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Maybe itís to do with toilet training, maybe concentration at school or perhaps itís concern for drugs and alcohol. It may have to do with not listening, breaking curfew, escalating conflicts or perhaps about sex. Whatever it is, at some point you may seek help for a child related concern and the first door opened can be that of the family doctor.
Your physician can bring perspective to your concern. In so doing, this alone may resolve the issue. If not, then your physician may refer you or your child for counseling.
It is important to note that there are many issues that can give rise to behaviour problems. Some of those issues include: a learning disability; attention deficit disorder, distraction by problems at home and with parents (domestic violence, child abuse, parental alcoholism/drug abuse, financial struggles); prior academic absences due to recurring illnesses creating gaps in learning; prior concussions; inadvertently permissive parents who donít hold the child meaningfully accountable to expectations; victimization by bullying, undiagnosed auditory processing issues; undiagnosed eyesight problems; limited structure after school to enable and encourage homework and/or access to too many electronic distractions. And these are only a few of many more.
Because there are so many different underlying causes to the same observable behaviour problem, to be most helpful, the right underlying cause must be targeted for intervention. The way to figure out the right underlying cause is through a bio-psycho-social assessment. That means meeting with a mental health professional who will assess the issue from multiple perspectives. In short, the assessor will wonder about biologically determined issues, psychologically determined issues and socially determined issues including family, school and community.
A bio-psycho-social assessment is conducted by meeting with both parents ahead of ever meeting the child. Only both parents can advise as to the childís developmental history as well as their own history as a couple and their respective family of origin. Typically, clues to the childís present day behaviour problems will be discovered, the result of this assessment and then the appropriate treatment protocol can be established.
For instance, the child who had mysterious stomachaches was referred for assessment after numerous medical investigations couldnít determine a cause. It turns out the child made up the stomachaches whenever his parents were in an argument in order to divert their attention from their fight. In another situation, the 8-year-old child who was thought to have ADHD, turns out to have had an auditory processing disorder when the assessment revealed numerous ear infections as a toddler, affecting higher order auditory processing development. Focusing only on the observable child behaviour issue would not have uncovered a child worried about parental conflict or may have seen a child placed on medication, when other educational compensatory strategies were required.
If you are seeking counselling on a child related matter, both parents should attend at least the first meeting together and without the child (regardless of age). It just may be that in meeting with both parents, obtaining a history, yet never meeting the child, the mental health professional can offer guidance appropriate to the assessed problem. That alone can lead to the alleviation of the child related concern and if not, it can lead to a more appropriate course of action.
Better assessment equals more appropriate treatment.
Direnfeld, MSW, RSW
Call Gary for your next conference and for expert opinion on family matters. Services include counselling, mediation, assessment, assessment critiques and workshops.
For information on Direnfeld's book, Raising Kids Without Raising Cane, click here.
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