By Sophie Smith, Clinic Director and Clinical and Developmental Psychologist
Earlier this month, I spoke as Clinic Director of The Young Mind Clinic at the National Counselling and Psychotherapy Conference (National Maritime Museum in Sydney’s Darling Harbour) focussing on the challenges facing young people today. I spoke about two important topics, the first of which I will talk about in this article.
This article summarises one of the aspects I spoke about and hopefully encapsulates our philosophy on working with families at TYMC which influences the way we do things at the clinic on an everyday basis.
From the perspective of clinical practice, one of those big ticket issues that contribute to the trajectory of a young persons development is the functioning of that child within their family environment. Family conflict and the eroded emotional resources of parents at the moment is a big challenge facing young people.
This has been particularly marked since COVID with it being most noticeable in the last 2 years of the pandemic in our practice. This is also something I hear being reported during my supervision of counsellors and psychologists in schools. But why is this the case? I think there are a few reasons why this might be happening. People have been more stressed overall which has definitely led to parents feeling the pressure when it comes to managing kids and this has also impacted on kids emotional problems.
We are also living in a time which has seen a great deal of change in the way we parent and we find that there is a generation of parents who are striving to do things quite differently to their parent’s generation. Also equitable parent role expectations are leading to there sometimes being conflict because of the differing styles of the two captains of the ship. We find that we are often working with parents who may have very different approaches with the same child. This can lead to confusion for the child but also frustration for parents which feeds into the cycle of family conflict and may be heightening child behavioural and emotional problems.
At the pointier end, this constellation of issues can be highly problematic. Conduct or behaviour problems in early childhood are the single most reliable precursor for mental health disorders across the spectrum in adulthood.
So what do we do about this? Sensitive parenting can change the trajectory of a young persons mental health and development. If we want to impact on future adult mental health problems, we need to approach difficulties that children may be having now and the most powerful way to do that is working with parents.
Behavioural parent training for conduct problems is one of the best supported and most effective psychosocial interventions for mental health problems. The focus of these interventions is to teach parents how to positively engage with their child to promote prosocial behaviour, and effectively reduce aggression and antisocial behaviour using sensitive rather than coercive discipline strategies.
However, it is really important not to blame parents in the process as parent- child relationships are transactional, meaning one influences the other. Children who may come into the world with more challenging temperaments could be eliciting parenting behaviours that may not have been elicited with a different temperament. Thus the parenting behaviours we may engage in are often unique to that particular child and that parent-child relationship.
The reality is that parents are the greatest resource for influencing their children’s way of responding to their environment and shifting developmental trajectories. So whilst we can’t identify a single cause for child conduct problems, a positive parenting approach is the solution.
Medicare has recognised to a some extent what the evidence tells us – granting us 2 parenting sessions out of every child with Mental Health Treatment Plan’s 10 rebatable sessions per calendar year.
Whilst it is a positive step for the system to recognise this as a key ingredient in improving mental health outcomes of young people – this does not by any stretch do enough to counteract the problem. Only a small percentage of families are accessing evidence based intervention and unfortunately we do not see the same outcomes by only working individually with the child.
We have come along way from when I first started by career close to 20 years ago – when it was common for people to respond to my telling them that I was a child psychologist with – what on earth would a child need a psychologist for?! Thankfully the world has woken up to the idea that most mental health problems don’t just appear out of nowhere when someone hits adulthood.
The key now is for us to truly embrace the idea of hitting the problem at the source – during childhood with the actual interventions that will make the largest impact.