How do I tell my friend that I think her child might need to see a therapist?

Q: I babysit for a girl that shows no remorse or empathy for anything she does. Minutes after she gets in trouble, she acts like nothing happened and goes back to playing. How do I tell her mom that she may need to seek counseling without her taking offense to it?

A: Good for you for wanting to be proactive and advocate for this little girl's health and well-being!  

I assume it was my posts on remorse that prompted you to write, but if not, here they are:

Those might give you some idea about what's behind the apparent lack of remorse, as well as some ways you can interact with her that can support the development of empathy.

Other sources of info on this topic that I like:

As far as communicating with her mother, here's what I'd recommend:

First, let her know you'd like to talk with her for a few minutes about something important at a time when you won't be interrupted or overheard. Ask her to let you know when a good time would be. That puts her on notice so she doesn't feel blindsided, and allows her to prepare herself mentally and choose a time when she is in a relatively receptive mood.

When she initiates the conversation, take a few breaths to make sure you are calm and collected. Remind yourself silently of the purpose of this conversation -- to get your concern on her mother's radar without judging her or her daughter.

Begin by mentioning something positive about her daughter: I enjoy taking care of Betty so much - I love those sweet little tea parties she sets up with all her stuffed animals, and how she generously makes sure their tiny tea cups are always full. 

Then, mention your concern about not wanting to meddle or intrude: I hate to even bring this up because it might be something you are already aware of and I don't want to sound like I am meddling. 

Then, mention your concern about the child. Keep your words brief, like this: I am a bit concerned that Betty doesn't seem to react with remorse when she hurts another child or gets in trouble. Maybe it's just a phase, but I wonder if it might be worth getting the opinion of a professional in case she needs some extra support to help her develop more empathy. If there's something I can be doing differently when I am taking care of her, I would like to know so I can help her be her very best self. 

Then be sure to end with: What do you think? to give her the opportunity to share her reaction to what you've said, or voice her own concerns.

And after her mother speaks, acknowledge her perspective:  So you have noticed the same thing and have been wondering what to do about it.  Or, So you have not noticed this. Or, So you think it's pretty normal and she will grow out of it. 

Finally, see if you can leave the door open for a future conversation:  Ok, thanks for listening. Would it be okay for us to check in about this again in a couple weeks after we've both had a chance to observe the situation for a little while? In the meantime, if there's anything you'd like me to do differently when I am taking care of her, please let me know. 

This gives her mother time and space to allow the information to sink in, and she will most likely be watching her daughter's reaction a little more closely to see if there's a problem. Allowing people to draw their own conclusions in their own time and way is a very effective way to reduce the likelihood of a defensive reaction that could threaten your working relationship.

I hope this helps -- please feel free to share your thoughts and let us know how it goes if you decide to give it a try.

warm regards,

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