Treat the parents, not the kids

From US News and World report on current treatment trends in Britain. How exciting, hopefully it will catch on here. This concept can hold true for any “behavioral problem” or “mental illness” in general. Though included should be training the parents to eat well  and having children stay away from things like food dye and a number of other food stuffs that has been proven to cause hyperactivity and other mental health issues.

Skip the Ritalin and Treat Parents Instead

England has a new plan for helping children with ADHD: Treat the parents first…

…”Sometimes, parents make that presumption, but when you’re talking about counseling—behavior management, proper rewards, consistency in parenting—it’s really a parent-focused therapy,” says Andrew Adesman, the chief of developmental and behavioral pediatrics at Schneider Children’s Hospital in New Hyde Park, N.Y., who is active with CHADD, an advocacy organization for people with ADHD. In other words, change the parent’s behavior, and the child’s behavior will change, too. The parent training recommended is not specific to ADHD but rather teaches behavior management skills that could be used with all children: having realistic expectations for a child’s behavior, clearly explaining goals and rules, identifying behavior that’s inappropriate, and following through with sanctions for rule violations and rewards for good behavior…

…Earlier this year, I spent a lot of time trying to figure out the secrets to raising great kids and learned that we know what works; it’s just that in the heat of the moment, we parents often do the wrong thing. A lot of what works is counterintuitive. Scientists have conclusively proven that nagging doesn’t work, for instance, but we all do it.

Saying that parents of a child with ADHD need training doesn’t mean that the parents are the problem, Adesman says. “But maybe they need to change their approach to the child, or be more realistic. The parents can oftentimes improve the child’s behavior.” read more here

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About Monica Cassani

Author/Editor Beyond Meds: Everything Matters

23 Responses

  1. Sloopy Cowbell

    Pardon the pun, but it would be nice to think that the National Institute for Clinical Excellence (NICE) has childrens’ welfare at heart.

    And that this policy shift is a sincere attempt to deal with bad behaviour in kids in a safe and compassionate manner.

    However, given NICE’s past record – and particularly the record of the NICE chairman, “Sir” Michael Rawlins – I somehow doubt that is the case.

    NICE is generally seen as the Drug Rationing Board of Britain’s National Health Service. It is the body which rules on whether a certain drug may or may not be prescribed for a given condition.

    Since 95% of all medicines in Britain are prescribed through the state healthcare system, NICE wields a lot of power – Rawlins & Co. can make or break a drug in the British market.

    So for Big Pharma, it always pays to be extra nice to NICE.

    God only knows what “arrangements” go on behind the scenes between the pharmaceutical industry and NICE. Rawlins has past form, in the respect, when he was chairman of the Committee on Safety in Medicine (CSM), back in the 1990s.

    Since the economy in Britain has tanked to a level of austerity not seen since the 1940s, I reckon this shift in NICE guidelines has more to do with cutting the NHS drugs bill.

    If it saves kids from a lifetime of drugging, then it’s no bad thing even if there is an ulterior motive behind it all.

    Alternatively, it may be that Ritalin which is now off-patent is no longer a cash cow to Big Pharma. And NICE has finally done the right thing (albeit for the worst reason), in pulling the use of Ritalin as a cosh for unruly kids.

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  2. Eve

    Wow, Mommy’s comment was rude. I’m a mother and I think you have every right to comment on parenting. I think all former children do and are, in fact, as good an expert as can be found anywhere on what it’s like to be a child–and what a good parent would be like.

    You go, girl.

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  3. I completely agree with the theory that everyone who has been a child has a valid perspective on parenting. Do I know what it’s like to parent a child full-time? No, I sure don’t, but I know enough to know that I couldn’t do it. 🙂

    And I certainly know enough about psychotropic drugs to know that if they can damage and confuse an adult’s brain and body as much as they did mine, it’s a pretty damned bad idea to prescribe them to children, for the same reasons that it’s a bad idea to allow children to get drunk or high or experiment with illegal drugs or tobacco. Things that are dangerous for adults are exponentially more dangerous for children, whose brains and bodies are still developing.

    That’s not parenting, that’s common sense.

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  4. It really frosts my cupcakes when people who do have children tell me I don’t know anything about children because I don’t have one. Common sense doesn’t require a degree in parenting, and having a child pass out of your womb does not make you a mother. There have been mothers in the world who would have been better off had they never had children in the first place. I can start with Medea, and finish at the moment with Casey Anthony.

    Just my opinion,

    Mr. Rochester, you have a great blog and beautiful kitties.

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  5. Well, if NICE is known for pushing drugs, and in this case is training the parents instead of pushing drugs, don’t you think that’s nice? Maybe the leopard has changed a spot or two…

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  6. David,

    I know it’s off topic, and I hope Gianna won’t get upset but I remember reading a book by Ann Rule a few years ago on the train, and she made a comment about someone- I cannot recall who- who was accused of murdering her child, and compared her to Scarlet, the cat who risked her life and got badly burnt getting her kittens out of a raging fire a few years ago in NYC.
    Scarlet passed away last month. For some reason that idea and the post Gianna had earliler with the tiger and piglets really stayed with me about mother love isn’t just in humans.

    I will never be a mother, but I am an Auntie, and I am blessed to be owned by a cat, who is right now on my lap, snoozing and waiting for me to go to sleep so she can stretch out on the comforter. And making it impossible to type or finish my work.

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  7. One of my boss’ relatives was a child psychiatrist. He used to say that in most cases the problem wasn’t the child but his/her parents. – Which contradicts what is stated in the article, but if “parents do the wrong thing”, wouldn’t that be a problem? And why are we so reluctant to say someone’s environment is a problem, all the while it comes so easy to talk about a “problem child”? – But that, if he told them, they’d just go and find another professional – who was willing to exempt them for any accountability without further discussion.

    Medea and Casey Anthony are just the tip of the iceberg. No one who has the self-awareness (and accountability) of a toddler should have kids themselves.

    No matter what the motives are (and I guess the motive here is to save money), it’s a long needed change to the better. – And I couldn’t agree more: “This concept can hold true for any “behavioral problem” or “mental illness” in general.”

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  8. I agree family dynamics should be looked at …at all costs to prevent medicating a child. Not only am I a daughter, I am a mother of 3 and a school teacher. Kids need to be kids and drugs a last resort.

    I also do not like it when people who are parents assume people without kids don’t have credidential to speak about parenting.

    We were all kids once, and in fact we still are those children in our souls and spirit.

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  9. That seems to be a lot of what’s wrong with the whole world right now–most people do not seem to want to accept responsibility and be held accountable for their actions.

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  10. I suppose this is now slightly off-topic, as we seem to have entered the realm of what it is and isn’t OK to tell parents about how to handle their kids, and honestly, I feel both sides. Before I was a parent, I remember many times thinking things along the lines of “why doesn’t someone wipe that kid’s nose?,” only to find now that it is actually impossible to have a kid whose nose is always wiped. I know we’re not talking about snotty noses here, but in a lot of ways the analogy holds for many aspects of parenting. I don’t say this to devalue what non-parents say about parenting, but as mother who used to hold many opinions about parenting that I have since revoked, I can say it really truly does look different when you’re on the other side. Living day in and day out with immense responsibility for a small child, who is pretty much guaranteed to drive you crazy at some point or another, is profoundly different than babysitting, teaching, treating, or being and aunt or friend (again, not to say the world doesn’t need lots of wonderful babysitters, teachers, doctors, aunts and friends).

    One thing I’ve also felt as a parent is profound isolation and profound criticism. Really, it is constant. Not necessarily directed to us personally, but certainly day in and day out in the press, and in public conversations about what is or isn’t wrong with kids in general. You are told not to discipline, that if you are at all harsh will squash your child’s spirit, and cause them mental health problems. You are told that if you do not discipline enough, you have caused your child’s problems. Really, the mixed messages are constant, and they are all delivered in a condescending tone by “experts” who know more than you. It is far more exhausting than I expected to face the constant criticism, and I think that experience may cause much of the defensiveness seen in comments like Mommy’s above.

    I also seem to have developed a much more independent (almost libertarian?) stance since having a child, something along the lines of “get your nose out of my family and keep your hands off my kid.” I don’t want well-intentioned “screening” programs in schools, or teachers trained to see ADD around every corner — though of course for me, this stems from a (probably reasonable) fear that any child that shows an ounce of pluck is likely to get pressured onto psych meds at some point– and god help anyone who ever broaches such a topic about my kid(s).

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  11. While I agree that a lot of the attitudes about my parenting are condescending and harmful, I wasn’t offended at all by the article. I am a firm believer in the significance of the strucure of family dynamics, and in all my years in therapy, it was never discussed. I learned about it in 12-step programs and lectures. Looking at parenting my kids as an opportunity to externalize my inner child, (no I don’t think that’s hokey,) is why my kids are quite a good deal happier than I ever was. I also got that from 12-step meetings.

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  12. Gianna– Just to be clear, I’m not saying you or any other non-parent should not be speaking about parenting, and certainly don’t think that you claimed to know what is right for any given individual (and of course I’m all for more folks pointing out we need to do more for our kids than pump in more drugs).

    What I was trying to convey, perhaps more in response to the comments expressing annoyance with parents for being defensive, is that parents have some pretty valid reasons to feel defensive, that may or may not reflect on what is actually going on inside their homes. And yes, as parents we absolutely are responsible for the dynamics in our families, but rest assured the complete lack of understanding and support from society at large, the isolation of individual families, and the overall rush to medicalize any slight blip on the radar screen (which is *not* what you and others here are doing, but *is* what happens in the world at large), certainly doesn’t help. OK, stepping down from soapbox now. You know I love what you do here.

    –TAW

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  13. Jon

    My wife is fond of saying, “If I’m expected to be a perfect parent, God needs to give me perfect kids”.

    We will all be perfect parents in the future, and we’ll have all the answers – when our kids have moved out and the job is done. THEN we become experts.

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  14. I came across this blogpost yesterday. (And couldn’t resist but had to comment. In part saying the same as I did here earlier yesterday).

    I liked this post because it says how it is in a very straightforward manner, no beating about the bush like in the article. (Yes, parents’ behaviour can change their kid’s behaviour. But no, it’s not the parents’ behaviour that in any way has as much as contributed to their kid’s behavioural problems. Hm… ) Neither it does insult or accuse or blame single individuals. Or tries to make them feel guilty about their thoughts, emotions and reactions. Nevertheless, it doesn’t fail to clearly point out the importance of awareness and acceptance of one’s own thoughts, emotions and reactions, if anything ever is expected to change.

    I maybe sounded a bit harsh in my comment above. It’s because I’m really fed up with a society that usually does nothing but disclaims responsibility for anything going wrong for any of its individual members, making the individual member its assigned scapegoat. It’s nothing personal. Personal is only that I do take responsibility for my thoughts, emotions and reactions towards my own parents. I just don’t want to be asked to feel guilty about these thoughts, emotions and reactions.

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