If you or your child have ever been involved in mental health services, you’ve probably received a different diagnosis from two different people. How could that be when the DSM creates distinct explanations for each one? It’s because what I see as the reason for a symptom may be completely different than what someone else does.
There is also the cultural issue when discussing common diagnoses. One of the most popular for children is ODD (Oppositional Defiant Disorder.) I’ll spare you the final details, but as you can imagine it involves a child who typically does the opposite of what you tell them to. Really? A child that doesn’t listen and will often even do the opposite of what you say?! Never heard that before! This would be considered normal by many, of course it depends on severity and how badly it affects their life. This is the part that can make things even more subjective.
In order to fit into the criteria of many of these diagnoses, the symptoms need to be persistent, pervasive, and exist in multiple environments. What persistent and pervasive is relative to the observer. Often, mental health professionals aren’t able to see the client in multiple environments which is then dependent on the reports of others, which is, you guessed it, subjective.
Family Voice, Family Choice!
The reason I state this is because as a parent, it’s your choice on who works with your child and how they do it (to an extent and in the vast majority of circumstances.) Best practice utilizes a person centered plan that as the parent, you most definitely should be involved in. By extension, no one mental health provider is going to work for every person on earth.
On the other hand, know that the providers job is to challenge you. That doesn’t mean they’re bad, it means they’re doing what they’re supposed to do. How can things improve if they don’t change, and how can things change if you aren’t challenged to change them? To be fair, their is an ideal way to deliver said challenges.
Regardless, if a therapist isn’t working out, don’t be afraid to request a new one. Alternatively, if you or your child has had the same therapist for years and nothing has changed, either you’re good on your own or you need a new therapist. All mental health providers come from different places with different experiences. People are trained to be as objective as possible and this is something that requires constant improvement, but no one has ever perfected objectivity. There are so many seen and unseen variables at work, no one can be right about what’s going on with an individual all the time. It’s “educated guessing.” Question is how educated that guess is.
You Are Your Child’s Advocate
The reason I decided to write about this subject, is because psychology is often heralded as a science. Those in the field often do this because they work in the field for so long, they identify with it. It takes a constant mindfulness to always be aware of how subjective it is, and realize that we as mental health providers can be wrong. It can also have serious consequences.
In my home state, when seeing a child, the child needs a diagnosis in order to be able to bill the insurance company. Further, that diagnosis needs to happen within 14 days. Sessions can go up to four hours or so but are typically 2 hours. 2 hours, once a week, in two weeks. That means you need to know everything about this child within spending 4 collective hours with them, and that’s hoping the child is present and engaged that entire time. Once that diagnosis is in place, that dictates what potential medication that child will be on. After all, a psychiatrist usually meets with a client for like 15 minutes and just gathers reports from other providers to make their decision. If you’ve never seen a child on medication they shouldn’t be on; I don’t recommend it. It can also have long term side effects.
Work *with* your mental health providers. Ask questions, think for yourself, talk to your child, get a second opinion, etc. This doesn’t mean to be unnecessarily mean to them, but it’s important to assert yourself.