Americans attitude toward counseling

[tango]

There comes a time if therapy does go on too long that it does exactly that, it enables instead of empowers. We always have to be careful about that and have that discussion with clients when it appears they are doing well about possibly discharging them. I've actually discharged four this month, so I feel pretty good about that. I have about 50 people on my case load right now.

That's certainly good to know.

With regard to where a learned behavior looks very much like a mental illness, how would you draw a distinction between a child who has learned he doesn't need to obey specific adults in his life and a child who has a condition that pharmaceuticals will actually address, or between a child whose parents insist he is "hyper" but is really little more than a teenage boy not being a mild-mannered teenage girl however much his parents wish he would be and a child who will benefit from medication?

I touched on this latter case a few posts back - I used to live next to a couple who had a teenage son and the mother in particular insisted he had major problems and needed medication. He was a teenage boy, going through a rebellious phase like most teenage boys do, and his mother (who probably had the most progressive/left-wing viewpoint I've ever encountered) was obviously having a hard time dealing with his budding masculinity. She insisted that he needed medication and from what I can gather put considerable pressure on their family doctor to write a diagnosis and basically drug him into compliance. In due course the rebellious oik of a teenager grew out of the bad phase and turned into a very pleasant young man. I dread to think what would have happened had his mother had her way and basically put pharmaceutical shackles on him.

 

[Stravinsk]

That's certainly good to know.

With regard to where a learned behavior looks very much like a mental illness, how would you draw a distinction between a child who has learned he doesn't need to obey specific adults in his life and a child who has a condition that pharmaceuticals will actually address, or between a child whose parents insist he is "hyper" but is really little more than a teenage boy not being a mild-mannered teenage girl however much his parents wish he would be and a child who will benefit from medication?

I touched on this latter case a few posts back - I used to live next to a couple who had a teenage son and the mother in particular insisted he had major problems and needed medication. He was a teenage boy, going through a rebellious phase like most teenage boys do, and his mother (who probably had the most progressive/left-wing viewpoint I've ever encountered) was obviously having a hard time dealing with his budding masculinity. She insisted that he needed medication and from what I can gather put considerable pressure on their family doctor to write a diagnosis and basically drug him into compliance. In due course the rebellious oik of a teenager grew out of the bad phase and turned into a very pleasant young man. I dread to think what would have happened had his mother had her way and basically put pharmaceutical shackles on him.

ADD and ADHD are commonly misdiagnosed ailments that line the doctor's and pharmaceutical company's pockets and give parents a "way out" if their child misbehaves. When I was married, my sis in law drugged her eldest son with ADHD drugs because the diagnosis of an ailment beyond her control/influence was easier for her to handle than either admit his behavior was normal or was in fact a reaction to bad parenting on her (or her husband's) part. Now I've never been a parent but what I can say with confidence is that the way both parents spoke to and of their children in our (the family's) and their(the children's) presence was beyond hurtful and disrespectful. As for having a disorder, the kid could sit and read a book without the aid of medication, but nevertheless, he had ADHD according to her.

 

[Lamb]

ADD and ADHD are commonly misdiagnosed ailments that line the doctor's and pharmaceutical company's pockets and give parents a "way out" if their child misbehaves. When I was married, my sis in law drugged her eldest son with ADHD drugs because the diagnosis of an ailment beyond her control/influence was easier for her to handle than either admit his behavior was normal or was in fact a reaction to bad parenting on her (or her husband's) part. Now I've never been a parent but what I can say with confidence is that the way both parents spoke to and of their children in our (the family's) and their(the children's) presence was beyond hurtful and disrespectful. As for having a disorder, the kid could sit and read a book without the aid of medication, but nevertheless, he had ADHD according to her.

I agree with you that there is too often a diagnosis where it could be other reasons instead. I worked with children for a long time as a Girl Scout leader, substitute teacher and youth choir director. During that time, I saw children drugged and only 2 out of the many children actually benefited. When they weren't on their meds they absolutely could not get a handle on their own behavior and apologized to me for it but still could not settle down no matter what.

 

[tango]

ADD and ADHD are commonly misdiagnosed ailments that line the doctor's and pharmaceutical company's pockets and give parents a "way out" if their child misbehaves. When I was married, my sis in law drugged her eldest son with ADHD drugs because the diagnosis of an ailment beyond her control/influence was easier for her to handle than either admit his behavior was normal or was in fact a reaction to bad parenting on her (or her husband's) part. Now I've never been a parent but what I can say with confidence is that the way both parents spoke to and of their children in our (the family's) and their(the children's) presence was beyond hurtful and disrespectful. As for having a disorder, the kid could sit and read a book without the aid of medication, but nevertheless, he had ADHD according to her.

That certainly seems to be the case in at least some situations. Like I think I said further up I know a guy who got a diagnosis of ADHD as an adult and the medication made a huge difference to his life. On the other hand it seems more and more parents set dismally low expectations of their children, excusing just about anything with "s/he's only four, what do you expect?". Along the way they set themselves up for failure because their darling offspring are never expected to behave, and any future attempt to raise expectations are almost inevitably going to end in failure.

I have a friend whose son, at the age of two, knew that he wasn't to start eating until the family had said the blessing over the food and he wasn't to get down from the table without asking to be excused. His language skills were much as you'd expect from a two-year-old but he knew what was expected of him. He'd say "blessing" before the meal, and when he was finished and wanted to get down he'd say something like "excoos" - his best effort at asking to be excused. When one of his parents said he was excused, he'd get down from the table and go and play. He knew what was expected, he asked appropriate permission as best he could, and he obeyed his parents. Compare and contrast to the kids running wild in restaurants while the parents ignore them, essentially expecting everyone else in the restaurant to put up with their meals being disrupted because little Tarquin is a bit energetic today.

Part of the problem is that every parent who figures that drugging their offspring into compliance is easier than actually parenting, who uses a convenient diagnosis as an excuse for why little Jimmy won't sit down and shut up, makes it that much harder on the people who genuinely do have a disorder that genuinely does need medication.

 

[Krissy Cakes]

I have had since I was little 12ish. I feel you need to find a good one as those are the best kind. I didn't always like it as I sometimes feel like I'm talking to a wall and not a human. Sad but true.

 

[NewCreation435]

That's certainly good to know.

With regard to where a learned behavior looks very much like a mental illness, how would you draw a distinction between a child who has learned he doesn't need to obey specific adults in his life and a child who has a condition that pharmaceuticals will actually address, or between a child whose parents insist he is "hyper" but is really little more than a teenage boy not being a mild-mannered teenage girl however much his parents wish he would be and a child who will benefit from medication?

I touched on this latter case a few posts back - I used to live next to a couple who had a teenage son and the mother in particular insisted he had major problems and needed medication. He was a teenage boy, going through a rebellious phase like most teenage boys do, and his mother (who probably had the most progressive/left-wing viewpoint I've ever encountered) was obviously having a hard time dealing with his budding masculinity. She insisted that he needed medication and from what I can gather put considerable pressure on their family doctor to write a diagnosis and basically drug him into compliance. In due course the rebellious oik of a teenager grew out of the bad phase and turned into a very pleasant young man. I dread to think what would have happened had his mother had her way and basically put pharmaceutical shackles on him.

It is difficult to tell what might be learned and what might require medication. One thing I look at is if the child is able to control him or herself in one setting, but has a problem in another. I have one kid right now that is an absolute angel at school, but really defiant at home. This is obviously learned behavior. In that case, you need to understand what function or need the defiant behavior is meeting. Because behavior always meets a need or serves some sort of function or it wouldn't exist. Even maladaptive behavior. in the young man's case that I just mentioned, after two months of working with him we are just now starting to get to the heart of what is wrong.

Also, I think after you have worked with several hundred kids it gets much easier to be able to say what is normal acting out and what is possibly chemically imbalance behavior. The hardest kids i have worked with were exposed to drugs in the womb. It changes the brain chemistry in a way that have an affect the whole life of the person in many cases

 

[tango]

It is difficult to tell what might be learned and what might require medication. One thing I look at is if the child is able to control him or herself in one setting, but has a problem in another. I have one kid right now that is an absolute angel at school, but really defiant at home. This is obviously learned behavior. In that case, you need to understand what function or need the defiant behavior is meeting. Because behavior always meets a need or serves some sort of function or it wouldn't exist. Even maladaptive behavior. in the young man's case that I just mentioned, after two months of working with him we are just now starting to get to the heart of what is wrong.

Also, I think after you have worked with several hundred kids it gets much easier to be able to say what is normal acting out and what is possibly chemically imbalance behavior. The hardest kids i have worked with were exposed to drugs in the womb. It changes the brain chemistry in a way that have an affect the whole life of the person in many cases

That makes a lot of sense.

Do you get very many parents pushing you to treat their kids as if they had a disorder when in your opinion they do not? I forget if you posted elsewhere to say just what it is you do with these kids - do you give a diagnosis or work with them regardless of diagnosis?

 

[JPPT1974]

I am in counseling due to my Asperger's and due to my depression. I do take medication. Plus been seeking it for twenty years and counting. As my family and I preferred a Christian counselor along the way.

 

[NewCreation435]

That makes a lot of sense.

Do you get very many parents pushing you to treat their kids as if they had a disorder when in your opinion they do not? I forget if you posted elsewhere to say just what it is you do with these kids - do you give a diagnosis or work with them regardless of diagnosis?

Since we are billing a third party (insurance such as a private insurance or medicaid) they have to have a diagnosis. If they don't meet criteria for a diagnosis when they come in for an assessment then we tell the parents they don't qualify. I have had that happen a couple of times where I couldn't really find anything to diagnose. The first step in getting services started is signing consents for treatment and having an assessment done. I have done several hundred assessments in the last three years.

 

[tango]

Since we are billing a third party (insurance such as a private insurance or medicaid) they have to have a diagnosis. If they don't meet criteria for a diagnosis when they come in for an assessment then we tell the parents they don't qualify. I have had that happen a couple of times where I couldn't really find anything to diagnose. The first step in getting services started is signing consents for treatment and having an assessment done. I have done several hundred assessments in the last three years.

Sure, I was wondering if you had many people coming in insisting that a diagnosis be given when the truth was that there was nothing medically wrong with their child, they just needed to be allowed to be themselves, or they needed discipline worthy of the name, or they needed boundaries, or whatever. Given my experience is fairly limited it's hard to know how representative it is of the population as a whole.

I certainly like to think my former neighbor can be written off as the silly fringe of the right-on progressive style of parenting in which their little darling can do no wrong and therefore anyone complaining about them is by definition being unreasonable, but sometimes wonder.

 

[NewCreation435]

Sure, I was wondering if you had many people coming in insisting that a diagnosis be given when the truth was that there was nothing medically wrong with their child, they just needed to be allowed to be themselves, or they needed discipline worthy of the name, or they needed boundaries, or whatever. Given my experience is fairly limited it's hard to know how representative it is of the population as a whole.

I certainly like to think my former neighbor can be written off as the silly fringe of the right-on progressive style of parenting in which their little darling can do no wrong and therefore anyone complaining about them is by definition being unreasonable, but sometimes wonder.

The last job I had was using a family therapy systems model called Eco Systemic Family Treatment. It is somewhat like what use to be called Structural Family Therapy. It looks at the relationships that people have in families and how some things including some behaviors are passed down by family members. For example, if you live with parents who are anxious you may see that anxiety as normal or adopt some of the same attitudes about other people as those parents. Also, if there is a history of abuse or neglect in the family that is very significant. Abuse or neglect makes a person feel unwanted and unloved and that can have an impact on self esteem and feelings of self worth. Most people in their lifetime experience some type of trauma, but some people seem to get more of it than others.

 

[tango]

The last job I had was using a family therapy systems model called Eco Systemic Family Treatment. It is somewhat like what use to be called Structural Family Therapy. It looks at the relationships that people have in families and how some things including some behaviors are passed down by family members. For example, if you live with parents who are anxious you may see that anxiety as normal or adopt some of the same attitudes about other people as those parents. Also, if there is a history of abuse or neglect in the family that is very significant. Abuse or neglect makes a person feel unwanted and unloved and that can have an impact on self esteem and feelings of self worth. Most people in their lifetime experience some type of trauma, but some people seem to get more of it than others.

Sure, all of that makes sense. I guess my question is whether, or at what point, feeling anxiety (whether from parents or not) qualifies as a "mental illness". I can't help thinking of it much like the concept of high cholesterol - when the guideline figures for cholesterol were revised downwards - surprise, surprise - millions of extra people were classified as having high cholesterol. Which was good news for the pharmaceutical companies that make the statins used to lower cholesterol. I still can't help thinking that all sorts of things being classified as a "mental illness" provides a convenient way to dodge responsibility for some while also trivialising the problems faced by those with more severe mental health issues.

To use a more physical example, it seems fair to say that people with obese parents are more likely to be obese themselves but I'm not sure I'd accept obesity being classified as an illness except in a very small minority of cases - most of the time it is best addressed by eating less and moving more.

 

[NewCreation435]

Sure, all of that makes sense. I guess my question is whether, or at what point, feeling anxiety (whether from parents or not) qualifies as a "mental illness". I can't help thinking of it much like the concept of high cholesterol - when the guideline figures for cholesterol were revised downwards - surprise, surprise - millions of extra people were classified as having high cholesterol. Which was good news for the pharmaceutical companies that make the statins used to lower cholesterol. I still can't help thinking that all sorts of things being classified as a "mental illness" provides a convenient way to dodge responsibility for some while also trivialising the problems faced by those with more severe mental health issues.

To use a more physical example, it seems fair to say that people with obese parents are more likely to be obese themselves but I'm not sure I'd accept obesity being classified as an illness except in a very small minority of cases - most of the time it is best addressed by eating less and moving more.

It's diagnosed typically when it really starts to interfere with daily life activities such as going to school, work or relationships. You have some people who have anxiety to the point they have difficulty staying in the classroom, leaving the house to go to work, driving a car or maintaining a relationship.

 

[tango]

It's diagnosed typically when it really starts to interfere with daily life activities such as going to school, work or relationships. You have some people who have anxiety to the point they have difficulty staying in the classroom, leaving the house to go to work, driving a car or maintaining a relationship.

At that level of interference in daily life I guess it's hard to argue that it isn't a serious problem.

 

[Krissy Cakes]

[MENTION=59]jsimms435[/MENTION] are you a counselor? I can't remember if you said you were or not.

 

[NewCreation435]

[MENTION=59]jsimms435[/MENTION] are you a counselor? I can't remember if you said you were or not.

yes I am.