Finding Psychological Help for Your
Ten years ago,
Lindy Garnette faced one of a parent's toughest challenges: She had to find psychological help for her child.
Her son, then 5,
had bipolar disorder, a diagnosis that might lead to a lifetime of prescriptions, therapy & behavior modification.
"He has his good days
& his not-so-good days,'' said Garnette, who is now the director for children & family mental health services
for the Virginia-based National Mental Health Association. "It's still a struggle.''
Parents of children
who need psychological treatment face a series of struggles. On top of the still-present stigma of mental illness, there's
the search for competent & appropriate professionals & the battle with health-insurance providers to fund the sometimes
long-term therapy needed.
But, Garnett &
others say, a little guidance & a lot of perseverance can make finding a good match for your child easier.
Do You Need Therapy?
Psychologist Kevin Leman's first advice to parents is: "Don't find a therapist for your child.''
"If there's a problem
& you want to seek outside help, you go,'' said Leman, a Tucson, Ariz.-based psychologist, father of 5 & author of
21 books. "Rushing your kids off to the shrink isn't good.''
Leman believes society is rushing to pin psychological labels on kids, a practice that lets parents off the hook & can leave kids feeling
Many parents hoping
to stem sibling rivalry, fighting in school & other relatively simple behavioral issues might do well to consult a professional
for parenting tips they can try at home, rather than signing the child up for sessions on the couch, he says.
"I've turned many a kid
around without ever laying eyes on the kid in my office,'' Leman said.
How do you know if your child needs outside help?
a child may truly need attention if "the daily tasks of life aren't being met.''
Experts offer the
following warning signs for depression & other common disorders in children:
Leman uses a second
test. If others - teachers, coaches, neighbors or family members - have alerted you to some of the above symptoms & you've
already noticed them, it may be time to act, he says.
The way you find a therapist, psychologist or other mental health
professional can be crucial to your child's success, said Dale Masi, a professor at the Univ. of Maryland graduate school
for social work. In her recent book "Shrink to Fit" (Health Communications, $10.95), she
suggests seeking referrals from mental health workers you know, your primary physician & people in support groups dealing with the same issues.
"You know, most
people find a therapist in the telephone book,'' she said. "I wouldn't necessarily recommend that.''
suggests that parents check with their insurance company or HMO for guidelines about what's covered & for how long. When
in doubt about a practitioner, she would turn to a trusted friend.
"Your best bet
is a friend who operates very much like you do,'' Garnette said.
Once you have a few names,
Masi suggests meeting with the doctors without your child. Go armed with a list of questions & get answers about their
education, experience, expertise with children & the specific issues or diagnoses affecting your child.
"You shouldn't feel uncomfortable interviewing a therapist,'' Masi said.
And think about the office atmosphere. Masi would have doubts about a doctor who claimed to specialize in children, but who
had no toys or child-sized furniture in the waiting room.
"Definitely look for an
expertise in treating children,'' Garnette said. "Children aren't all little adults. A lot of it has to do with how
you just click with a person because it's so personal.''
also seek someone with a few years' experience because "you do get better with practice.''
Leman also recommends
finding a therapist who wants to help the child, not finish the payments on his yacht.
who wants to get rid of you,'' he said. "If they're good, they want the child to be well & take off on his own.''
He'd also check
with the local mental health society or board for any misconduct cases against a professional you're considering.
Don't expect to rely on one psychiatrist, psychologist or therapist alone. Many cases are best helped by a network of parents &
professionals working together on different aspects of the child's therapy.
As a result, Masi
suggests asking about affiliations when interviewing the initial professional.
"If she's not a psychiatrist,
ask what psychiatrist she works with & if that person is a child psychiatrist,'' Masi said.
For many cases,
experts recommend a comprehensive plan, taking in a few professionals. i.e., a plan for a child showing severe attention problems
in school might include talk therapy with a family therapist, participation in a social-skills group & drug management
thru a psychiatrist.
"Ideally, you want a situation
in which all those people talk to each other & that 's really difficult,'' Garnette said.
The situation is made more difficult by current practices in health management
organizations & insurers that often have definite guidelines regarding length of treatment & the types of professional
On average, Garnette
says, managed-care companies will pay for 10 to 15 sessions, but it's often fewer. In advocating for her son, she once threatened a vice president of her HMO with a lawsuit before the company agreed to extra care.
"They want to cure everyone
in 4 sessions & it's just not possible,'' Garnette said.
And ask up front
how long the therapist expects his or her work with your child to continue. Even a rough estimate can help you plan for expenses
& the effect on the child & the family, Masi says.
Traumatic situations don't always allow for weeks of planning. However, some don't require a therapist either, Leman says. In the case
of a child grieving after a family member's death, Leman encourages parents to "give themselves more credit.''
"Why would a kid want
to see a stranger if they're grieving?'' he asked. "Share your imperfect self with your child. It's healthy for them to see you cry, pray, be concerned. That's OK.''
parents to remain involved in the therapy process so they'll see if changes are needed. Her son went thru 5 psychiatrists before he found one that seemed a perfect match.
"It's worth it when you get there,'' Garnette said. "Your gut feeling is often right.''