A Parent’s Guide for Mental Health Services for Your Child

The information in this article is based on a recent webinar featuring Dr. Amanda Ferriola, Dr. Michael J. Friedman, and Dr. Hui S. Jiang.

When your child faces emotional or behavioral challenges, knowing where to start can feel overwhelming. This guide offers clarity on mental health services, treatments, and detailed answers to commonly asked questions, supporting parents in making informed decisions.

Understanding Levels of Mental Health Care

Choosing the right level of care depends on your child's specific needs:

Outpatient Treatment:

Regularly scheduled therapy sessions while your child lives at home.
Ideal for mild to moderate symptoms with stable home support.
Focuses on teaching coping skills and strategies to manage symptoms effectively.

Partial Hospitalization Programs (PHP):

Provides intensive therapy during the day without overnight stays.
Suitable for children who need structured daily support and more frequent therapeutic contact.
Often includes individual, group, and family therapy sessions.

Intensive Outpatient Programs (IOP):

Intensive, structured therapy occurring multiple times weekly.
Designed for situations where regular outpatient care is insufficient, but PHP-level care isn’t necessary.
Balances intensive treatment with flexibility, allowing children to maintain their home routine.

Emergency Services:

Immediate care available through crisis hotlines, mobile crisis teams, or emergency rooms.
Essential for urgent mental health crises requiring rapid intervention and stabilization.

Community Mental Health Centers:

Accessible services, including therapy and support groups.
Often offer sliding scale fees based on income, ensuring affordability.

Evidence-Based Interventions

Evidence-based treatments are scientifically validated therapies effective for various mental health conditions, such as anxiety, depression, OCD, ADHD, and more. Common examples include:

Cognitive Behavioral Therapy (CBT): For anxiety, depression, and mood disorders. CBT helps children identify and change negative thought patterns and behaviors.
Exposure and Response Prevention (ERP): Specifically for OCD, ERP involves gradually exposing children to fear triggers and helping them resist compulsive behaviors.
Behavioral Parent Training: Focuses on coaching parents to manage oppositional or defiant behaviors through consistent routines, positive reinforcement, and effective consequences.
Dialectical Behavior Therapy (DBT): Especially helpful for adolescents experiencing intense emotional swings, DBT teaches mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.
Parent-Child Interaction Therapy (PCIT): A structured treatment for younger children with behavioral issues that involves live parent coaching to improve the parent-child relationship and behavior outcomes.
Acceptance and Commitment Therapy (ACT): A mindfulness-based approach that helps children accept difficult emotions and commit to values-driven actions.
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT): Designed for children and adolescents who have experienced trauma, combining trauma-sensitive interventions with cognitive-behavioral principles.
Comprehensive Behavioral Intervention for Tics (CBIT): An evidence-based behavioral therapy for children with tic disorders, including Tourette Syndrome.

What Should Quality Outpatient Therapy Include?

Effective therapy typically involves:

Comprehensive Assessment: Initial sessions identify your child's specific needs and establish clear, measurable treatment goals.
Psychoeducation: Informing you and your child about the condition, available treatments, and rationale behind interventions.
Structured Sessions: Regularly scheduled sessions with clear agendas, practical exercises, and home-based practice assignments.
Progress Monitoring: Consistent evaluation to ensure treatment goals are being met and to adjust the therapeutic approach if necessary.
Closure and Maintenance Planning: Strategies to maintain therapeutic gains and plans for accessing future support as needed.

Finding the Right Mental Health Provider

To start your search:

Insurance Company: Consult your insurer’s behavioral health line for recommended providers.
Online Directories: Use resources such as Psychology Today, state psychological associations, and local mental health organizations.
Community Resources: Seek guidance and referrals from local mental health associations.

Navigating Insurance Coverage

Understanding insurance coverage is crucial:

In-Network Providers: Have contracted rates with your insurer, simplifying billing and reducing out-of-pocket expenses.
Out-of-Network Providers: Typically require upfront payment with potential reimbursement; this may involve submitting claims yourself. Use this free tool to check your out-of-Network coverage (bottom of page): https://www.3ecenter.org/feesandinsurance
Single Case Agreements: If specialized care is unavailable in-network, request coverage for out-of-network providers at in-network rates. Documentation from providers, including diagnosis, treatment plans, and specific billing codes, is usually required.

Commonly Asked Questions by Parents

Q: My child refuses to go to therapy. What can I do?

It's very common for children to initially resist therapy due to fears, misunderstandings, or simply anxiety about new experiences. First, have a calm, open discussion with your child about what therapy involves and why it's important.

If your child had a broken arm, you wouldn’t let them skip the doctor just because they refuse to go. The same goes for therapy. Mental health treatment is not optional when a child is suffering—it’s essential care. Even if your child is anxious, reluctant, or unmotivated, it's still important to follow through with therapy just as you would with any other medical recommendation.

Consider Parent-Focused Options First
If your child remains unwilling, know that you’re not stuck. There are treatments that begin with the parent as the main agent of change. For example, the SPACE program (Supportive Parenting for Anxious Childhood Emotions) is an evidence-based intervention specifically designed to help parents reduce their child's anxiety-related behaviors without requiring direct child participation. Similarly, Parent-Child Interaction Therapy (PCIT) is an effective approach for younger children with externalizing behavior problems, where therapists coach parents in real time to strengthen attachment and improve behavior management. In both approaches, the parent—not the child—is the primary client. You can learn how to shift family dynamics, reduce reinforcement of anxiety patterns, and gently increase expectations—all without needing your child to buy in right away.

Collaborate with School
Some mental health concerns—like school refusal, or behavior challenges—don’t always require weekly therapy sessions with your child. In fact, in many cases, the most effective treatment starts with changing the environment around the child. For example, with school refusal, a clinician may work more closely with parents and school staff to create a structured, predictable, and supportive environment that addresses the underlying causes of the child’s avoidance.

Q: Therapy didn't help my child before. Should we try again?

Hearing "therapy didn’t help" is disheartening. You made time, found a provider, and perhaps even saw some initial hope—only to end up feeling stuck again. But one unsuccessful round of therapy doesn’t mean therapy can’t work. It just means that particular approach didn’t work for your child.

Much like teachers, therapists vary in training, style, and approach. It’s not uncommon to need to try more than one provider to find the right fit. Ask yourself: Did the therapist have experience with my child’s issue? Were they using a specific evidence-based treatment? Was there a plan, with measurable goals? If not, it may have simply been a mismatch.

When seeking a new provider, use what you learned from your previous experience. Ask, “What kind of treatment do you use for this diagnosis?” “How do you measure progress?” “When should we expect to see results?”

If your child is struggling, don’t wait for a tipping point to try again. Early intervention is more effective and usually shorter. It’s okay to try something new—with a different provider, method, or starting with parent sessions instead of child sessions.

Q: Should my child expect to be in therapy indefinitely?

When families first begin therapy, one of the most common (and reasonable) questions is: How long will this last? Will we be doing this forever?

No, Therapy should not be forever.

Good therapy is goal-oriented. That means it starts with a plan: What are we trying to improve? What does progress look like? How will we know when we’re done? Most children don’t need open-ended therapy. If your therapist hasn’t set any goals or cannot estimate a general timeline, it’s okay to ask.

Your child might complete a round of therapy, and then return a year later for a few sessions to reinforce strategies. That doesn’t mean therapy failed—it means life got harder or something changed, and your child had the tools (and courage) to ask for support.

A therapist should be able to say, "Here’s what we’re working on, here’s how we’ll track it, and here’s how we’ll know we’re done for now." That kind of transparency helps your child feel empowered—not stuck. It’s also helpful for parents to request a Good Faith Estimate from the provider, which outlines the expected cost of services over time. This can give families a clearer sense of the financial and time investment involved and helps reinforce that therapy is a structured, goal-driven process—not an endless one.

Q: My child likes the therapist but isn't improving. Should we continue?

Your child enjoys going to therapy. They look forward to their sessions. They like their therapist. But months have passed, and you’re not seeing much change. Now you’re asking: Is this helping?

Therapeutic Relationship Matters—but It’s Not Enough
Yes, feeling safe and understood is foundational. But therapy shouldn’t feel like a weekly chat with a nice adult. It should feel like work—with specific goals, hard conversations, and challenges that push your child forward.

Are There Measurable Goals?
Therapy should have a roadmap. Ask: What goals are you working on with my child? How do you track progress? When can we expect to see change? If the answer is vague or always "it takes time," that’s a red flag.

A Good Therapist Will Be Honest
Therapists who practice ethically will acknowledge when treatment isn’t producing results. They’ll offer new strategies, refer out, or adjust the treatment plan. If they don’t, it’s okay to bring it up. Say: “My child enjoys seeing you, but I’m concerned we’re not seeing change. Can we review goals together?”

Therapy Shouldn’t Be Comfortable All the Time
Much of evidence-based therapy—especially for anxiety, OCD, or behavioral issues—requires discomfort. It teaches children to face hard things, take risks, and practice new behaviors. If therapy is always fun and easy, it might not be effective. As a parent, you’re allowed to expect more than rapport. You can—and should—expect progress.

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