Does My High-Achieving Kid Need Therapy?

When adults think of kids who might receive therapy services, they often think of externalizing behaviors —behaviors directed toward others, such as aggression, high conflict, discipline problems at home and school, etc. What can more often get overlooked is internalizing behaviors, which are directed inward and can be harder to see.

Adults generally feel less challenged by internalizing behaviors versus externalizing behaviors, so these kids can more easily slip through the cracks. These are the kids that teachers describe as “just perfect,” or never having any issues. High-achieving kids can often possess internalizing behaviors, but it might go unnoticed that they’re struggling on the inside because on the outside, they’re doing well academically, excelling in extracurriculars, maintaining friendships, and aren’t getting in trouble at school.

Listed below are internalizing behaviors you can keep an eye on, especially in your high-achieving kid:

- Perfectionism

- Low tolerance for making mistakes

- Low tolerance for mess, disorganization, or disorder

- Negative self-talk, especially when a child has perceived they’ve made a mistake or aren’t good enough in some way

- Low tolerance for “bad” or uncomfortable feelings being acknowledged, felt, or expressed; this could include children only ever presenting as happy or calm

- Avoidance of risk-taking or discomfort

- Somatic complaints, such as frequently experiencing headaches or stomach aches (and medical issues have been ruled out)

- Low tolerance for losing control and a lack of flexible thinking

- Nightmares or difficulty sleeping

- Masking behaviors, especially at school

- People-pleasing tendencies

It’s not always obvious if a high-achieving kid needs therapy - on the outside, everything seems like it’s going great. Your high-achieving kid might be doing totally fine, but if you’re noticing that they’re limited in their emotional range and expression, avoidant of discomfort and mistakes, and engage in masking behaviors rather than presenting as their authentic selves, it might be time to pause, get curious, and see if more support would be helpful.

Play therapy becomes a place where children can practice making mistakes, embrace mess, learn that their worth as a person is not attached to their achievements, and start to embrace their authentic selves.