Welcome to Childhood Made Crazy, an interview series that takes a critical look at the current “mental disorders of childhood” model. This series is comprised of interviews with practitioners, parents, and other children’s advocates as well as pieces that investigate fundamental questions in the mental health field. Visit the following page to learn more about the series, to see which interviews are coming, and to learn about the topics under discussion:
Professor Tim Carey is a clinical psychologist with a background in preschool and special education teaching. He has a blog on Psychology Today (https://www.psychologytoday.com/experts/tim-carey-phd), a therapy (www.methodoflevels.com.au), over 100 publications including articles, books, and book chapters, and has presented nationally and internationally on helping people have more control in their lives. His latest book is called “Controlling People: The Paradoxical Nature of Being Human” and is available on amazon.com (http://tinyurl.com/zebe2bv).
EM: How would you suggest a parent think about being told that his or her child meets the criteria for a mental disorder or a mental illness diagnosis?
TC: I think it’s really important for a parent to understand that mental health disorders and diagnoses are different in important ways from physical disorders and diagnoses.
Receiving a diagnosis of a mental health disorder is not at all like being diagnosed with diabetes or leukemia. When a child is diagnosed with a mental health disorder all that means is that they have been identified as behaving in particular ways in different contexts. It doesn’t mean that there is anything abnormal or dysfunctional about their brain.
This is not to say that when a child is diagnosed with a mental health disorder that they don’t have problems. They may very well being having some difficulties and require additional support, but it certainly doesn’t mean that they are somehow deficient or “ill.”
Furthermore, it’s also really important to understand that a diagnosis is made almost entirely from an observer’s perspective and makes no comment at all, really, on how the child might be experiencing their environments. In order to understand if a child is struggling in different environments, it’s important learn from the child.
EM: How would you suggest a parent think about being told that his or her child ought to go on one or more than one psychiatric medication for his or her diagnosed mental disorder or mental illness?
TC: As a psychologist I have had very little formal training in medication, however, I have read quite a lot of information about the use of medications. People like Robert Whitaker, David Healy, Peter Breggin, Peter Gotzsche, and Joanna Moncrieff are all excellent authorities to learn from. It is fair to say, I think, that the benefits of medication have been grossly overstated and the harms have been drastically minimized.
Medication I think needs to be considered especially carefully with children whose brains are still developing. Adding chemicals to a developing brain is an extremely serious decision. As a parent myself, I can’t imagine a situation in which I would agree for my child to be medicated for a behavioral or psychological problem. If medication is ever to be used with children I think it should be monitored very carefully and reviewed regularly.
The long-term use of medication with children is especially worrying. If children are finding things difficult in any particular situation I would recommend psychological and social approaches rather than pharmacological ones.
EM: What if a parent currently has a child in treatment for a mental disorder? How should he or she monitor the treatment regimen and/or communicate with mental health professionals involved?
TC: I think parents should ask lots of questions about any treatment that is being recommended. Parents should know how the mental health professionals came to the decisions they did and what the evidence is for the basis of their decision.
They should also ask about what the mental health professional’s plan is for the treatment in terms of what they expect the benefits to be, what harms or problems there could be, how long they intend the intervention to last, and what their plan is for withdrawing the intervention.
Parents should also ask the mental health professionals for reading material or other sources of information such as websites so that they can become informed about the treatment that is being recommended for their child. An excellent website that provides lots of information about medication, for example, is www.rxisk.org. Being informed is an important aspect of making wise decisions. Parents should also ask about other treatment options that might be appropriate.
EM: What if a parent has a child who is taking psychiatric drugs and the child appears to be having adverse effects to those drugs or whose situation appears to worsening? What would you suggest the parent do?
TC: The parent should immediately discuss this with the mental health professionals with whom their child is working. They should also get as much information as they can about the medication. Again, the website www.rxisk.org is a wonderful resource for providing lots of information about people’s experiences of taking various medications.
It could be useful to seek out a second or perhaps even third and fourth opinion regarding alternative treatment options. The website www.madinamerica.com has lots of useful information about medication and the facility to make contact with them to ask for specific information. I think it’s also important to develop a skeptical and questioning attitude with regard to medication.
Unfortunately, a lot of the information that is provided about medication is produced by the pharmaceutical companies who make the medication and are motivated to maximize profits for their companies. Also, some consumer advocacy groups receive funds from pharmaceutical companies and this can influence the information these groups generate.
It can be very difficult to get a balanced picture about medication. That’s why authors like Robert Whitaker, Peter Breggin, David Healy, Peter Gotzsche, and Joanna Moncrieff are so helpful. Parents will know their child well and should believe their own observations and instincts. If you think your child has started behaving differently since taking the medication then you are probably right and the change may well be due to the medication and not to your child’s problems.
TC: I think we underestimate the powerful effects of relationships when people, including children, are having difficulties. It can be difficult in the hectic lifestyles we’ve created for ourselves but taking the time to get to know and understand your child can be invaluable.
What does your child like to do? Why do they like to do it? Spending regular time with your child in mutually enjoyable activities such as reading a book or going to the park and kicking a ball around or baking some cookies can be amazingly helpful in building relationships and helping your child develop a positive outlook on life.
Doing these activities on a regular basis – even 30 minutes day – is ideal. Talking to your child about what they want, how they see things, what their goals are, and so on can be invaluable as well. People experience contentment when they are able to routinely experience their world in the ways they desire. It’s important, therefore, to help your child think about the ways they like to experience their world and the things they can do to achieve the things that are important to them.
Helping children develop and realize goals on a regular basis is an important skill for developing robust and resilient states of mind. The downside, if it is a downside, is that these activities and conversations take time. Spending time with your child in constructive, enjoyable pursuits might be the most powerful thing you can do for your child beyond the formal, structured interventions that might be provided by mental health professionals.
This post was previously published on Psychologytoday.com.
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