When a Baby Needs Mental Health Treatment


Most of my career has been devoted to play therapy and the mental health treatment of children ages 0-5-with a particular focus on trauma. When I tell people this they often understand the play therapy and trauma piece but act quite surprised at the 0-5 aspect. In fact, I even had a mental health professional say they don’t “believe” in therapy for children under the age of 3. I felt like saying “I’m sorry is this a well-researched area of psychotherapy or a mythical unicorn?” There is actually a large body of research and evidence to support not only the effectiveness of this treatment but also its importance. It’s hard to explain your career and passion in a few short tidbits so I usually give a line or two to satisfy the curiosity but it always leaves me a bit sad knowing that most people are very unaware that infants and young toddlers experience mental health problems and can be helped.

The good news is more attention is being paid to language and learning in the first 3 years of life because of the rapid brain growth that takes place during this time. Most parents know that babies can only learn to speak if they are spoken to and only show an interest in books if they are read to. And in the same regard, babies don’t learn empathy if they aren’t empathized with. Babies are fully capable of all the feelings we feel-joy, sadness, fear, anger, etc. However, these feelings are felt as bodily sensations and they have no ability to talk about these feelings and very limited understanding of what these feelings mean.

Let’s talk trauma for a moment. Parents sometimes say, “I just want her to forget this happened”. But the truth is trauma is stored in the body and PTSD can happen in infancy and early childhood. For example, a young child might recoil with fear when hearing loud voices if exposed to domestic violence in the home as an infant. That child will never say that he remembers hearing mommy and daddy fight but their little body remembers the fear associated with yelling. Parents may say that their baby was always anxious or “jumpy” at loud sounds but upon a closer look, there may have been a trauma.

So then what everyone wants to know is what do you do with a baby in therapy? I always imagine people picture a baby sitting on my therapy couch telling me about their day. But in all seriousness, almost all the focus is on the relationship with the baby and an invested caregiver. We watch the baby’s reaction to their environment, I support the caregiver in creating a calm environment for baby, and we increase the stability of the parent-child relationship to create a strong foundation for mental health. If a baby is constantly screaming and the parent checks out because they can’t deal with the screaming-we address that. If the parent has their own trauma, which they often do, we work on that. It’s a complicated process at times but one that can have lifelong benefits.

When living in California there were a plethora of programs to help babies and young toddler-especially those detained by child protective services. In my short time in Indiana, I’ve seen that these services are severely lacking in our state. There are programs for babies that address speech, physical therapy, and OT….but where is the mental health?

Change starts with advocacy for these vulnerable babies that can’t speak for themselves. I wish I had more advocacy steps for Indiana residents to take but I’m just figuring it out myself. I’ve recently joined Infancy Onward, which is a group of individuals committed to strengthening relationships between infants, toddlers, parents, and other caregivers. Even if you aren’t a mental health professional, you can volunteer for this organization in many ways. And if being a formal volunteer isn’t in the cards, start with your own babies and educate others-babies and toddlers have mental health.