In need of good counsel

`he was nearly 10, and he went through two months of being constantly frightened

`he was nearly 10, and he went through two months of being constantly frightened. He was crying all the time, would cling to me, hold me tight. Apart from going to school, he just wanted to be with me the whole time."

Aisling and her husband decided to look for a counsellor for her son at the point where his behaviour, which had no obvious cause, appeared to be getting really extreme.

Another mother, Elizabeth, sought counselling for her daughter when she was in her first year of secondary school. "She was getting over-anxious about her work right from the beginning, worrying obsessively about getting everything right. She began to drift away from friends, and spent all her spare time studying."

A decade or so ago, many Irish parents would not have thought of looking for a counsellor's help if their child was anxious or depressed or exhibiting unusual behaviour. But not any more: nowadays, it seems, parents are not at all inhibited about looking for a therapist if they feel counselling could help. And many are willing to pay privately - anything from £30 to £60 a session - to avoid long delays for appointments.

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But how do you decide when a child's problem is severe enough for him or her to need a counsellor? Most of us know by now to do something if a child is talking about suicide, or is being bullied, or appears to be anorexic. But what about lesser but still distressing problems? And how do you find a counsellor you and your child can trust?

Andrew Conway, senior clinical psychologist in the Mater Child Guidance Clinic in Dublin, feels parental instinct is probably the best guide: "If parents themselves feel something is just not right, they should do something about it. I see a lot of parents who say `I wish I'd done something about this when he was eight', when now he's 16 and depressed."

Usually, Conway says, there are several indicators. "First, the parents have a niggling concern. Then they'll be talking to their child's teacher, who says something like `I feel he's a little highly strung' or `He's very shy, isn't he?' and something clicks.

"Very often, parents start with me saying, `We were at a parent/teacher meeting last week and decided we'd better do something'." Conway has a brisk, commonsensical approach to the business of psychology: "Most therapy is focused and brief, and should take, at maximum, probably eight sessions." (This is good news if you're planning to pay privately.)

If you're unsure, ask questions, the professionals say, and use the resources easily at your disposal: talk to other parents to get some sense of whether your child's behaviour is appropriate for his or her age; talk to other adults in his or her life - a class teacher in primary school, a guidance counsellor in secondary school.

You can explain your fears (in confidence, because privacy may well be important) and ask these people if their observations of your child agree with yours and if they can help - or get them to refer you on to somebody else.

Getting a counsellor by word of mouth - a recommendation from another parent - is probably as good a way as any other, says Conway; a spokeswoman for the Psychological Society of Ireland agrees. Conway also recommends asking your GP for advice.

Dr Adrian Hynes, president-elect of the Irish Medical Organisation and chairman of the IMO's GP committee, says it is important first to rule out any physical cause of a problem. "Bedwetting is a good example; it could have a psychological cause, or be due to a low-grade urinary infection."

Persistent stomach aches might not be school refusal; persistent headaches could be stress, a serious, hard-to-detect illness or just a child needing glasses.

Hynes says a GP is the best person to advise on whether counselling is needed, and to recommend what kind - psychological or psychiatric - is appropriate. Some parents might fear that a GP will somehow disapprove of the counselling option; this fear, he says, is unfounded. "Many doctors nowadays are trained in some kind of counselling themselves."

Breda Coyle of the Institute of Guidance Counsellors and Lee MacCurtain, a senior psychologist with the Department of Education's Schools Psychological Service, also caution about jumping too quickly to the conclusion that a child needs therapy.

Coyle points out that guidance counsellors in second-level schools are more than just careers advisers, and do have counselling skills. Overworked as they are, they probably will find time to talk to you or your child; they might either counsel themselves or refer you on.

MacCurtain says it's also important not to underestimate the power of a friendly adult sitting down and really listening to a child before looking for outside help. If the child is young, this might just mean a parent sitting down to play cards or to draw with them and letting the child open up - without interfering with comments or instant advice. (Listening, as anyone who's been on a parenting course knows, is a skill that many of us have to learn.)

MacCurtain, like many of the professionals, adds that a parent can talk to a counsellor first, to get advice, and the child might never need to see the counsellor.

Aisling's GP referred her and her distressed nine-year-old to a very good counsellor, who had one long session with her son at a point when his crisis was coming to a head; that seemed to resolve things. (It seems he was fastforwarding through puberty at a very young age, and was grieving for his vanishing childhood.)

But a year later her son's behaviour in school was becoming uncontrollable. This time, she ended up going for a few counselling sessions without him, to help her get a handle on the situation.

The good news is that, despite the constant talk about how difficult it is to get appointments, there are a lot - a bewildering lot - of counsellors out there, all over Ireland.

If you cannot afford to pay privately, it could take up to six months to get an appointment; but if it is an emergency, a child will be seen within a week, Conway says. Don't assume you can't get help quickly, or that you will need multiple sessions.

All health boards have child guidance clinics, and there are counsellors working all over the State, not just in Dublin. Also, some therapists have a sliding scale of fees, so people on low incomes may not have to pay as much as the minimum average £30 per session.

If you want to go looking for a counsellor directly, don't go leafing through the Golden Pages - where a brief glance reveals the telltale dimensions of a boom industry. So far, there is no statutory registration for counsellors and undoubtedly there are some unqualified people practising.

A body like the Psychological Society of Ireland, whose members will all have a minimum of a degree in psychology, can provide names of people in your area, with advice on who specialises in what.

Ask for what you want straight out, Conway says; if your child fears spiders, ask for a child psychologist who deals with this phobia. Ask what accreditation a counsellor has and make sure you're happy with the answers.