By Manny Vazquez, M.S., LMFT, Early Childhood Psychotherapist, Well Versed in Play Therapy

Monday, July 27, 2026

One of my favorite populations to work with as a psychotherapist is the category of children age 0-5. I’ve mentioned in previous blogs that a child age 0 is actually when the mother is pregnant. So, yes, I have worked with many pregnant women in my many years of practice. I have also worked with many toddlers and their moms. I intuitively know what pregnant moms and children age 0-5 need to feel safe and to be mentally healthy.

I would like to focus on the wonderful age of zero for children. As I stated, this is when the mother is pregnant. I want to start here in this blog because it’s a natural place to start, at the beginning of life, and the implications for toddlers ages birth to 5 years old are obvious.

Whenever I conduct assessments on pregnant mothers, I know that technically I’m assessing and diagnosing the mom, but in the back of my mind, I’m thinking of the child in her womb. I know that if the mom is anxious, her child is feeling it. And likewise, for depression and really, any mental health condition that the pregnant mom has, it will necessarily affect her unborn child. You would think that this is obvious, but many people do not understand this basic concept.

I’m going to extrapolate something very important from the psychotherapeutic treatment of pregnant moms that is going to seem like a bit of a stretch, but it is a pretty basic concept when it comes to the mental health treatment of children age 0-5.

I mentioned that when I’m treating pregnant moms, I’m necessarily treating her unborn child because whatever is happening to the mom is also happening to the child. It has to be this way. There is no way to separate mother and child at this stage of life.

And this is where the idea of dyadic diagnosis and mental health treatment of mother and child comes from. With a child who is age birth to five, his or her mother is, or should be, the most important person in that child’s life. The bond between a mother and her child is the toughest to break in all of humanity. That is why programs like the Department of Children and Family Services are so detrimental to children and their families. In taking a child from his or her mother, no matter the reasoning or cause, you are attempting to break a bond that God Himself has fashioned. I’ve asked many mothers the following question, would you die for your child? And invariably, the answer I get from the Moms that I work with is, “Of course I would.”

I know that there are moms in the world who would selfishly hold onto their miserable lives than to hold onto their child. I’ve actually met only one mom who literally disowned her two beautiful adult daughters in my session. I pray that I never see such a horrible thing again. The good news is that these two young women were Christians, and as I walked them down the hall after the session, they told me privately, “We knew that if we chose a Christian therapist, this would happen.” Smart girls. Bad mom.

Getting back to the dyadic mental health treatment of children, invariably, when a mother brings me her toddler who appears highly anxious or depressed, I assess the child in view of what is happening in the mother’s life. Children are not designed with anxiety or depression built into their system. They have mental health maladies because of what their mom (or dad) is experiencing. I have seen this play out time and time again.

So, what is the solution to the poor mental health of toddlers? Well, you address the poor mental health condition of their moms (and dads sometimes), and then you consequently solve the problem of the poor mental health of the child. Every time, guaranteed. I have sat across from many moms who started taking care of themselves and who eventually resolved that own poor mental health and then watched their children follow suit.

And, one final thing, I would submit to you that older children are also a reflection of the mental health of their parents, and in all truth and honesty, this can be true of any person, even as they get older. Parents and children can share dynamics that lead to poor mental health, whether it is a young mom and her four year old toddler or a 50 year old Mom and her 25 year old son. Amen.