My friend has a 6 year old daughter who suffered from third degree burns a few years ago. The scars cover most of her body. Lately, since school has started, she has started acting out, hurting herself, and trying to hurt others. She often says she hates herself because she is ugly. My friend is lost and doesn’t know what to do to make her daughter see herself as beautiful. Should she get her in counseling?

A. Yes, your friend should seek counseling for her daughter. The fact that she is attempting to harm herself and others is a sign of the severity of the problem. Unfortunately, children can be very cruel. Her daughter may be experiencing bullying. Bullying can have a significant effect on a child which may explain why your friend’s daughter is acting out in such a negative way. The psychological effects of bullying can be very serious. Studies have shown that children who are bullied may suffer from depression, anxiety, or suicidal thoughts.

Children are not born with low self-esteem. They often learn to think about themselves based on the feedback they receive from others. In the case of a child who is being teased, he or she may internalize what others are saying about them.

This problem also needs to be explored with school officials. The mother should speak to her child’s teacher or the principal about the possibility that the child is being bullied. If the school is unaware of a possible problem, they will not be able to take action.

I believe counseling would be very effective for the daughter. Counseling can also teach the child’s mother ways to help improve her daughter’s self-esteem. If she is being tormented now, she may also experience this same type of cruelty in middle and high school. Because of this, it will be important for the daughter to develop a healthy sense of self-esteem as soon as possible. I wish her the best of luck. I thank you for being a caring friend.