Tell your child ahead of time, in plain words suited to their age, that they will be seeing someone whose job is helping kids with feelings and problems, and that nothing is wrong with them for going. The American Academy of Child and Adolescent Psychiatry (AACAP) advises parents to discuss the purpose of a visit with the child beforehand, in supportive terms that are not accusatory, so it does not feel like a punishment.
Part of our guide: A Parent’s Guide to Child and Teen Mental Health
Keep the first talk short. You can come back to it as questions come up. Your tone will matter as much as your words, so try to raise it when you feel fairly calm.
If your child talks about suicide or self-harm, or you think they are in danger, call or text 988 (988 Suicide & Crisis Lifeline), call 911, or go to the nearest ER. Do not wait for the right moment to have this conversation.
Before you bring it up
- Get your own questions answered first. Know who your child will see, roughly what the first visit involves, and what parents do during it. The clinician can help you with what to say. AACAP notes that preparing the child is something clinicians should discuss with parents.
- Choose your moment. AACAP recommends having these discussions when the child feels safe and comfortable. A car ride or walk can work well, and just before school or in the middle of a fight usually does not.
- Align with other caregivers. Children notice if one parent thinks therapy is a good idea and the other rolls their eyes.
- Do not surprise them. Telling a child you are going somewhere else and arriving at a therapist's office can damage trust early on.
What to say, by age
AACAP's tips for talking with children about mental illness apply here too: be straightforward, speak at a level that fits their age and development, watch their reaction, and slow down or back up if they look confused or upset. The wording below is a starting point. Change it so it sounds like you.
Ages 3 to 6
Young children need simple words and reassurance. For a physician, AACAP suggests something like "a feelings doctor" or a doctor who helps children with problems and worries, and reassuring them, if it is true, that there will be no needles or painful procedures. If the clinician is not a physician, "someone who helps kids with worries" is more accurate. Check any promise with the clinician first.
"You've been having lots of big feelings lately, and it's hard. We're going to meet someone named [name] who helps kids with big feelings. There are toys there, and you can talk or play. No shots. I'll be close by."
Ages 7 to 11
School-age children may wonder if they are in trouble or if something is wrong with them. Name the problem in a way they would agree with, and make clear it is a shared effort.
"I've noticed mornings have been really tough, and your stomach hurts a lot before school. I don't think you're doing anything wrong. We're going to see [name], who helps kids figure out worries like this. You might talk, play games or draw. I'll be talking with [name] too, because I want to learn how to help."
Ages 12 and up
Teens tend to respond better to respect and honesty than to a sales pitch. Give them real choices where you can. Tell them what will stay private and what will not, in general terms, and let the therapist explain the details. See teen therapy and confidentiality.
"You've seemed really worn down, and I don't think I'm the right person to help with all of it. I'd like you to try talking with someone who isn't me and isn't at school. What you say there is mostly private, and they'll explain the limits. Give it a few sessions. If this person isn't a fit, we can look for someone else."
Answers to the questions kids ask
| They ask | You might say |
|---|---|
| "Am I crazy?" or "What's wrong with me?" | "No. Lots of people see someone to help with hard feelings. It's like getting help with anything else that's hard." |
| "Is this because of something I did?" | "You're not in trouble. This is help, not a punishment." |
| "Will you be in the room?" | "I'll be there at the start. Later you might talk with them on your own. I'll be right nearby." (Check with the clinician first.) |
| "Will you tell them about [embarrassing thing]?" | "I might share things that help them understand. I'll tell you what I'm sharing, and you can tell them your side." |
| "Will you find out what I say?" | "They'll explain what stays private and what they'd need to tell me if you weren't safe." |
| "Do my friends have to know?" | "No. That's your choice. We can also agree on what to say if anyone asks where you were." |
| "How long do I have to go?" | "I don't know yet. We'll ask [name] and check in on how it's going." |
If you do not know the answer, say so, and offer to ask together. Honest "I don't know" answers build more trust than guesses.
Things that can get in the way
- Using therapy as a threat. "If you keep this up, you're going to see someone" teaches a child it is a consequence.
- Framing the child as the problem. "So they can fix you" lands hard. "So we can all figure this out" is easier to hear.
- Overpromising. Avoid telling your child that everything will be fine right away or that they will love it. Trust and progress can take a while.
- Talking about them in front of them. Share your worries with other adults out of earshot, or ask the clinician how to raise sensitive things.
AACAP also points out something parents sometimes miss. Give your child permission to tell the clinician about whatever worries them, even things that might feel like private family matters. "You can tell them anything, including stuff about me. I won't be mad."
The American Academy of Pediatrics offers simple language you can adapt: "I care about you and want to make sure I understand how you're feeling." It also encourages parents to let children know they are loved and supported however they feel, that everyone struggles sometimes, and that help is available.
If your child says no
Refusal is common, and it does not always mean the end of the conversation. Try these steps:
- Ask what worries them. Often the reason is specific: a bad past experience, fear of being judged, or feeling that they will be forced to talk.
- Offer choices that are real. Which day, in person or by video where appropriate, and whether you come in at the start.
- Ask for a limited trial. Agreeing to two or three sessions feels different from committing indefinitely.
- Consider starting yourself. Parents can meet with a clinician first for guidance. Family therapy may also be easier for some children to accept.
- Remember that fit matters. AACAP says it is very important to find a comfortable match between your child, your family and the professional. Switching clinicians is allowed.
Younger children usually go when a parent decides it is needed. With teens, forcing it tends to go badly, although safety concerns can change that calculation. Whether a teen must agree, or can start without a parent, involves legal rules that vary. See minors and consent in New York.
On the day and after
- Remind them the day before, or the morning of for younger children, so it is no surprise.
- Bring a comfort item for a small child, and something to do in the waiting room.
- Afterward, try "How was that?" once, and then let it go. Avoid "What did you talk about?"
- Do something ordinary together. A snack or a walk helps show that therapy is part of normal life.
- Expect mixed reactions at first. Trust often takes a few sessions, so check in again after several visits.
If the appointment is an evaluation, you may also want to read what happens at a child psychiatric evaluation. For testing, see how parents can prepare kids for ADHD testing. Not sure which clinician to start with? Read when a child should see a psychiatrist or a therapist.
When you are ready to take the next step, you can request a consultation through the child and adolescent psychiatry and therapy page. The intake team confirms fit, scheduling and costs, and the fees and insurance page has more on costs.
FAQs
When should I tell my child about therapy?
Close enough that it feels real and far enough ahead for questions. For a young child, that may be a day or two. For an older child or teen, tell them as soon as you are seriously considering it, and include them in planning.
Should I call it therapy or use another word?
Be honest, and use words your child understands. Younger children may understand "a feelings doctor" (if the clinician is a physician) or "someone who helps kids with worries." Older children and teens are better off hearing the real word.
What if my child won't talk in the session?
That is common at first. Therapists are used to it, and they may use games, drawing or other activities. You do not need to coach your child or prepare answers.
Should I tell my child what I told the therapist?
In general terms, yes, when it is safe and appropriate. Knowing what the clinician has heard helps a child feel less talked about. Ask the clinician about sensitive topics first.
