Should my teenager see a psychologist or psychiatrist

It can be hard to admit that your teen needs help. But there are certain problems that you may not be able to solve as a parent. Some issues require professional counseling and intervention.

Teens may need professional counseling for behavior problems, emotional problems, mental health issues, substance abuse problems, stress, relationship difficulties, and traumatic experiences. The longer you wait to seek help, the worse your teen's problems may become. It's important to seek help as soon as you can. Learn about the warning signs that indicate it's time to get help.

Is It Just Normal Teen Behavior?

It can be hard to tell if your teen is having serious problems or if her actions constitute normal teenage behavior. Start by looking at your teen's daily life and asking yourself these questions:

• How is my teen doing at school?
• Does she have friends?
• Does she tell me what's going on in her life?

If you've noticed changes or you have some concerns, talk to a therapist or your teen's pediatrician. A trained professional can either give you peace of mind by saying your teen is fine, or they can provide guidance about how you can help your teen. It's always best to err on the side of caution if you're in doubt.

Signs That Professional Help Is Needed Immediately

There are warning signs of troubled teen behavior that you should be on the lookout for. These can be signs that your teen may be in immediate danger. Waiting to see if these problems go away is a bad idea because these problems are likely to get worse without professional help.

 If your teen is exhibiting these signs, seek professional help right away:

• Signs of depression
• Running away
• Participating in illegal activities
• Drug use
• Failing school: If this is the only problem, tutoring is a start, but talk to the guidance office as well. If there are other problems and this is just a symptom, seek counseling for your teen.
• Sexual acting out
• Self-harm/cutting
• Changes in friends or activities—especially if the friends are into drugs or other illicit activities.
• Eating problems: Have you noticed your teen not eating, overeating, or has she shown signs of purging after a meal?
• Inappropriate anger: Aiming angry feelings towards you or exhibiting violent behavior is cause for great concern.
• Increasing defiance
• Significant changes in mood or behavior

What to Do When You Think Your Teen Needs Counseling

If you decide to seek help for your teen, start by talking to your teen's doctor. A doctor can provide an assessment and help you decide if therapy or other resources could be helpful.

Perhaps you blame yourself for your teen's misbehavior. Or maybe you worry that you didn't recognize warning signs months or even years ago and that you should have gotten help sooner. It's normal to experience a wide range of emotions, ranging from regret to guilt when thinking about getting professional help. Don't let those emotions get in the way of getting your teen the professional counseling that can help get his life back on track.

Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

By Amy Morin, LCSW
Amy Morin, LCSW, is the Editor-in-Chief of Verywell Mind. She's also a psychotherapist, an international bestselling author of books on mental strength and host of The Verywell Mind Podcast. She delivered one of the most popular TEDx talks of all time.

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Recommendations for Pediatricians, Family Practitioners, Psychiatrists, and Non-physician Mental Health Practitioners.

Introduction
Child and adolescent psychiatrists are physicians trained to provide multi-system assessment, diagnosis, and treatment planning for children and adolescents with a psychiatric illness. Families seek the services of these specialists when they are concerned about the mental health of their child or adolescent. Others may present to a primary care physician, pediatrician, family physician, general psychiatrist or non-physician practitioner. Some managed behavioral health care organizations direct patients to non-physicians for initial evaluation. While many children and adolescents with mental health disorders are successfully treated by these practitioners, there are situations when intervention by a child and adolescent psychiatrist is recommended. The intervention is determined by a combination of factors including the:

• clinical presentation of the patient,
• training, skill and experience of the practitioner,
• family and environmental situation,
• availability of support services and personnel, and
• availability of a child and adolescent psychiatrist with relevant experience.

Types of Referrals
Practitioners should consider the following types of referrals:

• Referral for evaluation and ongoing treatment.
• Referral for evaluation and initial treatment with referral back for continued care.
• Consultation and an evaluation but without the assumption of ongoing medical responsibility.
• Consultation and an evaluation with continued supervision of treatment provided by other practitioners.
• Consultation without a face-to-face evaluation of the patient. This may occur through a treatment team within a clinic or an intervention team within a school.

In addition to these formal referrals, professionals may have informal professional discussion about patient care issues. These may also occur through informal processes such as a telephone, email or direct discussion with the treating practitioner and may be a prelude to a formal consultation request. Please note that physicians must adhere to all state and federal HIPAA regulations regarding transfer of information.

Specific Criteria for Referrals
The referring practitioner should consider the following criteria when considering the decision to refer.

1. When a child or adolescent demonstrates an emotional or behavioral problem that constitutes a threat to the safety of the child/adolescent or the safety of those around him/her. (e.g. suicidal behavior, severe aggressive behavioral, an eating disorder that is out of control, other self-destructive behavior),
2. When a child or adolescent demonstrates a significant change in his/her emotional or behavioral functioning for which there is no obvious or recognized precipitant. (e.g. the sudden onset of school avoidance, a suicide attempt or gesture in a previously well functioning individual),
3. When a child or adolescent demonstrates emotional or behavioral problems (regardless of severity), and the primary caretaker has serious emotional impairment or substance abuse problem. (e.g. a child with emotional withdrawal, whose parent is significantly depressed, a child with behavioral difficulties whose parents are going through a “hostile” divorce),
4. When a child or adolescent demonstrates an emotional or behavioral problem in which there is evidence of significant disruption in day-to-day functioning or reality contact. (e.g. a child/adolescent who has repeated severe tantrums with no apparent reason, a child reports hallucinatory experiences without an identifiable physical cause),
5. When a child or adolescent is hospitalized for the treatment of a psychiatric illness,
6. When a child or adolescent with behavioral or emotional problems has had a course of treatment intervention for six to eight weeks without meaningful improvement,
7. When a child or adolescent presents with complex diagnostic issues involving cognitive, psychological, and emotional components that may be related to an organic etiology or complex mental health/legal issues,
8. When a child or adolescent has a history of abuse, neglect and/or removal from home, with current significant symptoms as a result of these actions,
9. When a child or adolescent whose symptom picture and family psychiatric history suggests that treatment with psychotropic medication may result in an adverse response. (e.g. the prescription of stimulants for a hyperactive child with a family history of bipolar disorder or schizophrenia),
10. When a child or adolescent has had only a partial response to a course of psychotropic medication or when any child is being treated with more than two psychotropic medications,
11. When a child under the age of five experiences emotional or behavioral disturbances that are sufficiently severe or prolonged as to merit a recommendation for the ongoing use of a psychotropic medication, or
12. When a child or adolescent with a chronic medical condition demonstrates behavior that seriously interferes with the treatment of that condition.

If a patient is a member of a health plan that provides behavioral health services through a managed care network, the behavioral health care manager has the responsibility to locate appropriate care. The services of the behavioral health managed care organization should help the referring practitioner secure an appropriate referral/consultation.

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