A recent national study indicated that by adulthood about 90% of youth will have qualified for a mental health diagnosis at one point or another. However, only about 20% of these kids get any kind of mental health care. So, if your child is showing some distress s/he is in a huge club. But, if you’re getting him/her help for it, you are in an elite club.
Different mental health professions may go about their work in different ways. This blog entry is meant to characterize how an evidence-based psychologist might proceed. (While there are always exceptions, psychologists are the doctorally trained mental health professionals who most commonly provide talking treatments.)
The first thing the psychologist will do is an evaluation. These are the elements I believe constitute a cost-effective, evidence-based evaluation (each of these elements has been endorsed by the Pennsylvania Pediatric Mental Health Task Force):
• A family interview (who is in this interview can vary but often both birth
parents and the child of concern are included)
• An individual interview with the youth of concern
• The completion of behavior rating scales
• A review of relevant records (e.g., school records)
• A feedback session that reviews a diagnostic impression, addresses key issues (e.g., causes, prevalence, prognosis) and recommends a treatment plan
What follows are some common concerns I’ve heard from parents who are considering getting mental health care for their child.
If I take my child to see a child psychologist s/he might suffer self-esteem damage (e.g., mom thinks there is something seriously wrong with me).
Experienced psychologists know that this is a concern and have procedures in place for helping (e.g., assessing for your child’s strengths, making the experience enjoyable). Moreover, the symptoms that are troubling your child are far more likely to be causing, or to cause, self-esteem damage than interacting with a highly trained, caring and kind adult.
I’m not comfortable signing up for a long course of treatment.
Most research-supported treatments, for most problems, are designed to be short-term. Sure, there are instances where a longer course of care is indicated. In medical pediatric practice short-term treatments are more common than longer-term treatments; the same thing is true in mental health pediatric practice.
Treatment is too expensive.
I’ve been doing this work for over 20 years. I’ve never seen an instance where a
way wasn’t afforded to those with the will to be persistent. Please see this blog entry for a list of strategies. Moreover, the toll from untreated symptoms can be devastatingly higher.
I don’t want to weaken my child (e.g., encourage senseless whining, create dependency, promote externalizing responsibility).
Evidence-based psychotherapy is designed to make itself obsolete as soon as possible, to promote healing and to instill resilience. Alternatively, psychological symptoms often weaken functioning, dampen the human spirit and lower the ceiling on interpersonal, educational and vocational outcomes.
My kid doesn’t want to come in. There’s no point in doing this if s/he won’t cooperate.
Most kids and teens are neutral or opposed to the idea of mental health care. Actually, if a kid is interested in counseling it suggests either that he or she is very psychologically minded and/or is in a great deal of pain. I tell parents new to my practice not to worry about this. It’s their job to get their kid to my office. It’s my job to make the time worthwhile.
The final chapter of my book Working Parents, Thriving Families, goes into much more depth on this topic, including describing what the most common evidence-based treatments entail and how to tell if your child is getting quality care. Please also see these related blog entries:
Seven Common Myths About Counseling
Signs that a Kid Needs Mental Health Services
Mental Health Concerns are Nearly Universal by Ag2 21
Ignoring Kids’ Mental Health Needs is Expensive
I’ll close by stating that I travel widely within my profession. My experience suggests that the average child psychologist is an extremely devoted and mission-driven person who really cares about kids and doing right by them. If you’d like to check this assertion out for yourself, click here.
Dr. David Palmiter's Blog for Hectic Parents 