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To see or not to see....a psychologist

65 replies

hocuspocus · 21/01/2006 22:16

My dh and I have a dilemma.

We are struggling to maintain a happy home at the moment due to the strain of dealing with the challenging behaviour of my ds(4). On a good day, ds is charming, great fun, and of course devilishly handsome . The not so good days (more often that not) are filled with conflict whenever we ask ds to do something which he doesn't want to do.

We have tried to combat the tantrums (screaming, laying on the floor etc) by use of time out and sticker charts in the past - but the reality is starting to sink in that we don't really seem to be making much headway. Dh and I have always consoled ourselves that ds will grow out of this behaviour (or it would as least improve!) as he got older....but our optimism is now fading.

We are also getting more concerned as ds is due to start school in September and we anxious that he will be labelled as a "problem child". His behaviour is also having more impact now on dd (1), as I feel that she gets an unfairly small portion of our time as so much energy is directed at keeping ds under control.

In desperation, we have thought about seeing a pyschologist. I have no experience in thie field. Do they really help? I wonder whether we will just hear the same advice (star charts etc) that we have already followed - or is it worth a try?

I am also worried that a consultation at this stage will form part of his records when he starts school - and would like to avoid this if possible.

Can anyone help?

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usandbump · 22/01/2006 03:46

Hi Hocus Pocus, I work in a pre-school and if you/we had concerns we have 2 options

  1. call your health visitor with your permission
  2. call our area senco (special educational needs co-ordinator) again this has to be done with your signed permission.

The area senco would come in and observe your child and then share their findings, they then can direct you where to go next and have the power to make referrals. You can meet with the senco at the end of her visit and discuss his behaviour at home.
I personally usually prefer the 2nd option they usually prove much more useful. Have you seen the observations his nursery have taken, you may pick up on something they haven't, this would also ensure they HAVE been doing as they said they have and are taking things seriously.

Hope this helps and I wish you luck

chipkid · 22/01/2006 13:09

hocuspocus-I had somebody come into nursery to observe ds (the nursery said it would help them know how best to handle him)
I was a little unsure at the time but said that as long as ds was unaware of it I would not object.
Her opinion of ds was that he was very bright and was bored and understimulated in the group that he was in and that he should be moved to the older group and have his time much more directed.
They did this and the difference was noticeable at nursery. School probably donot have any problems as he is being stimulated and is interested in the work.

shrub · 22/01/2006 13:56

another vote for Sophable's recommendation 'how to talk so kids will listen'.have found how to talk so kids will listen and listen so kids will talk website if anyone interested - gives some good examples and info. very american but it really works.

hocuspocus · 22/01/2006 14:26

Shrub,

Looks like it's definitely worth a try...didn't make it to Ottakers unfortunately but did take the positive step of purchasing it from Amazon. Should arrive in next few days so I shall burn the midnight oil and post a review...

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hocuspocus · 22/01/2006 14:32

Chipkid,

I suspect that my ds may also be a bit bored - he is now the oldest in his year (Sept b'd) and I think he is now ready for more than just structured play.

I should be told the results of the nursery school observations at the end of this week - if they don't make any headway then I will follow your suggestion and ask for an "outsider" to observe and give their opinion.

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shrub · 22/01/2006 14:41

Hocuspocus - just to add make sure your dh reads it aswell. i'm still reading mine and have found dh is still using old pattern of talking which can be frustrating. i should have bought 2 copies!
take care and remember you are doing your best!
xx

callaird · 22/01/2006 17:53

My youngest twin 3 yrs (I'm his nanny) is going through real bad tantrum stage, every night at bath/bed time he would start screaming and not stop for about an hour when he fell into an exhausted sleep. One night last week before his parents came home, (his parents bath him and put him to bed most nights) I sat twin I in front of a dvd and took Twin II into another room so he wasn't distracted by the tv, sat him on my knee and asked him to look at me, then I explained to him that the tantrums made all of us upset and that we were very sad when he screamed like that, and I told him if he could be a good boy, he could have a packet of crisps after Kiddy Kapers (baby gym!) and that we would all be very proud of him and happy with him. He was as good as gold. The next night I did the same with the promise of a chocolate cookie after nursery if he was good and the next night the promise of going to play on the trampolines (which they both love, but I hate cos they make me go on too!!). The following night his parents had "the chat" with him and promised to take him somewhere nice if he was good. He hasn't had a tantrum since. Touch wood. Fingers crossed. Luckily, most of the things we have promised him are what would happen normally anyway!! So no hardship to us. We are going to keep doing "the chat" for this week and then next week we are going to stop.

chipkid · 22/01/2006 19:05

hocuspocus-it does sound like your ds is not being stretched enough. He is the other extreme to mine in terms of age-my ds is only two to three months older than yours yet he is already in reception-and it has been really good for him.

The other thing that I always remind myself is that I am always breaking ground with ds as he is my first. I have no idea what are phases and what will pass-so worry about everything as if this is how it will always be with him!

With dd it is different-she has a tantrum and I think-aw she's having a tantrum-how funny! she is 15 months and I know she won't be behaving like that forever!

I am sure your ds is just another example of a rowdy, noisy, testosterone fuelled boy!

tegan · 22/01/2006 19:44

My GP asked has sai she will consider DD for a referal to a shrink when she is 2 (all down to her not sleeping ) but I have put my foot down and said there is no way she is going.

Blossomhill · 22/01/2006 19:49

Tegan - there is such a stigma attached to pyschologists but we found the one who helped with my ds's sleeping problems a real help.

mojomummy · 22/01/2006 19:54

Does DS have artifical colours/additives ? I am aware that removing these (if in the diet) can make a major difference. Also perhaps adding fish oils (omega 3/6's) to his diet ?

I would also cut the TV right down to perhaps one 'harmless' sitting a day.

Perhaps your DS needs to be aware of everything - a sense of control - this is with reference to the coat. So perhaps could have said, "right we're going for a walk & your going to wear this coat as your favorite coat is having a wash, won't it be nice to wear a different coat " I had to use this tactic to get DD into her snowsuit this morning...pleased to say it did work.

nannyme · 22/01/2006 20:16

Ok, this one isn't a plug I promise.

There are people like me that can help who aren't 'Head Drs'.

I have seen a Child Psychologist about my daughter and although she was a lovely lady it took eighteen months to be seen and was a complete waste of time other than it was an opportunity for me to offload each week.

We went following my ex husband leaving us one day and disappearing off to Spain. DD started sleeping badly amongst other things. Having got through it on my own essentially and also through experiences through work and training i would now rely on the skills I have personally developed in order to deal with anything like this again. Never again a Psychologist.

My OH sees a Psychologist and Psychiatrist and this is very important and helpful for him as an adult with issues from his childhood but I think with children you can deal with things on a far more practical level and you don't need a shrink to do this.

Visit this website www.familycaring.co.uk/course_parents.htm and if funds allow, I recommend purchasing some of their resources. I base much of parent coaching on this type of approach. I have also trained parents and been a parent on their O-5's behaviour management course.

Well, I am giving away trade secrets here so I'll shut up. If you are in London CAT me and I'll see if I can help if you would like. But I really would recommend a nosey at the site I mentioned. I have one of the books and would be happy to loan out to you with notes for guidance!

hocuspocus · 22/01/2006 21:59

Mojomummy,

I try to keep additives etc to a minimum but they inevitably creep in at times. I am interested in your fish oils recommendation - I started ds on this about 2 weeks ago, and haven't seen any dramatic changes yet. I expect it's far too early though and will keep it up as I have also read reviews about their link with improved behaviour.

Have you used fish oils with your ds/dd and if so how long before you saw any changes (hopefully improvements only!)?

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marytee · 22/01/2006 22:02

Hi Hocuspocus

Thought it might be worth clarifying some of the points made so far with respect to what you might and might not expect from a clinical psychologist (i am one!). Unfortunatly it can be somewhat confusing as there is quite a lot of variation in practice within the profession, so i can only give you some general ideas.

The benefits of seeing one is that most child psychologists can and do work in a variety of ways depending on the 'problem'. So, as others have said, sometimes they provide very limited input other than to provide families with the space to re-evaluate their own situation, maybe with a few ideas thrown in. At other times it is about providing much more concrete help with regard to implementing strategies and evaluating if they are working. And sometimes it is about looking at the wider picture and helping to identify whether there are other difficulties within a family that are impacting on a child's behaviour and thinking about how these might be changed.

As a psychologist i try to work in collaboration with families, rather than as an 'expert'. There are times when some technical know how is useful however, so i may on occasions give 'advice'. The effectiveness of using rewards (like sticker charts), for example, is based on lots of factors. A few tweaks here and there can (sometimes!) make all the difference.

I can't for one minute promise that all other child psychologists have the same approach. However, most work with children in this area tends to be extremly practical. You may go over some of the same ground (such as the charts), as this tends to provide incredibly useful information about what to try next.

With regards to school records, you would need to discuss this at an initial appointment, however any information shared with school could only be done so with your consent. Therefore if you did not give this, information would not be passed to school. (There are some exceptions to this, but they relate to child protection concerns). Recordings of the appointments would form part of your sons's health service records. You can ask for details of the health trusts record keeping policy with regards to what might happen to the information, but in essence it is as confidential as talking to your GP etc.

A magic wand remains an elusive tool which we would all like to offer. In reality, finding solutions can be a slow and painful process, and sometimes we aren't the right people to help, or it isn't the right time or the 'problem' simply disappears of its own accord.

Hmm, anyway think am waffling. Sorry. In summary, yes, it might be useful to ask to see a child psychologist, but they are certainly not the only source of possible help. Might be worth a chat to with ds's GP to see whats available locally. Also might be worth exploring whether there are any 'Webster Stratton' parenting courses run in your area (sometimes run by psychologists, but not always), which some parents I have talked to have rated quite highly. They are very much aimed at the difficulties you have described and are very practical.

Nannyme - I appreciate that you might not have benefitted from your contact with a psychologist in the past. However I think its important to emphasise that adult and child work is very different. I certainly would not consider the work i do with children to resememble a 'shrink' in any way.

Sorry hocuspocus, very long and not too coherant rant. Thats what 4 months on mat leave and a baby has done to meHope its a bit helpful at least .And best of luck!

hocuspocus · 22/01/2006 22:03

Nannyme,

Thanks for the website you recommend - haven't had a chance to look yet but am willing to explore new ways of looking at things.

I may yet take you up on a one to one consultation...

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hocuspocus · 22/01/2006 22:10

Marytee,

Are you looking for any private client work whilst on maternity leave ?

Seriously though, thanks for taking the time to lay out all that useful info - the position re school records etc is much clearer.

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nannyme · 22/01/2006 22:21

marytee, if only you had been the Psychologist I had seen with dd!

However, my point was exactly as (I think) you point out and that is that there is a big difference between adult and child psychological services. Having experienced both I would say that both have their uses but that child psychologists, in solely my experience, offer far more practical assistance whereas adult services - whilst offering a range of therapies - tend to be cognitive biased. As a result my own experience has led me to ask "does one really need to see a psychologist in order to sort out behavioural problems in children"?

I think it would be really useful to know what additional support a Psychologist could offer somebody in hocuspocus's position beyond that of a good parenting course or similar. I am sure that there is a good answer to this question and I am not being at all facetious in asking what that is!

mojomummy · 22/01/2006 23:21

Hi hocuspocus, might be worth looking out for additives/sweetners in squashes - if you're DS drinks them. If you find them, go for a very diluted pure fruit juice.

I did buy a stash of haliborange for my DD ( not specifially for behaviour, but for the essential fatty acids as she doesn't like salmon) Unfortunately she doesn't like this concoction either, so unable to give a personal opinion. However, I have heard great results from increasing them in childrens diets. (mental note to grind up a seed mixture to add to her cereal)

I expect you've watched Tania 'House of Tiny Tearaways' etc ?

tegan · 23/01/2006 10:30

Blossomhill - The GP seemed to think that we would have to sit as a family and discuss things whic I can't see is going to help DD2 and DD1 is horrified at the thought.

AggiePanther · 23/01/2006 10:45

Hi hocuspocus,
I don't know what its like in your area, but here there is a long waiting list to be seen by the child and family guidance team, so maybe worth getting yourself on the waiting list anyway - if things improve you can always cancel.
The health visitors here are also trained up by the team to deal with many behavioural problems - have you contacted your hv? (sorry not read the whole thread). I know from when I used to work for the service that the first thing we would ask parents to do is keep a record of what was going on including a) what was happening before the behaviour started b) what exactly the behaviour was c) how you responded and d) what the outcome was . Including times, dates, length of time problem lasted etc. It might be worth doing this kind of thing as it might save you some time. HTH

marytee · 23/01/2006 11:05

hocuspocus - a clinical psychologist with sleep deprived mashed potato brain may not be a good bet

Nanneh - Sorry,I did misread your post somewhat. I think you make a really good point about what a psychologist might offer above and beyond a good parenting course. I think it?s a common question even for people working close to us, perhaps we should work harder to try and answer.

For some people, I?m not sure the process or outcome is very different, whether they attend parenting courses, see a psychologist or use material such as the book discussed here. For others, putting the advice into practice can be extremely hard or simply isn't enough as the problem is more complex. Sometimes parents own experience of being parented is important, and this is usefully explored. Sometimes a child's difficulties are symptomatic of difficulties between other family members.

These are only examples, and I?m not suggesting that these factors are relevent to this thread. The difficulty, of course, is knowing whether these factors are present or not without an in depth assessment.

The other benefit of a psychologist is that they can draw on a range of approaches and tailor them completely individually to the family. For example, I do use some CBT, but generally with children over a certain age or with parents. There are other approaches, such as a narrative approach, that are useful for difficulties with younger children. Some people might accuse us of being jack of all trades and master of none, and I think that is a fair comment. It is really necessary to keep up to date in a very broad field. Finally, I always complete at least one, but usually numerous, observation sessions during the assessment. I'm not sure this happens during a parenting course. I often try to observe a child in multiple environments, as this can give a lot of information regarding what makes difficulties more or less likely.

There are some downsides of course. It can be a fairly intensive and intrusive process, even when handled sensitivly. In addition, you don't get the support and ideas from other parents that you might on a course. I certainly don't see psychologists as a panacea for all behavioural problems. However, i do think that there is a tendency for behavioural principles to be presented as more simple than they are (in particular 'Supernanny' really gets my goat!!). I do think that having a thorough grounding in behavioural psychology (not the exclusive territory of a clinical psychologist)is a real asset in applying this type of approach.

Does this all make sense?

Sorry hocuspocus i appear to have hijacked your thread a bit - hope some of it is useful. If you have any more general questions about what might be involved i would be happy to have a stab at answering.

chipkid · 23/01/2006 13:43

got my book this morning-how to talk to children etc-it looks interesting!

chipkid · 24/01/2006 21:11

how are things today hocuspocus?

hocuspocus · 24/01/2006 22:24

Marytee,

I don't mind you hijacking my thread, so long as I can have it back now - an excellent example of sharing, I think you will agree....

Seriously through, your comments are helpful and give a useful overview of what to expect if we do decide that this is the best way forward.

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hocuspocus · 24/01/2006 22:29

Hi Chipkid,

These guys must be on the ball - my book arrived today! I plan to retire to bed now and delve into the first chapters.

Only one major incident to report in last 2 days (not bad going) - ds told his key worker to "shut up" when she asked him to wait to wash his hands . I am (probably naively) a bit shocked by this as we would not use that type of language at home. I guess it's something that ds has picked up from other kids, or perhaps the TV (back to the action heros again).

The Incredibles has suddenly disappeared, BTW.

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