Quick Guide: When to Refer an Expat Child or Teen for Therapy

When therapy can help a child

Many expat/international/cross-cultural children and adolescents experience periods of sadness, stress, or struggle. Most of the time, this is transient and can pass on its own without professional intervention. Adults, teachers, school counsellors and others are often expecting a period of adjustment when a child is transitioning to a new country or feels pulled between two worlds. Every move, change or challenge doesn't necessarily dictate a need for therapy. However, sometimes it’s not transient — and fast, effective intervention can help get that child back on track quickly. So how do you know the difference? Here’s our quick guide for when to a child or teen (hereafter referred to as ‘child’) to a therapist.

1. Any signs of risk (to self, to others, or from others) indicates a need for therapy/referral to a therapist

If a child talks about:

• Hurting themselves or wanting to hurt themselves

• Wanting to die or not wanting to live

• Wanting to hurt someone else

• Being hurt by someone else, especially if this is an adult

It doesn’t matter if you feel the child is “bluffing” or it seems like a “throwaway comment.” This is something a professional therapist should assess.

2.There is a challenge causing significant distress or interfering with functioning. 

For example, the child may be unable to: 

• Attend social events due to anxiety

• Pay attention to schoolwork due to attentional difficulties

• Get to school on time due to low mood or sleep problems

• Make friends because of an explosive temper or difficulty reading social cues 

• Is being a bully or is being bullied 

3. A significant change from their usual self that lasts more than a few weeks

Kids have ups and downs. However, when we know them, we have a sense of what their usual “baseline” is. If you notice a change that lasts for more than a two to three weeks, this may indicate something is wrong. 

Changes you might notice include:

• A drop in academic performance

• Feeling sad or low most days

• Feeling anxious and avoiding stressful situations (exams, social events, school, etc.)

• Noticeable changes in appetite, sleep, and/or weight (increasing or decreasing in a short period)

• Significant shifts in personality or mood

• Difficulty concentrating, completing work, or paying attention

• Expressing “hating” school

  
  

4.  A period of transition (such as becoming an expat) accompanied by noticeable, negative change

1. International/national relocation

2. Parents separating or divorcing

3. Recent death or loss of a loved one

4. Exposure to a traumatic event

5. Struggles related to identity, including gender or sexuality

If any concerns persist for more than 2–3 weeks, interfere with daily functioning (learning, home life, friendships, etc.), or cause the child significant distress, it’s time to refer to a professional.

At Hola Therapy, we specialise in supporting international, bilingual and/or cross-cultural families. Please reach out if you’d like to discuss a concern or learn more about how we can offer support.