By Julie T. Steck, Ph.D., HSPP
For the past 35 years I have had the opportunity to work with children, adolescents, young adults and their families. Most of the time, I am joining the family at a low point in their journey. The child (even if he/she is a young adult) is struggling in some aspect of life. The parents are frustrated, confused and often angry that their efforts to assist their child have not helped. Many times the families have invested a great deal of time and money in services such as therapies, tutoring, or other types of programs that promise results. They have asked teachers, friends, and extended family members for advice. Yet, the child continues to struggle. The parents have been cheerleaders – telling their child that they can overcome the problem, expressing optimism, and fighting against the opponents. Each time they tried a new approach, they started out enthusiastically and over time began to feel defeated once the initial surge of optimism is replaced with…more frustration. Their won/loss record has not improved over time.
The families who have allowed me to work with them all have one thing in common when I first see them: they don’t have a game plan. They don’t know the nature of the problem or at least only have a partial picture of the problem. When I see a family for the first time, I know that there are at least four questions they want answered:
- What is it? What is the nature of my child’s problem(s)?
- What caused it?
- What can we do about it?
- What does it mean for the future?
Without answers to those questions, the family and those who work with the child and family will flounder. As a psychologist, I find it very difficult to assist a family without a good evaluation. Many times the families bring with them an evaluation or a number of assessments but the information has not been integrated to formulate a diagnostic picture. In other situations, no evaluations have been done so we need to start with a comprehensive evaluation.
An evaluation should address all aspects of the child’s life – cognitive level, learning strengths and weaknesses, social-emotional-behavioral factors, and adaptive functioning. If a child is struggling, there is usually more than one aspect of his/her life that is being impacted. Evaluation data from multiple sources (parent report, teacher report, school records, previous evaluations, and direct observations and testing) help to identify the diagnoses/conditions that are impacting the child. Once the diagnoses are identified, the psychologist is able to begin educating the family and direct them to research-based information regarding treatment. This is the beginning of the coaching with families – helping them to gain knowledge that translates into better understanding. A coaching approach meets the family and the client where they are. It allows the psychologist to validate the feelings of frustration and then begin to educate the family about the nature of the child’s difficulties before outlining a different approach to addressing his/her needs.
Parents almost always want to know what caused the problem(s) their child is facing. While this question cannot always be answered through the psychoeducational evaluation, referrals are made if there are medical issues that need to be addressed. Frequently, families will recognize a family pattern in the child’s difficulties and recognize that they want a different outcome for this family member. They had hoped that being more supportive parents and cheerleaders would make a difference, but recognize that they need more strategies to “coach their child” to success. Coaching their children entails helping that child come to understand whatever questions he/she has about his/her difficulties and needs at that point without simply telling the child how to feel or what to do.
The question that parents want answered most is, “What can we do about it?” Once the diagnostic picture is clarified through an evaluation, a game plan can be delineated. The game plan usually starts with parent education regarding the nature of the problems. My work as a psychologist entails helping parents to develop effective ways to help their child learn more about his/her problems in ways that the child can understand. Depending on the diagnoses, the treatment plan (game plan) will vary but may include recommendations for support through their school system in the form of an IEP, accommodations under a 504 Plan or as a student with a disability at the college level, strategy instruction, ADD coaching, tutoring, medication consultation and/or direct individual or family psychotherapy. These interventions should be tailored to the individual based on the diagnostic information and the needs and resources of the family system. All interventions should have research-based support. It is important for families to realize that that game plan will need to be revised over time, based on the age of the child and the progress that is made with intervention.
This leads to the final question and the one that is the hardest to answer. What does this mean for the future? This answer is often what the family fears the most. There may be a long-term significant cognitive, learning, or psychiatric issue that does not have a cure. On the other hand, there may be a diagnosis that can be addressed through medication, specific tutoring, and environmental interventions and supports. However, an honest answer to this question is important in formulating a game plan and helping parents to be effective coaches.
One of the things that I have learned over time is that every parent wants to be the best parent they can be. But parenting is not a one-size-fits-all type of job. Our children don’t come with owner’s manuals. So we need to see ourselves as shepherds, guiding each of our children to become that best person they can be. I believe that this requires truly understanding our children’s strengths, needs, and uniqueness. For some children, these attributes are apparent and they seem to guide us in knowing how to parent them. However, other children can be baffling to parents. This is when families should seek input through a psychological evaluation so that they are able to formulate a game plan. The game plan will help them coach their child to greater success and happiness through increased knowledge and acceptance.
