Divorce:Parents are the most important people in a child's life. When parents can no longer live together and choices must be made, children are deeply impacted. Their sense of security and safety are threatened, even in the "best" of divorces. Children often become angry, feel abandoned, and/or feel like the divorce was caused by something they did or did not do or say. Children who witness or overhear their parents' arguments have a more difficult time than those who do not. Self-esteem and self-confidence are often shattered for everyone in the immediate family, including children, when a divorce occurs. http://www.childrenanddivorce.com

Death Loss: The death of a parent or other close loved one brings overwhelming emotions. One six year old child described to me that losing his mother was like someone "sticking a hand in his chest and ripping his heart out". Children often hide their pain from a grieving parent to avoid adding additional burdens to the family. A grieving child needs a safe place to begin to work through the pain of loss and move toward healing. http://www.childgrief.org

Domestic Violence: Witnessing or being victimized by domestic violence, whether physical or verbal, is very disturbing to a child. A recent study published in the Journal of Pediatrics (146(3):309-310) found that children who had been exposed to violence suffered symptoms of post-traumatic stress disorder, bed wetting or nightmares and increased health problems. For more information on the effects of domestic violence, visit this link: http://www.acadv.org/children.html

Trauma and Abuse: Emotional and psychological scars from trauma and abuse can be long-lasting and severe. Eating disorders, drug abuse, anxiety and depression are a few of the possible outcomes for untreated trauma and abuse. Children are traumatized when they are abused physically, emotionally, sexually, and/or through neglect. Child abuse is defined as any act, or failure to act, that endangers a child's physical or emotional health and development. I am required by law to report any suspected or disclosed child abuse or neglect. Therapy can help a child develop healthy coping skills to address the scars of trauma and abuse.

Low Self-Esteem: Children develop low self-esteem from a number of causes, including all of those listed above. From early in life through adolescence, children have a tendency to blame themselves for whatever is amiss in their lives or their loved one's lives. Divorce, the death of a loved one, domestic violence, verbal abuse, abandonment and other forms of emotional abuse profoundly impact a child's feelings of self-worth. With therapeutic support, a child can begin to build a stronger sense of self and self-worth.

Behavior difficulties: Children act out intense feelings in ways that can be very upsetting to parents. Anger, rage, withdrawal, acting younger than their current age, bed wetting, lying, cheating and other surprising behaviors are a sign that your child is struggling with something. He or she may not have the words to express the source of their troubles. When your child is "acting out", it is time to turn your attention and efforts toward finding the root of the problem.