“Getting Effective Therapist or Counseling Help For Your Child”
By Bill Schacht, MS, LCSW
Family separation and divorce create many complex challenges for children. The two most common experiences children report are…
- Scary thoughts and feelings.
- Being distracted (i.e. in school, etc.) because of uncertainty of the future of family life structure.
Children experiencing such fears and worries will begin to show symptoms both physical (i.e. headaches, insomnia, stomach aches, etc.) and psychological (i.e depression, anxiety, short temper, lack of participation or finding pleasure in activities which they previously enjoyed.
When children show theses signs of distress, parents, other relatives, and professionals with whom they are in contact (i.e. teachers, school counselors, clergy, pediatricians, etc.) will come to a conclusion that they need help from someone who has professional expertise in such cases (i.e. a psychologist or psychotherapist,etc.).
Let us all be clear that bad therapy is worse than no therapy just like a bad back surgery is much worse than no back surgery.
Psychotherapy is a service provided for people who have a clearly diagnosable mental health disorder. Most children showing symptoms from family change and divorce are have well within normal range of response to complex and massive family and residence changes. They are not “mentally ill” (see posted article on POD, “RED ALERT”).
Determining if they have a diagnosable condition or not is critical.
If you are going to seek an evaluation and possible treatment from a licensed mental health professional use the guide below to ensure that you child will be getting appropriate, safe and effective treatment.
Guide for Parents and Guardians Seeking Psychological Services For Children
Copyright 2006 -William D. Schacht, MS, LCSW
Your child may have been referred or recommended for psychological evaluation or counseling to an agency outside of your school system by a school psychologist, school social worker, counselor, or teacher. The following information can be used as a guide to assist you in helping your son or daughter secure psychological services that are useful and meet his or her needs. For further support, call Performance Enhancement Behavioral Health & Counseling Services at (414) 427-7347.
Question: Do you know for what reasons and services your child is being referred?
Ask what reasons the referral source is suggesting your child requires additional evaluation and/or service. Attention deficit, depression, anxiety, family situation adjustment are examples of such conditions. The agency or mental health professional will ask you why you are seeking services for your child. This gives the therapist a starting point with your child. If you describe in writing a set of symptoms or behavior observations and how long your child has been experiencing these problems will be helpful to the therapist.
Your child could be referred for the following services…
What agency and mental health professional you choose should be skilled in the area assessed as the problem for your child. For example, if your child is being referred for adjustment issues due to a divorce, ask the therapist about his/her experience in dealing with marriage, family, and divorce adjustment issues. How many cases of this type have been seen?
Question: How do I know which therapist will be best for my child?
Word of mouth referral is a good process. School professionals, your primary care physician, your attorney (in divorce situations), and friends can be a good place to start. If you hear one agency or therapist name come up consistently, that is meaningful.
Make sure the therapist and agency are properly licensed. When choosing an agency (or clinic) ask if it is “State Mandated.” This means it is accredited by the State of Wisconsin.
Ask the therapist if they are “licensed.”
Ask the therapist to tell you what his/her definitions are for…
“Psychological Evaluation” (Answer should include “accurate diagnosis, prognosis, and treatment plan with concrete measurable treatment objectives and measures of success and failure for each objective”).
“Psychotherapy” (Answer should include “your child will learn how to make changes in his/her thinking patterns, emotional responses, and behaviors consistent with his/her treatment objectives”).
Therapist should communicate his/her philosophy on using psychotropic medications as part of treatment (medication masks symptoms, but many times does not address the underlying cause of the child’s problem).
Ask therapist how he/she will communicate with school personnel and the child’s primary care physician in regards to your child’s diagnosis and treatment. Good therapists see treatment as a team approach with other professionals who provide care and support for you child.
Question: How does treatment begin?
All treatment must begin with an effective evaluation. A good therapist should inform you of evaluation findings including…
- Treatment plan with concrete measurable treatment objectives and a projected number of sessions for each objective.
- Measures of treatment success and failure and what adjustments to treatment will occur if treatment fails.
If the therapist cannot tell you these things, consider finding a different therapist.
Good therapy and medicinal treatment can only occur with accurate diagnosis. Inaccurate diagnosis can lead to improper treatment. For example, if a child is diagnosed with ADHD when, in fact, the child is experiencing anxiety from a potential divorce situation, treatment can be detrimental, rather than useful. If a child is diagnosed with depression when, in fact, they are smoking pot twice a day and this is not known, treatment will not be useful.
Question: What is a “concrete, measurable treatment objective?”
For example, if your child is referred for social or performance anxiety, a vague, useless treatment goal would read’ “Reduce anxiety symptoms.” Of course! That is obvious!
A concrete measurable goal would read like these…
“Will attend speech class on every day he is scheduled to give a speech.”
“Will initiate social conversations with two other children in school she does not know within 6 weeks.”
“Will identify and eliminate obsessing about negative self thoughts in 4 weeks.”
These are real, meaningful type of objectives that are of immediate value to your child and you.
If treatment goals are not being met on projected timelines, ask the therapist for an explanation. If you are not satisfied, seek a second opinion.
Question: What should I be willing to pay for my child’s treatment? What is good value?
Insurance benefits in mental health are rapidly decreasing for most health insurance plans. Deductibles and co-pays are increasing. Some quality providers choose not to be part of insurance panels that have low reimbursements. So, getting quality care at good cost value can requires good therapist selection and savvy consumerism.
Bad therapy is worse than no therapy. Make sure your child has an effective therapist for his/her problem(s).
Consumers are trained that treatment cost should be assessed by fee per visit. This is not an accurate measure of true cost or consumer value.
Cost should be calculated by the therapist’s projected cost for your child’s entire treatment, rather than the cost of an evaluation or a therapy session.
For example, a $30 co-pay for 25 sessions is more than a $60 co-pay for 8 sessions if the resulting therapy outcome is the same.
Also consider how expensive it may be for you child not to receive effective treatment for his and her problem. Marriage counseling that may cost you $3,000 out of pocket is less than $6,000 of attorney fees and family turmoil of a divorce.
For more information on selecting good psychological services for your child, call Performance Enhancement Behavioral Health & Counseling Services at…