For nearly 10 months of the last school year, Sheila (not her real name) spent an hour or two every night lying in bed with her nine-year-old, Ava, as she cried about her social troubles at school. Ava’s problems ranged from fights with friends to worrying about no one liking her. Not a night went by when she was not upset by what she perceived as a wrong from a good friend or classmate. By the end of the school year, Sheila was at her wits’ end. Ava entered Grade 5 this year and, within two weeks, she had started to complain and cry again about “mean girls.” She had constant anxiety and trouble falling asleep. Then a friend suggested Sheila take Ava to the therapist her own nine-year-old goes to, for identical problems.
Ava now sees a Toronto therapist once a week. In doing so, she joins a growing number of young children who are in therapy—and not to deal with family issues or because of a life-changing experience, such as death, but over the ups and downs of life at school and in the playground. “We have noticed a steady increase in referrals over the last five years in our clinic,” says Alisa Kenny Bridgman, a child and adolescent psychologist at Toronto’s New Bridges children’s health clinic, whose waiting list can be several months long. She says the most common concerns she hears are anxieties about peer relationships, followed by fear related to academic performance and family relationships. “Clinicians continue to see children and teens with severe symptoms, but also children with subclinical issues as a preventative measure,” she says.
While the types of stressors may have been the same in previous generations—what young child hasn’t been traumatized by a fight with a friend?—their severity now seems amplified. Children don’t communicate with each other the way their parents did. “They are texting, Facebooking, Instagramming, and this comes with a whole host of anxieties and feelings of insecurities,” says Bridgman, who also sees children with what she calls “adult worries,” such as concerns about money, politics and wars.
Krysti Dedi, a psychotherapist in Winnipeg, has seen a rise in kids as young as six and seven at her practice. Parents, she says, are coming in with the idea that they want to help their children when they are young, so they get help before those emotionally charged adolescent years. “I think we believe that if a professional can do it faster and more effectively, then why not?” asks Linda, whose nine-year-old is in therapy over problems relating with peers.
Some mothers, such as Jennifer (all parents’ and children’s names in this story have been changed), whose daughter goes to therapy for anxiety about friends and homework, worry about seeking professional help when every other generation has figured out friendship problems on its own. But parents and therapists agree that children today live in a changed world. “Children feel increasingly responsible for things that happen to them, and to others who are close to them,” says Dedi. “They don’t yet have the experience or wisdom to know they can’t control everything that will happen in life.” She has met with eight- and nine-year-olds who have years of family conflict under their belts. Children, says Linda, don’t always want to talk to their parents, either. Bridgman agrees. “[They] often say they want to help their parents and not give them more to worry about,” she says.
Therapists suggest tools such as writing in a “worry book” and brain games, like counting to 100 by twos, or laying a piece of paper on their stomachs as they breathe in and out; watching the paper rise and fall calms them. “My daughter wrote down 18 worries, ranging from ‘I don’t think my parents are proud of me enough,’ to ‘No one likes me at school,’ to ‘I hate when people say to be positive. It never works!’ ” says Sheila. The brain games the therapist suggested, she says, seem to work. “She does them every night in bed and it helps her fall asleep.” Art and play therapy are also popular.
Child therapy, like adult therapy, costs from $150 to $200 an hour, putting it out of reach for many. Parents are sometimes, but not always, privy to what the child says to the therapist. Bridgman sees children for 45 minutes, then parents for 15 minutes to go over strategies learned in that session. Other therapists strongly suggest that parents do not ask their children about what happens in sessions. And most parents do not press. Lisa sent her kids to therapy after her divorce. “My children rarely talked about what they did in therapy,” she says. “My older daughter, who was 10, didn’t want me in the room. [With] my youngest, who was eight, I was allowed in for two sessions, so she could open up with me in front of the therapist, then she went on her own.” Sheila didn’t push her daughter into telling her about her sessions. But, she says, “She was keeping a journal that I will admit I peeked at, just so I could make sure there was nothing really bad going on. It was mostly just, ‘This person was mean to me today.’ ”
Therapy does not help all kids. Jennifer stopped taking her daughter after a handful of sessions. “I think it could be helpful, but she wasn’t practising the techniques that were suggested and I think that is necessary for it to work.” The tools therapists give children to help get over peer problems need to be practised over and over.
The solution has its own problems, as Daphne Merkin suggested in a memoir in The New York Times Magazine. Merkin, who started therapy at age 10, called herself “a one-person boon to the therapeutic establishment,” and wrote that she’s not sure she’s fared better as a result of her 40-odd years of seeing therapists, though she did find it tremendously addictive.
As for the question of how young is too young for children to benefit from therapy, the moment for that conversation appears to have passed. “It may be that these days we are very comfortable with seeking help from experts,” says Cassandra White, director of Rocky Mountain Psychological Services in Calgary. “We’re time-pressed and would rather look something up or find out from an expert than blindly figure it out on our own. We use this same kind of thinking on the topic of parenting and helping our children cope.”
She says while most parents don’t see therapy as a necessity in the same way that seeing a dentist is a necessity, they have no qualms about accessing support and services that can help their children.
The persistence of peer issues in the classroom spurred Dana Kerford, a former teacher from Calgary, to start GirlPower, a program designed to teach girls to foster healthier friendships. Since 2009, she has worked with more than 10,000 girls in workshops she runs across North America and Australia. Kerford says she’s heard from hundreds of parents wondering if they should send their children to therapy or seek professional help. Part of the problem, she says, may be that some moms and dads are riding what she calls the “roller coaster of emotions” with their children. When their children are upset about friends who were mean at school, parents take it personally, too. “Parents need to learn to disconnect a little bit, because they, too, are crying along with their children.” One thing parents have—or should have—that children don’t, she says, is “perspective.” Hyper-parenting, says Jennifer Kolari, author of Connected Parenting and a child therapist, is also partly to blame for children now being oversensitive. “No longer, for example, can you call a parent. She will say, ‘My child would never do that!’ Teachers’ hands are tied, because they have parents constantly complaining. There’s a ripple effect, which makes for a lack of empathy in children.”
Parental over-involvement has a side effect, Kerford says. “There are parents storming into school after a girl says something mean to their child. Or the mom will threaten to call the principal, and that can make it worse. So the children don’t want to speak to their parents and they end up suffering in silence.”
Therapy can work in some situations. “It’s an expensive place to go and vent for a nine-year-old,” Kerford jokes. “But there are a lot of mothers who really don’t know what to do and don’t have the time. There are practical strategies that parents and children can learn without intense therapy.”
This includes role-playing, and something she’s come up with called the friend-o-meter, where she teaches that girls need to be civil and pleasant but they don’t have to hang out with people who don’t “lift them up.” She also tells children she doesn’t believe in the term “BFF” (best friends forever). “Children feel locked in and trapped. I prefer the term ‘besties,’ because it puts less pressure on them when they get in a fight.” Of course, children can break up with their ever-changing “besties,” but it takes “forever” out of the mix, so they feel less anxious, guilt-ridden and ensnared by the relationship.
As for Sheila, she says she’s seen an improvement in Ava after five sessions. “She barely cries at night and, when she does, she knows to go practise her brain games and go to sleep.” But Sheila worries sometimes. She doesn’t want her 10-year-old daughter in therapy for the rest of her life. “My daughter really loves going to therapy. She feels special there. But I don’t want her to get too used to it. It is somewhat of a luxury.”