Key points: 

• There are three basic paths when it comes to pediatric mental health care: therapy, medication, or psychological assessment. Often, families benefit from one or more of these working together. 
• It can be hard to know where to start unless there are clinicians or tools to guide you. 
• Starting with therapy is ideal when symptoms are mild or moderate. 
• Adding medication management may be considered when symptoms are more severe. 
• Testing is conducted when there are concerns about developmental disorders such as autism, learning disabilities, or other complex conditions.
• In many cases, these interventions work best together — especially when they’re coordinated by a care team that understands your child as a whole.
• A diagnosis can come from any of the above paths, and a diagnosis isn’t necessary for starting therapy or medication management. 

You've noticed changes in your child. They are more withdrawn than normal. Or, perhaps their teacher expressed concerns about attention or behavior. Whatever the case, you are now wondering, “How can I best help my child? What kind of support do they need?” These questions don’t mean you’ve waited too long or done something wrong. They usually mean you’re noticing early signs and trying to act thoughtfully, which is exactly when support can be most effective.

When it comes to mental health care, there are several options. The main options for kids and teens are medication and therapy. If further diagnostic testing is needed, psychological testing can help inform treatment. You may feel overwhelmed trying to figure out which one is the right choice.  This is a hard decision, and there is no universal answer that applies to every child. 

The good news is that understanding more about each type of support can help you make the right choice and feel more confident about getting your child help. 

Why this decision feels so hard for parents

It can be hard for parents to know what kind of support their child needs, because there are several different choices and levels of care. 

This is something that millions of other parents are also facing. Childhood mental health concerns are not rare. In the United States, as of 2021, 1 in 5 children aged 6-17 years had at least one current mental, emotional, or behavioral condition. However, only about half of children with these disorders receive the mental health treatment they need, according to the latest data published in the Journal of the American Academy of Child and Adolescent Psychiatry.

Three types of support and what each one actually does

The first step is to understand what you're actually choosing between. There are three core paths when it comes to mental health care for kids and teens. Each option serves a different purpose, and most work better together than alone.

Therapy

Therapy is an intervention that helps kids and teens learn how to manage their emotions and behaviors. Therapy works effectively for a range of symptoms and behavioral changes, from depression to obsessive-compulsive disorder.

Therapy helps children build skills, like emotional regulation, coping, and communication, that support them long after treatment ends.

One of the most well-known (and most studied) approaches is Cognitive Behavioral Therapy. This type of therapy focuses on the connection between thoughts, feelings, and behaviors. The American Psychological Association describes CBT as particularly effective for anxiety and depression in children. The benefits tend to last because kids learn skills they can use for life.

Family therapy can also be very helpful when parent and sibling relationship patterns contribute to your child’s struggles. For younger children who aren’t yet developmentally ready to talk about their feelings, play therapy is often used. 

Therapy can be very helpful beyond symptom relief. The National Institute of Mental Health emphasizes that psychotherapy provides children with the tools and strategies that they need long-term to thrive. It helps them build resilience, develop coping skills, and better understand their emotions.

Medication

Medication can be a helpful part of a treatment plan for children, adolescents and teens, particularly when symptoms are severe or when there are concerns about self-harm or suicidal behavior. 

Medication reduces symptom intensity by changing the way that neurotransmitters work in the brain. Usually, medications are combined with therapy for the best approach.

For a child with severe depression, this might significantly improve their mood and allow them to participate in therapy. And, for a kid with ADHD, it might help them focus better. It's important to note that psychiatric medication for children is carefully monitored. 

According to the American Academy of Child and Adolescent Psychiatry, medication decisions should always involve evaluation by a qualified health professional who specializes in pediatric mental health.

Many parents believe that once their child is on medications, they will be on them forever. That isn't often the case. For many kids, medications help improve symptoms, which can then be treated with other interventions instead, like therapy. 

Psychological testing

Psychological testing is often helpful when there are concerns about ADHD, autism, or learning disorders. Testing can help your child get specialized, targeted support if they are struggling. 

Testing is an important part of early intervention for things like autism and other developmental disorders. Early identification of autism spectrum disorder and learning disorders is important. According to the CDC, when ADHD and autism spectrum disorder are caught early, it often leads to better outcomes. 

The proper diagnosis enables children to access important school accommodations and evidence-based treatments and services that they might not have access to otherwise. 

When is therapy the best place to start? 

For many families, therapy is the best starting point. It makes sense when your child is having a hard time, but still manages to get through the day. Signs that therapy might be the right first step include: 

• Excessive reactions to stress 
• Persistent sadness or worry that doesn't go away
• Social withdrawal or avoiding things they used to enjoy 
• Difficulty managing anger, fear, and other strong emotions 
• Having a hard time making friends or navigating social situations
• Unexplained physical complaints (headaches or stomach aches) 

Therapy is effective for a number of conditions, including anxiety, depression, and behavioral challenges. It is a supportive place to begin. 

When medication may be appropriate

Medication becomes part of the conversation when symptoms are moderate to severe, when there are safety concerns, or when therapy alone isn’t enough. Medication decisions are best when they are made collaboratively between families and clinicians. 

Several different psychiatric medications can be used in children and teens. These include anxiety medications for children, depression medications, and ADHD medications. 

Specific signs that medication may be considered include severe mood changes, suicidal thoughts, self-harming behaviors, or significant anxiety. So, for instance, if your teen has depression that makes it hard to get out of bed in the morning, even after sleeping 10+ hours a night, a medication evaluation might be helpful. Another example is a child with ADHD symptoms that create significant academic problems or social impairment. 

Many parents worry about side effects with the medications, or are concerned that they will make their child into a “Zombie.” These concerns are understandable. However, most of the time, side effects are mild. And, most kids don’t have a flattening of emotions. 

Antidepressants do carry a Boxed Warning from the FDA for an increased risk of suicidal thoughts or behavior. This risk is greatest at the beginning of treatment. Close monitoring by a psychiatrist can help lessen the risk of this. 

If your child is on medication, keeping appointments for regular check-ins is important. Also, therapy plus medication typically yields the best outcomes for anxiety, depression and other mental health conditions. 

When ADHD or autism testing is helpful

If any of the following are present, you might consider ADHD or autism testing before therapy or medication. 

• Teachers are raising concerns about learning or your child is having trouble with paying attention in the classroom 
• Your child has tried therapy or other interventions already, and has not made much progress
• You notice developmental differences (example: speech delays). 

When it comes to identifying autism spectrum disorder, the earlier the diagnosis, the better. This leads to improved outcomes. For autism specifically, getting a diagnosis early can make a significant difference in communication and social development.

Like with autism spectrum disorders, getting an ADHD evaluation earlier is significantly better for outcomes. ADHD testing for children involves a combination of observation, questionnaires, and sometimes other assessments. This helps distinguish ADHD from other conditions that can look similar, like learning disabilities or anxiety. 

One important point: you don't need a formal ​​child psychological evaluation or diagnosis to start therapy, but having one can unlock specific accommodations, especially at school. 

An official ADHD or autism spectrum diagnosis often qualifies children and teens for specialized services and accommodations that wouldn't otherwise be available. A comprehensive evaluation provides a detailed written report that helps you understand your child’s strengths and needs better. 

How these options work together

The most effective mental health care plan is usually not just medications or therapy. It's often a combination that may include therapy, medication, and sometimes testing. Care evolves with your child's needs.

Here’s how that looks in real life. A child with ADHD might take medication to help with impulse control, focus, and concentration while also working with a therapist on emotional regulation and relationship skills. 

A teen with depression might start medication to reduce severe symptoms, like self-harm, and then engage in therapy once they are better able to work on underlying issues contributing to depression. 

Testing often comes first when the picture is unclear. This can then guide treatment planning. Once you know what your child is dealing with, you can choose interventions that target these specific challenges. 

The key is staying flexible. Your child's needs will change. The approach that works when they are 9 years old will likely need adjustment at 14. Mental health care with Emora is not one-size-fits-all. It’s flexible, iterative, and designed to change as your child grows.

You try something, see how it goes, and adjust if it doesn’t work. 

Personalize intake session with a licensed clinician

Explore therapy, medication, or other options and determine the best next step through a personalized intake session.

Start an intake session

A simple decision framework for parents

If you're still a bit confused and not sure where to start, here's a helpful framework:

• Mild to moderate symptoms. Your child is struggling but still able to function okay most of the time. For example, they have mild irritability or anxiety from time to time. In this case, therapy is a good first step. It can help your child better identify and understand their emotions, build skills, and improve relationships. A good therapist can assess whether additional support is needed.
• Urgent or severe symptoms. Your child has a significant impairment interfering with their daily life, or there are safety concerns. For example, they talk of wanting to die. Consider a medication evaluation right away, along with therapy. Don't wait for a breaking point to get help. 
• Unclear symptoms. You're not sure what's causing your child to struggle or their symptoms are unclear. Consider testing with a psychologist who can help you figure out what's going on.
• Developmental concerns. Your child has significant speech delays, unusual behaviors, or social differences that seem beyond shyness. Pursue psychological testing early. 
• If you’re unsure what to do, a clinical intake session can help. You’ll meet with a licensed clinician who can help you weigh therapy, medication, or other options and guide you toward the right next step — without committing to treatment right away.

The Emora Health difference

At Emora Health, we understand that these decisions are hard, and that you shouldn't have to navigate them alone. Unlike other online therapy platforms, Emora Health is built specifically for children, teens, and young adults — not adapted from adult mental health care.

with an integrated care team that can provide therapy, psychiatric medication management, and psychological testing all under one roof.

We are a collaborative team. Your child’s therapist, psychiatric provider, and evaluation team work together — sharing context and adjusting care as a group, rather than operating in silos.

You're not juggling multiple appointments at different offices with professionals who've never spoken to each other. Everything is connected, and you're included in every step.

We know that supporting your child's mental health affects the whole family. That’s why we incorporate parents into treatment with helpful family sessions, when appropriate.

Whether you need a clinical intake session to explore testing for ADHD or autism, or need to connect with medication management services, we can help. We offer specialized support for kids, teens, and young adults. 

Parents’ most frequently asked questions

Do I need a diagnosis before starting therapy?

No, a diagnosis is not necessary. Many children start therapy without a formal diagnosis, and that's perfectly fine. Some therapists can diagnose mental health disorders. But it’s not required to begin therapy. 

What if we choose the wrong first step?

There is no “wrong” first step. If you start with one intervention and figure out you actually need another, that is not a problem. There's no penalty for changing course. In fact, it’s almost to be expected. 

Is medication a last resort?

No. While it's true that therapy alone is often effective for mild to moderate symptoms, medication isn't something you should avoid because you think your child’s issues are not serious. Taking mental health medication early can prevent some more serious symptoms, just as taking medication for your physical health does. 

Should my child take medication? 

This is a decision that should be made along with a physician (psychiatrist) or prescriber. It’s a very personal decision and depends on many factors. 

Can we change treatment plans later?

Absolutely. Children grow and change, and so do their needs. Many kids start medication and eventually taper off. Other kids begin with therapy and later add other services and supports. The treatment plan should change to meet your child’s unique needs. 

Important: The information in this article is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or qualified mental health provider with any questions you may have regarding your child's mental health.