It is the NHS's specialist mental health service for children and young people up to the age of 18 in England. Referrals can come from GPs, schools, social workers, or other health professionals depending on the area.
Once referred, your child will typically receive an initial assessment appointment. This is not therapy. It is a meeting, usually with a clinician, to understand what is happening, gather a full picture of your child's history and current difficulties, and decide what level of support is appropriate. Parents are usually involved in this process, particularly for younger children.
After assessment, children may be offered therapy, medication, or a combination, or they may be signposted to a lower tier of support if their needs do not meet the threshold for full CAMHS involvement. Thresholds vary by area and this is a source of significant frustration for many families.
The honest reality about CAMHS right now is that waiting times are long. As of 2024, tens of thousands of children in England were waiting over a year for treatment to begin. This is not acceptable and it is not your fault and it does not mean you should not pursue the referral. But it does mean that waiting for CAMHS alone is rarely enough, and that exploring what you can do in the meantime matters enormously. We wrote a whole piece on exactly that which you can read here: What to Do While You Are Waiting for CAMHS.
Organisations and helplines that can help right now
YoungMinds Parents Helpline is free to call on 0808 802 5544, Monday to Friday 9:30am to 4pm. They offer confidential advice and support for any adult concerned about a child or young person's mental health.
Place2Be works with schools across the UK to provide counselling and mental health support and has a useful resource section for parents.
Mind and the Mental Health Foundation both have parent-facing resources and can help you understand what your child might be experiencing.
Hub of Hope is a national database where you can search by postcode to find local mental health support for children and families.
What About Private Therapy?
Because NHS waiting lists are so long, many families explore private therapy. This is not about privilege. It is about not being able to watch your child struggle for eighteen months while waiting for a service that is overwhelmed through no fault of its own.
Private child therapy can feel daunting because it involves cost and because the landscape of practitioners is varied. Child psychotherapists, child psychologists, play therapists, CBT therapists, and counsellors all work with children but they have different training, different approaches, and different specialisms. Understanding what each offers is worth doing before you begin your search.
What a consultation is and why it matters
Before most private therapists offer ongoing sessions, they will offer an initial consultation. This is different from a session. It is a conversation, usually between the therapist and the parents, sometimes with the child present and sometimes without, where you discuss what has been happening, ask questions, and get a sense of whether this person and their approach feels right for your child.
A good consultation should feel like a conversation, not an interview. You should come away with a clearer sense of what the therapist thinks might be going on, what approach they would take, how they would involve you as a parent, and what the process would look like. You should also come away knowing whether your gut says yes to this person, because that matters enormously in therapeutic work.
Consultations typically last between 45 minutes and an hour. Some therapists offer them free of charge. Others charge their standard session rate. Always ask upfront.
How long are therapy sessions?
Standard child therapy sessions in the UK typically run for 50 minutes, though some practitioners offer 45 or 60 minute slots depending on the child's age and the type of therapy being offered. Play therapy sessions with very young children are sometimes shorter. Sessions are usually weekly, at the same time each week. Consistency matters in therapeutic work because children need to be able to rely on the session being there.
How long the overall work lasts varies enormously. Some children need a focused block of 8 to 12 sessions to work through a specific difficulty. Others benefit from longer-term work that might run for a year or more. A good therapist will review progress with you regularly and be honest about how things are going.
How to find the right therapist for your child in the UK
The most important thing to look for is proper qualification and registration with a recognised professional body. In the UK, child psychotherapists are trained through the Association of Child Psychotherapists and you can search their directory for qualified practitioners. Play therapists can be found through the British Association of Play Therapists. For counsellors and psychotherapists more broadly, the BACP directory and the UKCP directory are both searchable by location and specialism.
When you contact a potential therapist, you are allowed to ask questions. Ask about their training and how long they have been working with children. Ask what age range they work with. Ask what their approach is. Ask how they involve parents. Ask about their fees and cancellation policy. A therapist who is right for your child will welcome these questions.
Trust your instincts. The research on what makes therapy effective consistently shows that the quality of the relationship between the therapist and the client is one of the most significant factors. If something does not feel right, it is okay to keep looking.
You Are Doing Something Important Right Now
Seeking help for a child is one of the most loving things a parent can do and one of the hardest. It requires you to sit with uncertainty, to navigate systems that can feel impenetrable, and to hold your child's pain alongside your own.
You are already doing it. You read this far. That tells you everything you need to know about the kind of parent you are.
If you are not sure where to start, start with one conversation. Your child's teacher. Your GP. The YoungMinds helpline. You do not have to figure out the whole path tonight. You just have to take the next step.
And if you want to keep reading, here are some other pieces that might help you right now:
You do not need to have all the answers before you take the next step. You just need to take it.
You do not need to have all the answers before you take the next step. You just need to take it.
Josh Ezekiel
Josh Ezekiel
You do not need to have all the answers before you take the next step. You just need to take it.
Josh Ezekiel
You noticed something was different about your child. Something shifted. And instead of pushing that feeling down, you are here, asking questions, looking for answers, trying to understand. That is not a small thing. In the world of child mental health, early attention from a parent who is paying close attention is one of the most powerful protective factors a child can have.
There is no rulebook that tells you exactly when to seek therapy for your child. There is no line in the sand that makes it official. What there is, is you. Your knowledge of your child, your instinct that something needs attention, and the willingness to act on it even when you are not entirely sure.
That willingness is enough to begin.
You noticed something was different about your child. Something shifted. And instead of pushing that feeling down, you are here, asking questions, looking for answers, trying to understand. That is not a small thing. In the world of child mental health, early attention from a parent who is paying close attention is one of the most powerful protective factors a child can have.
There is no rulebook that tells you exactly when to seek therapy for your child. There is no line in the sand that makes it official. What there is, is you. Your knowledge of your child, your instinct that something needs attention, and the willingness to act on it even when you are not entirely sure.
That willingness is enough to begin.
About the Author
Josh Ezekiel writes about child development, family mental health, and the real experience of parenting children who are struggling. He is not a therapist, but he has spent years researching and writing about the systems UK families navigate when they need support.