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:
James E. Maddux, Ph.D., is University Professor Emeritus in the Department of Psychology and Senior Scholar at the Center for the Advancement of Well-Being at George Mason University (Fairfax, VA). He is the former Editor of the Journal of Social and Clinical Psychology and former director of the clinical psychology doctoral program at George Mason University. Maddux is a Fellow of the American Psychological Association’s Divisions of General, Clinical, and Health Psychology and a Fellow of the Association for Psychological Science. His recent activities have included extensive international travel that has involved giving lectures, teaching graduate students, and organizing workshops on evidence-based clinical interventions and related topics.
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?
JM: I think parents need to understand that being diagnosed with a "mental disorder" is not the same as being diagnosed with a medical disease. Psychiatric diagnoses are based purely on the description (almost always an adult's description) of the child's behaviors, thoughts, and feelings, not on the identification of some underlying medical or biological condition. To say that a child "has" ADHD, for example, is not the same as saying that the child "has" the flu. In addition, psychiatric diagnostic criteria are ambiguous and highly subjective, not precise and scientific. I think understanding a little more about the nature of psychiatric diagnoses can help a parent feel a little less alarmed by the whatever label is given to his or her 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?
JM: This depends on the problem that the medication is supposed to address and whether or not medication is to be the only treatment or will be used in conjunction with a behavioral or psychological intervention.
If a pediatrician, for example, prescribes only medication for the treatment of a child's problem and does not also recommend referral to a mental health professional, then the parents should ask about this. Parents should also ask if the medication being suggested has been approved by the FDA for use with children.
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?
JM: A plan for monitoring adherence to a treatment regimen and the child's response to it is the responsibility of the mental health professional. Unfortunately, not all mental health professionals are concerned with this or knowledgeable about how to do it. Parents should insist that the child's responses to treatment should be routinely evaluated and should ask about what they can do to assist. In fact, the parents' observations of changes in the child's behavior and emotions may be the major component of this evaluation.
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?
JM: Potential adverse effects should be thoroughly reviewed before any medication is prescribed, and any adverse effects should be immediately reported to the physician who prescribed the medication.
JM: Attending support groups for parents of children who are experiencing the same or similar problems can be very helpful. Not only do such groups help parents feel less alone and less guilty for having a child with a mental health problem, but they also provide a forum for the exchange of information and strategies for dealing with a child's problems and its effects on the family. The internet is also a rich source of information that can provide parents with information that may lead to questions for care providers that could lead to enhancements of the child's treatment.
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