Most couples disagree from time to time about how to best parent their children. These disagreements can escalate into full-blown fights when a child is newly diagnosed with a psychiatric condition and decisions about treatment must be made. It is an overwhelming and emotional process, and it requires a lot of time and attention. Many treatment options exist and the stakes are high. How can parents navigate the process from diagnosis to intervention to maintenance without tearing each other apart?
No matter what the diagnosis, it is important for both parents to be well informed. Parents should attend doctor visits together as much as possible, particularly at the time of diagnosis, and they should prepare a list of questions prior to the visits. Appointments are time limited, and you want to be prepared and assured that both of your concerns are addressed. The same goes for school visits. When a child is diagnosed, parents often need to meet with the school to explain, and possibly to implement a behavior plan or ask for accommodations. Children with ADHD, for instance, typically respond well to environmental modifications, and they need their teachers to understand that about them.
When one child is diagnosed, it is the entire family’s issue to deal with. Each family member has to take responsibility for the way they manage difficulties and contribute at home. It is usually appropriate and recommended to explain diagnoses to children at an age appropriate level. Teens in particular benefit from understanding their condition so they can develop coping mechanisms and fully participate in interventions. Solution-focused marital and/or family therapy can be extremely useful so parents and family members feel united. Together you can establish rules and consequences, recognize your parenting strengths and weaknesses, and anticipate struggles. Consistent parenting is key to helping children manage their mental health.
It is very common for parents to disagree about whether or not to medicate a child. The choice is more obvious when a child has a medical condition but it can be murkier when it comes to psychiatric conditions. In cases of ADHD, for example, one parent might worry about side-effects and dependency while the other sees their child’s grades slipping, friendships suffering, and self-esteem diminishing and believes that time is of the essence. Both parents have a point, but who is right? It is important to work closely with doctors and to be as well informed as possible. If your child is a teen, involve him in the decision-making process. Discuss the pros and cons of medicating, and help him understand that there is no magic pill. Medication will help him focus, but he will continue to be responsible for practicing strategies developed in collaboration with therapists and/or teachers.
The stakes are even higher when parents are divorced and children split their time between two homes. No matter how bad it gets between you and your ex, try to remember who is important. Try to be civil enough to get through doctor appointments and make decisions in the company of a professional. Whatever you agree on in the office should continue in both homes. Certain medications need to be taken consistently, and you will harm your child by taking him off them even for a few days. It is just as important to do your best to maintain a consistent structure in both homes. Rules and consequences apply. There should be no good guy or bad guy.
Parenting is full of surprises. It is impossible, unfortunately; to be sure you are making the right decisions all the time. Try to be open-minded and consider your co-parent’s perspective. Remember that you both want what is best for your child.
Dr. Jaime Black is a licensed psychologist practicing in Westchester and New York City. In addition to providing general mental health services, Jaime works with individuals of all ages on the autism spectrum, doing psychotherapy, conducting evaluations, and facilitating social skills groups. Visit www.spectrumservicesnyc.com, e-mail JaimeBlackPsyD@gmail.com or call (914)712-8208.