Opinion

When does a child need professional help for an emotional problem?

Tuesday, September 30, 2014

Often, after the fact, when a child has run away, or exhibited severe behavior problems, is hurtful to himself or others, people will rally around and provide support to the family.

That is well and good, and essential for the recovery and day-to-day survival of the family. But what can a we do before hand to help the child and the family? Afterward is often too late, if the child is successful in hurting others, or even taking his/her own life. What can we do before the terrible, and perhaps final, act occurs?

First, we need to know the symptoms of emotional disturbance in children.

Is there socially unacceptable behavior: like lying, stealing, fighting, hurting animals and doing poorly at school when the child has average ability (called anti-social behavior)?

Do we notice a child's development going backward instead of forward: Reverting to earlier forms of behavior such as bed wetting, soiling, thumb sucking or self-hurting such as pulling out eyelashes or hair, or scratching or cutting on him/herself (habit disorders)?

Is the child unable to stand up for him/herself, easily intimidated by others, avoiding responsibility, manipulating others, having physical complaints with no cause, and passively refusing to cooperate (poor sense of self and poor conscience development, possibly depressed)?

Does the child have irrational fears which are persistent and severe or panic attacks (anxiety disorder)?

Is the child overly controlling or needing things done in a ritualistic way which interferes with normal activities (obsessive-compulsive behavior)?

Is the child having visions, not connected to reality, living in a dream world or acting irrationally with unorganized thinking and distortions of thought (childhood schizophrenia)?

Second, we need to ask ourselves whether a symptom is serious or normal? How often does it occur? Does it appear at home, in school, in the neighborhood, where? How long does the behavior last? Is it getting worse? Have parents' and teachers' efforts to help the child failed?

Obviously, the longer the list of symptoms, the less age-appropriate the behavior, the longer the duration of the problem, and the more resistant the child has been to efforts to help, the more important it is to seek professional help.

Third, what causes a child to have emotional problems? Family relationships might give a clue. Do parents accept or reject the child? Are they too controlling or too critical?

Family interactions play a part: Is there a disturbed husband and wife relationship? On the verge of a divorce or violence in the home? Or are mother-father roles confused or lacking or contradictory? Is there dysfunctional parenting -- lenient, too harsh, neglectful, abusive?

Fourth, the child also contributes his or her own thinking to the situation -- what does the child fantasize or imagine? Is the child misinterpreting what is happening in the home?

Fifth, what events and circumstances in the environment contribute to the problem? Has there been long term physical illness? Long separation from parents? A traumatic event: fire, car accident, physical or sexual assault by an adult? Moving often or being cared for by constantly changing adults?

School counselors are a good source for making recommendations for professional help. Teachers are usually insightful about a child's behavior and can give a parent good input if asked.

And, of course, we are fortunate in Putnam County to have two centers for professional help with emotional problems in children as well as many fine private practice therapists.

Consult the Mental Health America of Putnam County for further information at 653-3310.