Monday, May 6, 2019

What do psychologists do (and why would you go to see one)?

So, you have taken the leap and decided to see a therapist. Or your child might benefit from counseling. Either way, you are faced with a range of choices and decisions. What type of therapist should you see? What approach is best? How do you distinguish between the different mental health specialties, and why should it matter?

Information online may be even more confusing. Some therapists espouse amazing results. Testimonials from clients are not permitted by many licensing boards, yet are listed on some websites. Life coaches sometimes boast high rates of success, despite the absence of any licensing, certification, or regulatory board that monitors competence in coaching. And unfortunately, there are endless debates about what approach works best for different problems.

I often see questions and comments online that reflect understandable confusion about the differences between mental health professionals, particularly psychologists and psychiatrists. Psychological and intellectual testing are confusing as well, along with questions about who can administer and interpret evaluations. What exactly is involved in a gifted or ADHD evaluation? Are psychologists merely "testers," as some have labeled them?

Even more troubling, I recently stumbled across online comments  that characterized psychologists as less helpful than other mental health professionals. The author claimed that psychologists are more focused on psychopathology, and are less "strength-based" than members of other counseling professions.

Why is commentary like this a problem?

  • It is inaccurate and delivers misinformation to the public.
  • It contributes to unnecessary and arbitrary divisiveness among mental health specialties.
  • It creates divisions that have nothing to do with how therapy is implemented, or with the quality of services that are provided.
  • It perpetuates meaningless stereotypes about what "clinical" means, and when or how therapy is helpful.

I have worked as a clinical psychologist for over 30 years, and have had the privilege of collaborating with a range of mental health professionals. I have tremendous respect for the diversity of training and experience of psychotherapists in different fields. Since we all benefit from the variety of approaches, training and experience among mental health professionals, it is disheartening to witness divisiveness or stereotyping about different mental health professions in print or online.

In response to this confusion - and some misinformation out there - I felt prompted to write about the mental health specialty that I know best. And while any given psychologist is not necessarily a better psychotherapist or the right therapist for you, there is some basic information that needs clarification about the field:

1. Clinical psychologists have more years of training than any other mental health specialty. That's right - even more years of mental health training than psychiatrists. They receive a doctoral degree after approximately five or more years of post-graduate education and training, and then are required to earn post-doctoral hours before licensure. Much of their training involves supervised experienced within a range of internship settings. (Psychologists cannot prescribe medication, though, except for those with additional training who are granted prescription privileges within a few states in the U.S.)

2. Psychologists (including school psychologists and neuropsychologists) are the only mental health professionals with adequate training, and authorized by most states in the U.S., to administer and interpret intellectual and psychological testing. Along with psychiatrists, psychologists also are authorized to diagnose mental health disorders.

3. Psychologists receive training in research methods, and they use research-based strategies to inform their treatment decisions. Their research training helps them evaluate recent findings in the literature, and determine what is useful to include in their work.

Despite claims that psychologists are too "clinical," or too focused on psychopathology or "diagnosis," they still can be strength-based, compassionate, creative, and relational. These abilities are not mutually exclusive! In fact, training in diagnosis and the complexities of personality and psychological disorders is a good thing. Would you go to a primary care physician, a reading specialist, or even a car mechanic who was not trained to "diagnose" the problem? Understanding what causes distress informs treatment decisions. It does not detract from one's ability to empathize, relate and offer support in psychotherapy.

Does this mean you must see a psychologist for psychotherapy or parent coaching? Of course not! 

There are thousands of excellent, highly skilled psychotherapists who would be the right fit for you or your child. Make sure that any therapist you choose is licensed, has training and experience in the area which you are seeking to address in therapy, uses good boundaries (i.e., does not spend the session sharing his/her personal life with you), and is someone with whom you can achieve a good rapport. Coaching is an unlicensed and uncertified profession, so use even more caution with personal or parenting coaches.

If you need to find a psychotherapist, seek out referrals from respected sources, such as your physician, spiritual adviser (e.g., minister, rabbi, priest), or a school counselor. Trust your instincts. Get informed. Pay attention to what works for you. Don't just assume that your insurance company will provide a helpful referral. In fact, many therapists refuse to accept insurance because of meager reimbursement and possible breaches to confidentiality.

When you start therapy, come prepared to work hard and to collaborate with the therapist. Learn more about what to expect, and identify personal goals for yourself. You may feel uncomfortable at first, since speaking with a stranger can feel awkward, but give it a few sessions before making a decision. Of course, if you or your child feel extremely uncomfortable, or your gut instinct tells you that the therapist would not be a good fit for you or your child, then look elsewhere. All because your physician or neighbor recommended a particular therapist does not mean he or she is right for you.

In my opinion, a great match is a highly trained, experienced psychotherapist who is collaborative, empathetic, compassionate, curious about the human condition, and respectful of differences, individual values and boundaries. Your therapist is never going to be your friend; however, you must feel accepted, understood and valued. If you are seeking therapy for your child, find a therapist with child or adolescent training and experience, who engages easily with your child, and who readily includes you in the treatment. Although therapists guard children's privacy, helping you feel part of the therapy process and understanding how to better communicate with and help your child is essential. This might entail occasional or frequent meetings with you and the therapist, or meetings that include your child, or even the entire family.

Therapy is just a start. Ultimately, we all need to extend what we learn in therapy to the world at large. Improved self-esteem, communications skills, self-awareness, and the elimination of nagging symptoms can be a springboard for enhanced relationships with our children, family, friends, neighbors, and colleagues at work. It provides a unique opportunity for exploring long-standing concerns in greater depth and receiving useful, direct feedback. Therapy also encourages us to make healthy and meaningful decisions, enjoy the present moment, and feel better about ourselves.

The following are blog posts about psychotherapy for those who are gifted or who have gifted children:

When is it more than giftedness? A psychologist's perspective

A gifted person's guide to therapy

Five misconceptions about therapists

Gifted children and adults: When is therapy helpful?

Stress management toolbox: Nine tips for parents of gifted children

When does therapy benefit gifted adolescents?

Wednesday, May 1, 2019

Is it all right to feel proud of your gifted child?

Parents of gifted children often struggle with disappointment, frustration and fears that extend beyond routine parenting dilemmas. They feel compelled to advocate at school, worry about their child's social connections, and fret over complexities of executive function and asynchronous development.

But what happens when parents feel proud of their gifted child?

Is it okay to feel pride when your gifted child shines... when he excels in school, wins an award, attains a stellar SAT score, or wows the audience with a musical performance? What about when she receives a scholarship, is accepted into her first choice college, or if she is recognized for humanitarian volunteer efforts?

How do you manage that swell of pride, the tears, that flush of astonishment when your child accomplishes something amazing? You feel like you might burst... yet, worry about whether to share your joy with others. Will you appear to be bragging? Is it fair to parents of struggling students? Are you just supposed to feel grateful that your child is gifted, and keep quiet about anything beyond that?

Many parents of gifted children feel compelled to squelch their enthusiasm. They apologize for any expressions of pride or downplay their children's successes with commentary about their drawbacks (yes, he won that award...but you should see his room!). Given widespread misconceptions about gifted children, media critiques, and unfair assumptions lobbed at their parents, it is unsurprising that some parents keep their child's accomplishments a well-guarded secret.

These are some questions many parents consider before sharing their gifted child's accomplishments with others:

Will it seem like bragging?

Fear of boasting and bragging is often the strongest deterrent to sharing your joy with others. It is hard to mention your child's accomplishments when he appears to outshine your friend's child, who tries just as hard - or even harder - to succeed. What do you say when your friend's child sings karaoke at the school talent show, but yours just won a concerto competition? How do you share that your child landed a prestigious merit scholarship when your friend's child struggled to graduate?

Some parents feel guilty if they display excitement over accomplishments that other parents would easily shout from the rooftops. Some don't even share certain information or achievements at all, as if their mere mention (e.g., the lead role in a play, admission to an elite college) were equivalent to bragging. Many parents learn to save their enthusiasm only for those who truly understand.

What will others think?

Along with fears of bragging, parents of gifted children often worry that others assume they are "tiger" parents who push, prep and "hothouse" their children. We all have witnessed parents who actually boast and brag, who are inappropriately demanding, who break the "rules" so their child will get ahead (e.g., the recent college cheating scandal), or view their child's talents as a means of fulfilling their own personal needs. Most parents of gifted children do not fit these stereotypes, and shudder to think that others might project these assumptions onto them.

Parents of gifted children certainly may care about their child's achievement and academic success; however, most stand back in puzzled wonderment as their child dives into interests and passions, with little input on their part. In fact, many parents struggle to keep up with their whirlwind children, seeking activities that maintain their interests. But people who have not walked in your shoes may not understand, and assume that giftedness stems from flashcards or prep classes or grit or growth mindset. You may need to accept that you cannot control what others think, and move on with just being there for your child.

What if my child exerts little effort?

Sometimes your gifted child might receive recognition or attain top grades without trying very hard. You want to support her accomplishments, yet it feels inauthentic to praise her for relatively effortless work. So you weigh your options. At least she turned in her assignments and didn't get in trouble for being bored in class. I don't want to be overly critical - after all, she brought home all A's. Is it okay to show enthusiasm when I know she didn't put in much effort? 

You know what your child is capable of, and struggle with mixed emotions over successes that seem big to other parents, but were relatively easy for your child. Many gifted children learn to tailor their efforts to only meet the school's expectations, rather than challenging themselves. Some become underachievers under-the-radar - experts at exerting minimal effort, and avoiding detection by the school because of their relatively good grades. Parents struggle with guilt and ambivalence about their reactions, and question when it is okay to feel good - or not - about their child's successes. Is it okay to be discerning and feel ambivalent when I know he is capable of so much more? Or can I just feel good about his accomplishments, even though he could have tried harder?

When did you feel proud?

When did you feel most proud of your gifted child? 

I know that I felt the most pride when my children accomplished something that was difficult for them, when they had to push themselves, and when they showed compassion, insight and creativity. Routine awards at school were nice, but often reflected the whims and preferences of the teacher. My children recognized the limited "value" of perfunctory trophies (everyone on the soccer team gets rewarded for just showing up!), and conversely, learned that truly meaningful accomplishments sometimes go unrecognized.  

Parents of both gifted and neurotypical children feel pride when their children excel. Sometimes it coincides with awards, honors and performances. Other times, it will catch you by surprise. Attempts at something new, a fear that was overcome, an act of kindness, an unexpected success - all evoke pride. Even though gifted children's accomplishments may come easily to them, and sometimes seem to outshine those of other children, their achievements deserve of your loving attention and recognition. And as parents, we are entitled to feel pride when our child succeeds, and share our joy with others who understand.

Please share in the comments section below how feelings of pride have affected you. Thanks.

For more blog posts related to being the parent of a gifted child, see the list below:

When your gifted child disappoints

Your child is gifted! Now what?

Welcome to gifted parenting: A checklist of emotions

Weathering rough times: The highs and lows of raising a gifted child

Guilty thoughts: What parents of gifted children really think

Fearless advocacy: A day in the life of a gifted child's parent

What hidden emotions complicate parenting a gifted child?

This blog is part of Hoagie's Gifted Education Blog Hop on Parent Considerations. To see more blogs, click on this link.