Vijai P. Sharma, Ph.D
The scientific debate about the effectiveness of treatment seems to be limited to such narrowly formulated questions as, "Is medication or therapy alone, or in combination, proven to be a more effective treatment for depressed children?" We should be asking instead, "Is treatment more effective when a child has family support now and the child-parent relations were satisfactory in the past?"
The most effective way to help a troubled child is to first ensure that the child receives love, time and attention from parents and then we can add medication and counseling if required.
In order to help a troubled child, it is also important to understand the peer group factor. In the social matrix of the adolescent, we can identify three types of children, "Alpha," "Beta" and "Gamma."
Alpha children acquire the reputation of being "popular" or "leader of the pack." Positive alpha children are assertive, intelligent and creative, but there is also the negative alpha, who is aggressive, callous and destructive.
Beta children are the followers. They constitute the "pack" of the alpha leader. They want to be recognized and loved. They aspire to be like Alpha children who might be either positive or negative role models.
Gamma children don't engage in a popularity contest or obsess over what someone else does or says; they are focused on academic and other life goals.
Gamma children rarely get into trouble. If you are a parent of a Gamma child, you can relax.
Beta children are not troublemakers in their own right, but can get into trouble trying to follow the leader.
Alpha children, depending on the degree of built-in sense of responsibility or delinquency, can be positive role models, as mentioned earlier. If they are the negative type, they are likely to get into trouble and take others down with them.
These types are not fixed for life. The personality and behavior of a child's personality can change, especially, as they course through the adolescent years. Some children, to start with, are emotionally healthy and goal directed, but later get depressed, anxious or angry and resentful. Such emotional disturbance may often result from their belief that the significant adults in their lives don't really love them and don't really care about what they do or what happens to them.
Such an emotional turn may not be a sudden or acute reaction to a major life event such as the divorce, death of a loved or a major stressful change. In other words, there is often no specific traumatic event one can identify in order to understand why a child suddenly changed for the worse.
Rather than a "response" to a traumatic event, it can be a growing traumatic "conviction" the child has formed over time that nobody cares and nobody loves. That child, on the inside, might have been feeling unloved and unattended for years. He or she might not have expressed any such feelings, but harbored them nonetheless.
At least, subjectively the child feels he or she is all alone. Negative thoughts become louder and more repetitive, such as, "Nobody gives it a damn and nobody cares!" When a child reaches that point, grades often plummet. Drugs may be involved. The doors of the child's room stay shut and he or she may enter into an emotional cocoon.
More negative outcomes of such negative belief follow. Temper flares up unpredictably. Behavioral problems mushroom. Conflicts and fights at school and brushes with the law force parents' attention. The child at this point is likely to enter the mental health system for medication and, or counseling.
When this child comes for treatment, medication or counseling can be a massive distraction from the real solution. For example, a child already on sedatives might be too sedated to emotionally and behaviorally react to the environment. The non-reactivity might be seen as "improvement." It would be assumed that an emotional disorder, chemical imbalance or teen hormones were the cause of the problem. Thus, the real problem might never be resolved. Emotional scars might never be healed.
In still another scenario, intensely defiant and rebellious children may override the intended effect of the medication and counseling, and continue to exhibit similar problems or worse. In that case, medication and counseling might be seen as a failure. Parents thinking they have done everything they could be at loss and left feeling hopeless.
Medical doctors and counselors can facilitate communication and build a bridge between a concerned parent and a drifting teen, but they can't build a highway over a mile-long and a mile-deep chasm.
In such a situation, it makes more sense that a parent or both parents if available, individually or jointly spend at least 30 minutes with the child doing whatever the child wishes to do during that time. Then, medication and or counseling may be tried.
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Copyright 2004, Mind Publications
Posted June 2004
Dr. Vijai Sharma
Your Life Coach
By Telephone