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more constructive to have said that their child is indeed strong-willed and
can behave in an antisocial way at times, but he or she has many strong
points that have become obscured by his or her reaction to the stress of
school difficulties. The parents clearly are doing their best for their child
by bringing him or her to be seen. If they receive support to do more of
the useful things they are already doing, there is hope for improvement.
In other families the reverse may be true, and an approach which gives
a diagnostic label can take the strain off family relationships and help all
involved parties to focus on the child’s needs. This can work for a number
of reasons:
1 An official ‘label’ is, for some families, the single most important thing
they take away from their contact with child mental health profession-
als. Particularly with ‘out of the ordinary’ disorders, such as childhood
autism or Tourette syndrome, it can be an enormous relief to know
that the problem has been recognised. It is no coincidence that demons
in fairy stories often lose at least some of their power once they have
been named. A child and family’s sense of isolation is usually lessened
once they know that other children and families have similar problems.
Professionals should inform families of relevant voluntary groups. There
are local and national parents’ organisations for some child psychiatric
disorders. By joining these groups, families are able to meet other people
in similar situations, and may also gain access to newsletters, pamphlets
and talks.
2 A diagnosis may also be the ‘passport’ children and families need to
be allowed access to special educational help, extra allowances, special
holidays, and so on.
3 A diagnosis often comes with a prognosis. When the prognosis for
natural remission is good, the family may be happy to leave well alone
and let time do the work. Indeed, defusing anxiety about the future may
hasten spontaneous recovery.
4 Explaining the implications of a diagnosis is also an opportunity for
conveying important information on the nature and origin of symptoms.
This, too, may have therapeutic value, as illustrated by the follow-
ing three examples. Knowing that childhood autism is not caused by
parental unresponsiveness may help parents and others move beyond
guilt and blame. Teachers and parents may find it easier to deal
constructively with a hyperactive child once they know that he or
she is not just being naughty. Knowing that Tourette syndrome is a
neurobiological disorder may help dispel ideas of ‘possession’.
5 A label can be used in therapeutic work to stop a child being scape-
goated. For example, rather than blaming a child’s propensity to jump
up and down during dinner and fidget constantly on his wickedness and
unswerving desire to wind up his mother, the parents may be helped
to ‘externalise the problem’ and see that it is his hyperactivity that’s
making him fidget. Then both the boy and his parents can be on the
same side in trying to beat the difficulty.