Psychological therapy in preschool — when your child needs a child psychologist | Blog

„Does my child need a psychologist?” — one of the harder questions a parent asks themselves. On one hand nobody wants to „medicalise” natural development. On the other — you sense something’s off, and you don’t know whether it’s a phase or a signal that support is needed.

At our preschool in Saska Kępa a child psychologist works on site, on staff. That means seeing children in the group every day, knowing the family context (parent conversations), and being able to move smoothly from observation to intervention. This article was written from 16 years of experience by our psychologist Klaudia Markiewicz (SWPS, food therapy, QEEG Biofeedback) and her conversations with parents asking „is this the moment to do something?”.

What a child psychologist does in practice

A child psychologist doesn’t „cure” the child. They work with the child on their way of experiencing the world — emotions, relationships, behaviour regulation. They often also work with the parent and the family system, because a child’s difficulty is often a signal of changes/tensions across the family.

It’s a different model from adult psychotherapy. You can’t sit with a 3-year-old and talk for 50 minutes. A child psychologist works primarily through play — figures, games, drawing, costumes. The child enacts their conflicts, fears, dreams. The psychologist accompanies, names, suggests strategy.

For older children (5-6 years) more direct conversational elements are introduced. But the foundation is the same — a safe space where it’s allowed to feel everything, without judgement.

Signs to consult a psychologist — 3-year-old

At age 3 emotional difficulty often expresses through body and behaviour, not words. Signs worth attention:

Separation anxiety stronger than peers. Adaptation still hard after 3-4 weeks, the child cries daily, doesn’t want to enter the room, repeats „I won’t go” at home in the evening. Our standard adaptation takes 2-3 weeks — if it stretches longer, we engage the psychologist.

Developmental regression. A child who was potty-trained starts wetting again. Spoke in sentences, now only single words. Slept alone, now wants to be in the parent’s bed again. A short regression after stress (move, sibling birth) is normal, prolonged is a signal.

Tantrums more intense than peers. All 3-year-olds have tantrums (typically 1-3 times daily, lasting 5-15 min). Signal: tantrums lasting 30+ min, aggressive toward self/others, occurring a dozen times daily, the child unresponsive to parent’s presence.

Social withdrawal. The child doesn’t engage with other children, plays alone in the room, stands aside at the playground. At this age preferring solo play is fine — but the child should also want to join others sometimes.

Food refusal, eating regression, restrictive diet. All 3-year-olds have „I don’t like this” phases. Signal: child limits to 5-7 products, refuses to try new things, loses weight.

Signs — 4-5 year old

At ages 4-5 the child starts naming emotions. Difficulty expresses as a mix of body, behaviour and first words.

Specific fears. Afraid of darkness (typical), spiders (typical), but also: masks, a clown at the theatre, vacuum noise, leaving home. Fears that realistically limit family activity.

Excessive confidence / denial. A child who never admits a mistake, always right, blames others. Often a defence strategy against fears about self-worth.

Difficulties at preschool. Conflicts with children, constant „they don’t want to play with me”, stories about „the teacher is mean”. Ask the teacher for her version — often she sees differently.

Difficulty concentrating. Doesn’t finish tasks, moves from activity to activity, „distracted” in the group. The line between age norm and ADHD diagnosis signal — unclear, needs 3-6 months of observation.

Frequent psychosomatic complaints. Stomach aches without medical cause, headaches, sleep problems (long falling asleep, night fears). The child’s body communicates what the mind can’t yet name.

Signs — 5-6 year old (school readiness)

The first year before school is often when difficulties hidden in the safe preschool group surface.

Anxiety from comparison. The child compares with peers („Antek already reads, and I don’t”), loses confidence. A sign they need self-esteem reinforcement.

Learning difficulties. Doesn’t remember rhymes, gets lost in sequences (days of week, months), difficulty with hand-eye coordination (can’t draw a line). May signal specific issues (dyslexia, developmental dyscalculia) — needs consultation.

Regressive behaviour under stress. Cries before a test, doesn’t want to go on a school trip, has crying fits the evening before the first school day.

Difficulties in mixed groups. OK in the preschool group, but won’t participate in extracurriculars (dance, swimming). Fear of new social situations.

What happens at the first consultation

At our preschool the first step is observation in the group — our psychologist sees the child in their natural environment 2-3 times (different situations: play, meal, conflict, independent work). Takes notes but doesn’t intervene.

Second step: conversation with the parent (45-60 minutes). Without the child. Questions:

When did what worries you start?
What’s happening at home? (routine, atmosphere, recent changes)
How does the child fall asleep, sleep, wake?
How do they eat?
How do they react to separation, to others’ presence?
Were there similar difficulties in the family?

Third step: diagnostic consultation with the child (30-45 min). Most often free play, sometimes specific tasks (Family Drawing Test, free story-telling with figures).

Fourth step: closing conversation with the parent. What the psychologist sees, hypotheses, recommendations:

Is therapy needed? What form, how often, for how long
Or is home modification + monitoring enough
Are additional diagnoses needed (speech therapist, child psychiatrist, neurologist)
What specifically can the parent change NOW

All of this is usually within 2 weeks of the first signal.

How therapy differs from workshops / clubs

This is often confusing. Psychological workshops (e.g. „emotion-coping workshop” for 4-5 year olds) are group classes run methodically, with a specific programme, for children without deep difficulties. Good for everyone but don’t replace therapy.

Psychological therapy is individual or small-group work with a child on a specific challenge. Individual goals. Frequency typically 1× a week, over 3-12 months or longer. Has diagnostics and effect evaluation.

At our preschool we run both — group workshops (e.g. TUS = Social Skills Training for 4-6 children, 1× a week) and individual therapy (1-on-1 sessions with the child). The choice depends on the need — we help decide.

When a child psychiatrist instead of a psychologist

Sometimes a child’s difficulty requires a psychiatric consultation (medical doctor + possibly medication), not just psychological. Signs:

Very strong anxiety states not responding to psychologist’s work
Depressive symptoms in older children (5+) — loss of interests, anhedonia, prolonged sadness
Tics, obsessions, compulsions
Suspected ADHD requiring formal diagnosis
Autism spectrum — diagnosis made by a team with a psychiatrist

Our psychologist cooperates with several child psychiatrists in Warsaw. If we see it’s needed — we recommend specific specialists.

What the parent can do NOW, before booking a psychologist

Some difficulties resolve through home modifications — without therapy. Worth trying:

1. Daily routine. Sleep, food, activity at consistent times. A child with chaotic routine often has chaotic emotions.

2. Reduce screens. Especially evening (1-2 hours before sleep). Blue light + fast image cuts dysregulate the nervous system.

3. „Mere presence” time with parent. 15-30 minutes daily when the parent IS with the child, WITHOUT phone, WITHOUT plan. Just shared game/walk/play.

4. Naming emotions. „I see you’re angry. That’s because…” Instead of „don’t get angry”, „calm down”. A child whose emotions are named learns to recognise and regulate them.

5. Reduce the schedule. Sometimes the child is simply overloaded — preschool + 2-3 extracurriculars + weekend trips. Free time (boredom) is essential for development.

If after 2-4 weeks of modifications there’s no improvement — then psychologist.

How to start at Siedmiu Krasnoludków

If your child is at our preschool and you observe something that worries you — talk to the group teacher. She sees the child daily, has good context, and can do a preliminary assessment. Next step is booking with our psychologist Klaudia Markiewicz — a brief diagnostic consultation, decision on next steps.

If the child isn’t with us but you’re looking for a child psychologist in Praga-Południe — we can recommend specialists from our team’s referral network. Call: +48 510 915 565 or email: biuro@siedmiukrasnoludkow.pl.

Our whole therapy team is available for our preschoolers in their tuition (consultations, TUS workshops, individual therapy up to 4 sessions monthly). For children outside the facility — sessions paid individually.

Psychological therapy in preschool — when your child needs a child psychologist