By Katharina Manassis MD FRCPC
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Additional info for Case Formulation with Children and Adolescents
An impending separation or divorce, the serious illness of a family member, or a family member going to prison) are also often not shared with young children, and yet these outlying factors may influence their mental health profoundly. ” is critical to include in every child and parent interview. , 2002). Thus, children may experience more or fewer symptoms than their parents describe, or one parent may have a completely different view of the child’s difficulties than the other. These differences are less likely to be elicited in family interviews than individual ones.
The age of onset of puberty can vary even more widely. Sometimes, there is a therapeutic value to correcting unrealistic developmental expectations. This is particularly true when parents’ expectations are clearly too high or too low. For example, parents who expect their 6-year-old to do a chore every day in order to earn a treat on the weekend are harboring unrealistic expectations. These parents may become angry when the child does not comply, thus creating interpersonal problems that could easily be avoided if they understood they have set an overly high developmental expectation.
Emotions clinicians observe can thus provide valuable clues to the child’s psychological problems, though none are diagnostic. , their parents). For example, children raised by critical parents may try to please the clinician or take a long time to respond due to fear of the clinician’s reaction. By contrast, children who are in conflicted relationships with their parents may behave defiantly, seeing the clinician as the parents’ ally. Each of these observations can be made in the parent as well as in the child interview.
Case Formulation with Children and Adolescents by Katharina Manassis MD FRCPC