CHAPTER 36
Intervention: First Principles
Parents, children and adolescents come to mental health services for a
variety of reasons. They bring with them a number of beliefs and fears
about the nature of the problem and what needs to be done. They will be
carrying out an assessment of the service they receive from the moment
they come through the door.
Engaging the family
If the family feel poorly handled and not understood, they are unlikely
to come back again. If this happens, then no matter how thorough and
accurate the clinical evaluation has been, the opportunity to do useful
therapeutic work will have been lost, and the family may also have been
put off seeking help at some later date. Discovering the family’s beliefs
and fears, and responding to them sensitively is vital to the whole process
of engagement. If they feel they are understood, and treated as respected
individuals, then the chances of their taking part in treatment will be far
greater. This calls for considerable flexibility in response rather than one
fixed ‘right’ way of doing things.
When are labels useful?
It can take considerable courage to walk through a door where the service
is for ‘mental’ problems, and some parents are fearful that either they or
their children are going to be labelled mad, bad, abnormal, or sick in the
head. They may be fed up with being made to feel useless by a range
of people in authority who tell them that what they are doing is wrong.
Under these circumstances being told, for example, that their son has a
serious condition labelled ‘conduct disorder’, and that they need a course
of instruction to learn the ‘right’ way to handle their child may play into
their sense of inadequacy and despair. For such a family it might have been
Child and Adolescent Psychiatry, Third Edition. Robert Goodman and Stephen Scott.
©c2012 Robert Goodman and Stephen Scott. Published 2012 by John Wiley & Sons, Ltd.
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