Why Is It So Hard to Hear That Your Child Has Difficulty?

Alice left the meeting at school feeling scared and worried. Charlie’s teachers were concerned that he was not following the rules of school—he was resistant, uncooperative, and sometimes disruptive. They had even asked the school psychologist to observe Charlie in class and consult. Now they were all recommending that Alice and her husband Ray meet with a mental health professional to help them get a better understanding of what was underlying Charlie’s misbehavior. They were hopeful that the consultant could guide Alice and Ray to interventions that would help Charlie control himself better and comply with teachers.

Alice knew she had to follow up. She had wondered about this next step for some time and had discussed the idea with the pediatrician, but had never followed through. Now she felt guilty for her procrastination. She dreaded the conversation with Ray who was always a little uncomfortable with doctors, but she knew she could no longer delay.

Anticipation of a consultation with a psychologist, psychiatrist, social worker, or other mental health professional can bring up many feelings in a parent. For some, the feeling of getting help is one of relief. But for many, like Alice, the anticipation is unpleasant and they delay or never go at all. This can be an outgrowth of previous negative experiences. If you have not felt helped in the past, if you have felt judged or have been disappointed, then a referral for a consultation can feel like something you just do not want to do. Beyond trepidation and the anticipation of disappointment, it can feel like a mirror is being held up in which all their weaknesses, problems, and shortcomings are reflected. Feelings of failure, anxiety, shame, or anger can arise, just as guilty feelings did for Alice.

Here are three steps to help minimize your anticipatory distress:

1. Think through any similar experiences that were upsetting to you. You are trying to close the gap between not wanting to do something and also expecting to feel badly if you do not do it. How did you handle this in the past? What was helpful?
2. Note the differences between how you handled difficulties as a child and how you are able to address difficulties now as an adult. How have your life experiences added to your ability to keep things in proportion, broadened your perspective, and developed increased resilience? How much better can you now think things through and solve problems?
3. Recognize that there are different outcomes that are possible now. You can navigate a different path because you have awareness of your past experiences to serve as guidance and the expert is there to assist you in helping your child. This is a shared goal. Knowing that the consultant’s job was to help her and Ray help Charlie made it easier for Alice to move forward, even though Ray remained a bit uncomfortable.

A consultation can feel like a time when you and your child are being evaluated for the story that you are telling. The key here is that you are facing up to some truths that may be difficult, and at the same time you are hoping to find a partner in the expert you are meeting. Can they be someone who can help you and your child work through what is affecting your child’s behavior?

Here are three things to consider in these initial consultative sessions:

1. Can you work with this particular professional? Do they listen attentively? Do they speak in a language you can understand and in a tone you can tolerate and, hopefully, feel better from? Does it feel like a good “fit” between you?
2. What is their professional opinion of what is going on for your child? Do you understand how they see the issues, and does it make sense to you?
3. What is the initial treatment plan they suggest for moving forward? Do you understand how they reached that plan? Do they want other professionals to add additional expertise, like a psychologist to do educational testing or a psychiatrist to evaluate the usefulness of medication, or do they feel that is unnecessary at this time? Do you agree with the plan and how they suggest you proceed?

You can expect that the professional you are consulting also will want to meet with your child. The ultimate treatment plan may or may not involve therapy sessions with your child, but it is usual for your consultant to meet with your child firsthand during this evaluative phase. Although Alice and Ray felt comfortable with the psychologist they met, they felt completely unprepared for introducing him to Charlie. They expected a lot of resistance and were not sure how to handle it. The psychologist discussed their concerns and helped Alice and Ray prepare to raise this with Charlie, even providing them with some words and an explanation that made it easier.

Introducing your child to the idea of meeting with a professional can range from a “breeze” to daunting. Although you should expect help from your consultant in breaching the idea to your child, here are three scenarios to consider:

1. At a time when your child is upset with what is going on, mention that you, too, have been upset about this and have talked with someone, a professional, who you think can be very helpful.
2. Explain to your somewhat resistant child that you want them to meet with a professional who specializes in helping children find out more about themselves and why things are going so hard for them. If your child balks, it is best to suspend the idea for a while, rather than taint it by pressuring the child. Interventions like therapy will not work if the child does not want to be there.
3. When the child is required by the school to see a professional, explain that he does not have a choice, just like going to school is not a choice. Though difficult, it is important to use parental leverage to follow through on the requirement. You can explain that once he has met the professional and learned more about the plan to help him, he will have an opportunity to discuss it with you.

Consulting with a mental health professional is a big step. It is important to feel optimistic about the consultant, even if you feel pessimistic about the problems. Think of the consultation and therapy as helping your family get through a period when there are difficult but important issues to deal with. We have found that self-esteem, often at the root of many childhood issues, evolves once the child is engaged in doing the hard therapeutic parts and settling emotionally. Being able to look back on the struggle and the accomplishment can be strengthening and a source of well-deserved pride.