Child Counseling in Salisbury and Bethesda, Maryland
Child counseling helps children with worries, strong emotions, behavior and school problems that are getting in the way of daily life. Because young children often cannot explain how they feel, therapy with them can include talking, playing and other activities, and parents or caregivers stay involved. We see children in Salisbury and Bethesda.
Who it helps
A child who seems fearful or worried much of the time
Frequent tantrums or irritability that feel bigger than the situation
Stomachaches or headaches with no medical cause found
Grades that have dropped, or a child who now resists going to school
Trouble making or keeping friends
A child adjusting to a move, a loss or changes in the family
Signs a parent might notice
Parents are usually the first to see that something is off. Every child has rough days, so one bad week is not a reason to worry. What matters is a change that lasts, or one that other adults in your child's life have noticed too.
These can be signs that a child would benefit from an evaluation by a mental health professional:
Frequent tantrums, or being irritable much of the time
Often seeming fearful or worried, including regular refusal to go to school or to sleep
Frequent physical complaints, such as stomachaches or headaches, with no known medical cause
Being in constant motion and unable to sit quietly, beyond ordinary play
Sleeping too much or too little, or persistent nightmares
Little interest in playing with other children, or difficulty making friends
A marked fall in school performance, or poor grades despite trying hard
Repeating actions or checking things many times out of fear that something bad may happen
First, a conversation at home
A gentle, honest talk about feelings is a good first step and can often help. Pick a calm moment, use words that fit your child's age, and listen more than you speak. Your child's doctor or teacher may also have useful observations.
If the problem continues over time, or others who know your child are concerned, it is reasonable to ask for a professional opinion. Seeing a counselor does not mean something is wrong with your child or with your parenting. Our article on how to talk to your child about therapy has wording you can borrow.
If your child talks about wanting to hurt or kill themselves, treat it as an emergency. Call or text 988 or call 911. Our office does not provide emergency services.
How counseling works with younger children
Adults talk through their problems. Many children cannot do that yet, so their therapy looks different. Psychological therapy with children can include talking, playing or other activities that help a child express feelings and thoughts.
In play therapy, the therapist may use toys, blocks, dolls, puppets, drawings and games to help a child recognize, name and put words to feelings. The therapist watches how the child uses the materials and looks for themes or patterns. To a child it feels like play. To the therapist it is a way of understanding what the child cannot yet say.
With older children, sessions may involve more conversation and more skill practice, such as what to do when worry or anger starts to build. Several of our clinicians use cognitive behavioral therapy, an approach that looks at the links between thoughts, feelings and behavior.
Our Salisbury office has a play area for children.
What parents and caregivers do
Share the background. At the start, the therapist invites you to describe what has been going on, when it began and what you hope will change. An evaluation typically includes talking with parents and may include information from school.
Stay involved. Even when the therapist works with your child directly, it is important for parents or caregivers to be part of treatment. That may mean joining part of a session or meeting with the therapist separately.
Practice at home. You may be given something to try between visits, such as a new bedtime routine or a way to respond to meltdowns. Children learn skills faster when the adults around them use the same approach.
Ask how progress will be shared. Good questions to ask early: how will we be told about our child's progress, how often will you meet with our child, and will you see our child alone or with the family.
School concerns
School is often where a child's difficulties show up first: falling grades, trouble sitting still, tears at drop-off, or calls from the teacher. Counseling can help a child build skills for the classroom and can help you understand what is behind the behavior.
Children whose challenges interfere with school may also benefit from plans or accommodations provided by the school. You can ask your child's school what options exist. If you would like the therapist and the school to share information, talk with the therapist about how that would work and what permission is needed.
When the strain is felt by everyone at home, family therapy may be suggested alongside or instead of individual sessions for your child.
Privacy, appointments and cost
Parents and guardians are part of a child's care, and children also need to feel comfortable, safe and understood with their therapist. How much detail from sessions is passed on to parents depends on the child's age and the situation, so ask your child's therapist at the first visit how information will be shared. Therapists must act if there is a risk of harm and must report suspected abuse.
Appointments are available in person and by telehealth through both offices. Whether telehealth suits your child depends on their age and attention, and on where you are located during the session. Please ask when you call.
We accept a number of insurance plans, including Medical Assistance / Medicaid. Coverage depends on your plan, so verify benefits first. Self-pay rates and our Sliding Fee Program are on the insurance and fees page.
Getting started
Call 443-978-8688 or use our new patients page.
Tell us your child's age and your main concern in a sentence or two.
Ask any questions about who should come to the first visit.
Frequently asked questions
How do I know if my child needs counseling or is just going through a phase?
Look at how long it has lasted and how much it gets in the way. A change in mood, sleep, behavior or schoolwork that continues over time, or that teachers and relatives have also noticed, is worth a professional opinion. An evaluation does not commit you to treatment. It can help you understand your child's emotions and behavior and decide what to do next.
Will I be in the room during my child's sessions?
It varies. With young children, a parent is often present for some or all of a session. With older children, the therapist may spend most of the time with the child and then bring you in. Parents and caregivers stay involved either way. Ask the therapist at the first visit how they plan to structure sessions for your child.
What will the therapist tell me about what my child says?
Therapists keep parents informed about goals and progress, while giving children enough privacy to speak freely. The exact balance depends on your child's age and the situation, so ask the therapist directly how information is shared. Safety is the exception: if a child is at risk of harm, or abuse is suspected, the therapist is required to act and to report.
Is play therapy just playing?
No. Play is how many young children communicate, so therapists use toys, drawings and games on purpose. The therapist watches for themes in how a child plays and uses them to help the child recognize and put words to feelings. It may look relaxed from the outside, but the activities are chosen with your child's goals in mind.
Does insurance cover counseling for children?
Many plans include mental health benefits for children, but what is covered depends on your specific plan. Call the number on your insurance card and ask about outpatient mental health visits for your child, your copay and any deductible. If you do not have coverage, ask us about self-pay fees and the Sliding Fee Program, which is based on household income and family size.
Can young children do therapy by telehealth?
Telehealth appointments are available, but whether they suit a child depends on age, attention span and the reason for coming. Some children engage well on video, and others do better in a room with a therapist. Availability also depends on where you are located during the session. Tell us about your child when you call and we can talk through the options.
What should I tell my child before the first visit?
Keep it short and honest. You might say you are going to meet someone whose job is to help children with worries and big feelings, and that there will be time to talk and play. Let your child know they are not in trouble. Avoid promising what will or will not be discussed, since you do not know yet.
Ready to talk with someone?
Call 443-978-8688 or request an appointment. We see clients in person in Salisbury and Bethesda and by telehealth across Maryland.
Sources
American Academy of Child and Adolescent Psychiatry: When To Seek Help For Your Child
National Institute of Mental Health: Children and Mental Health: Is This Just a Stage?
Centers for Disease Control and Prevention: Treating Children's Mental Health with Therapy
If you are in crisis or thinking about suicide, call or text 988. In an emergency, call 911.
