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Opinion & Essays - Mar, 2000 Issue #67 

When Growing Up Doesn’t Happen
Naturally:

Do We Need Expert Help?
By Cliff Johannsen, Ph.D.

[Dr. Johannsen has worked in the mental health, substance abuse, & juvenile corrections fields for 31 years. He has been a licensed psychologist for the past 16 years. He currently has a private practice in Oregon’s North Willamette Valley and is the Clinical Director of Catherine Freer Wilderness Therapy Expeditions. He and his wife, Linda, have raised 2 daughters. Some of that was “struggling.”]

A Scenario: 
Samantha and Mark felt that 13-year-old Tiffany was slowly slipping out of their grasp. They knew their parenting wasn’t what it should be; now their daughter was too far off-track. She was just suspended for smoking marijuana at school.

The first question for Mark and Samantha is:

Does Tiffany’s behavior make sense?’
Can we apply common-sense ideas such as “spoiled,” “out-of-control,” “in a negative peer group,” or “upset about something” to her behavior?

There are 3 possible answers:
A) Agreement that the misbehavior is easily understandable, 
B) Both are perplexed by what she is doing, or 
C) They disagree.

When parents conclude their child’s problems are understandable, they have the basis for a self-help strategy. Frequently their first step is to more conscientiously apply their same old parenting techniques. In a minority of families, that will be sufficient to bring the child’s behavior back in line with parental expectations. But in my experience most families require “something different” rather than “more of the same.” Many parents cannot be open-minded about the alternatives until they have first given their “best effort,” then failed with their own method of parenting. It is helpful to think of such renewed efforts as an “experiment” which may or may not be successful.

When parents agree their child’s behavior is easily understood and are ready to shift to new parenting techniques, there are too many options. Some parents try to absorb every point of view and the contradictions can be overwhelming. It is crucial to choose techniques that match the needs of the particular child (see the previous column, “What Am I Supposed To Do When Experts Disagree?” Woodbury Reports # 55, Dec. ‘98/Jan. ’99, p. 4.

Some professionals offer consultation about the best parenting “fit” for a child, typically charging a fee. When looking for such advice it is appropriate for parents to ask ‘How familiar are you with the range of parenting options and the effectiveness of each with different kinds of children.?’ There are no “pat” answers; most experts base their opinions on experience rather than research. You should avoid those who have a “one size fits all” approach. Although the professional you hire might not conduct a face-to-face evaluation of the child, he or she should ask lots of questions about the child prior to making recommendations. Such a consultation can also be a “double check” on the appropriateness of continuing with only a self-help strategy. When parents conclude that a child’s misbehavior is too perplexing for them to understand, then a professional evaluation may be helpful and provide ideas about what can be done.

Next scenario: 
Tiffany’s parents ask how much she is smoking marijuana and whether she is also using alcohol or other drugs. Some teens will be honest, but many will not. Tiffany may say the episode at school was her first contact with marijuana and that she never used other mind-altering substances. If so, being suspended may be all that is needed.

But if Tiffany has ongoing problems with negative attitudes, Samantha and Mark should conclude that Tiffany lied and get a thorough drug and alcohol evaluation. The professional will know questions to elicit detailed information from Tiffany, will draw conclusions from what she says, and will make recommendations for both self-help and professional care.

Principles that apply when parents are perplexed by the behavior:

1)  Parents should use common sense. If they don’t understand their child’s behavior, they should get a professional assessment. 
2)  If there is a chance they can solve the problem without professional help, then they should do so. 
3)  If they have made their best effort and the child is still having significant problems, then both self-help and professional help are indicated.

Next scenario: 
Mark thought the time had finally come when he and Samantha had to shape-up as parents. He thought they could do it themselves. Samantha felt more overwhelmed than Mark. She thought a therapist was needed for Tiffany. The girl became more unpleasant and less compliant at home while her parents could not resolve this impasse and begin to take action.

In this case, the parents disagree about their understanding of their child’s behavior as well as on how it should be addressed. They may even frame their positions in terms of “I’m right and you’re wrong,” and won’t be able to make progress with their child until they are “on the same page” that is, until they can share a common perspective and can act in a consistent and mutually supportive manner. Seeking such agreement is a valid reason for seeking help from a neutral person such as a parenting coach or consultant. Sometimes even a marital therapist might be appropriate.

The mother in the above scenario wishes for relief, for someone to take over and make the problem go away. Parents in this situation often envision the therapist bringing such about changes, at least to the degree the child will comply with parental expectations. In reality, the therapist rarely causes the child to comply. Individual and group therapists are best at teaching teens how to recognize and cope with inner thoughts and feelings, and need to maintain a mostly positive relationship with the youth, in order to accomplish that goal. It is tempting for parents to think the child’s therapist is the best person to offer parenting advice, yet it is not usually the case. Therapists may know only the child’s limited and distorted view of reality, and also must be cautious about helping parents too much, lest teens feel they have been betrayed. Therapists could find themselves in a “dual role relationship” with at least potential conflicts of interest. While there are few exceptions to this rule, generally the child’s therapist should not also be the parent coaches and/or family therapist, though the different professionals should be given permission to consult with each other.

Family therapy can be very helpful to parents in Mark and Samantha’s position. The sessions can be unpleasant at times and family members may wonder “why are we torturing ourselves this way?” But families do tend to behave better in such sessions than at home, with the advantage that a therapist can interrupt the typical patterns of argument. Discussing parental and marital conflicts in family sessions with children present sometimes works quite well. I tend to error on the side of openness, but some discussions should take place “behind closed doors.”

For struggling teens who can live at home, parents are still the most influential people in their lives. Parental control of the child’s life on a 24-hour-per-day, 7-days-a-week basis has far more impact upon behavior than does an outpatient therapist; but can cause the parent to sometimes be “hated.” Some combination of behavior control at home, exploration of inner psychological workings in individual or group therapy, and modification of interaction patterns in family therapy will fit the special needs of many adolescents. Others will require lower or higher levels of care.

These principles apply when parents disagree about their understanding of, and strategies for, their child’s behavior:

1)  Parents need to be on the same page, to be effective.
2) Regardless of the problem, parents are always part of the solution. It can’t just be turned over to a professional.
3)  Parents and professionals have different jobs. It’s a division of labor. Don’t ask professionals to do a parent’s job and vice versa. Therapists generally don’t make kids behave.
4) Sometimes behavior problems are just behavior problems. Then it’s the parent’s job.
5) Samantha and Mark might be more comfortable and effective if they receive education and encouragement from a professional other than their child’s therapist.

Next scenario: 
Mark and Samantha’s parenting of Tiffany unraveles, as it became clear that Mark was finding excuses to avoid being in the parent role, increasingly blaming Samantha for failing to straighten out Tiffany. He harped that she gave-in too much with the girl. Samantha was exhausted from screaming conflicts with both Mark and Tiffany.

In this case, the parents disagree about their parenting strategies. Though the “tough” father and “soft” nurturing mother may be a USA stereotype, in my practice I see the hard-mother/soft-father pattern just as often. Such parents often find they are attempting to compensate for each other, burdening themselves with their attempts to make up for what they perceive their partner lacks. Many couples could benefit from professional help to change these patterns.

While parents do not take on the role of “therapist,” to some degree they end up transforming their homes into a kind of treatment program. As anyone who has worked in residential treatment knows, it is difficult work and can be emotionally draining. It is extraordinarily strenuous for a single parent to do so. While she is not one of those, Samantha probably feels the parenting job is her burden alone. Mark’s avoidance of the parenting role with Tiffany may eventually become a critical factor in the child needing a higher level of care or out-of-home placement.

Lectures, reminders, pleading, and second chances, parental attempt to persuade or talk a child into compliance, may work to some degree with average-needs teens. However, with special-needs youth these approaches quickly deteriorates into parental whining, debates, yelling, and threats, apparently intended to wear-down, frighten, or intimidate children into compliance. These techniques also tend to elicit similar behavior in both one’s partner and child. Too rigid and frequent adherence to just these methods is an indication that professional help is needed.

When parents disagree about parenting strategies, these principles apply:

1)  When parents become polarized as one provides “all the love” or “all the discipline,” in most cases professional help is required.
2)  Abdication of the parenting role may result in the child receiving an inappropriate style of parenting (such as permissive) by default. It probably isn’t what the child needs and professional help might be necessary to get a parent re-involved.
3) Screaming might be thought of as a kind of addiction. If parents can’t access being “calm, cool, and collected” on their own, then professional help may be beneficial.

In conclusion, I have provided a range of concerns for parents to think about and some guidelines for choosing from among various strategies. Those include increased efforts, education, self-help, professional consultation, and therapy.

Copyright © 2000, Woodbury Reports, Inc. (This article may be reproduced without prior approval if the copyright notice and proper publication and author attribution accompanies the copy.)

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