Dear Deborah:
In lieu of how our last session ended with Marsha, I felt it important to share my professional thoughts.
For over eleven years, I have been servicing children and their families and take great pride in working with this population. In fact, I am very careful and conservative when it comes to working with children because their hearts and minds are very delicate as they try to find their way into this world which begins with their most valuable and impressionable relationships—parents and extended family.
It is understood that Marsha has been suffering with moderate to severe anxiety and as a result is taking psychotropic medication and through her verbal report and family reports, this has been controlling a seemingly genetic/organic situation. So then, to better serve Marsha, who I believe is also dealing with panic attacks and separation anxiety, it was important for me to take this information, along with knowing from the very beginning that Marsha had been using specific anxiety techniques which time and time again were detailed in her journals, and combine an additional technique, behavioral therapy, in hopes that it would help her effectively develop familial relationships. Furthermore, regarding Marsha's fear of dying, this phobia is considered normal in children ages 7 to 16 years and in my professional opinion needs to be dealt with not by the need to “fix”, but rather, by the position of acceptance and respect in order to better help her rise above.
I am not sure what type of information you have received from your family member who is a Psychologist, but as a Doctor of Psychology myself, I have read and studied many therapeutic theories and use an eclectic approach to better serve my clients. But within that knowledge, I understand that each psychological theory within my field is primarily based upon the personality type of the theorist who created it which takes on a self serving position at that. In addition to this, psychology is not an exact science that many professionals or lay people believe it to be which can be confirmed by a collection of for or against arguments which includes the assessment, diagnosis and treatment of any disorder including anxiety disorders. For example, there is an anxiety theory by William Glasser called Choice Theory for children and adults which mainly focuses on belonging, connecting, love, power, significance, competence, freedom, responsibility and fun learning—cognitive and behavioral therapies used. In addition, when you examine Generalized Anxiety Disorder (GAD), my insurance diagnosis for Marsha (diagnosing being a tool), is postulates that it is not yet known what causes GAD; however, it tends to run in families and it is possible that there is a genetic component, but it could also be that it is a learned response within a family (please note that there were no absolute words in the sentence above, but rather, the words used in successive order were: tends, possible and could). In fact, modern brain scan technology may eventually help determine if there is a particular area of the brain that is the site of General Anxiety Disorder. Continuing on, another study postulates that panic disorders in young children are less likely to have the symptoms that involve ways of thinking (cognitive symptoms, thus cognitive therapy). For example, panic attacks in children may result in the child’s grades declining (or exceptional grades in Marsha’s case), not fitting in with peers (one of Marsha’s issues) and separation from parents (another issue for Marsha) and in the end, with the real causes of panic disorders not being known. Furthermore, when researching and evaluating effective ways parents/caregivers can alleviate stress and anxiety in children, the initial treatment options include not dismissing her feelings, listening to her, offering her comfort and distractions and setting a calm example. These are things that Marsha has been asking for in our sessions in relation to you, her father and Margie which all of you have been seemingly working on. In a nutshell, these techniques fall under the realm of behavioral therapy—relational issues. But all in all, who is to say which therapeutic technique is the best for any given client? We do not know and that is why our client’s voice matters as we patiently and carefully assess, diagnose and treat and then look at the results of our work from week to week. The greatest success I have had with children, families, their educators and comprehensive treatment professionals, no matter what the issues, has been in helping to build stronger and healthier relationships—across the board.
After evaluating your therapeutic concerns that were shared in our last session, to include Margie, I am concerned that Marsha may now feel that what she has accomplished thus far in our work together has not been good enough—again, a relational family issue which I believe deserves to be therapeutically explored while attempting to better understand what percentage her condition is based on genetics, environmental stressors and/or brain function. And although Marsha and I have talked about the possibility of her outgrowing her anxiety issues, focusing on that is not enough in terms of helping her to cope with the current reality of her anxiety—helping her to learn how to “live with” who she is as apposed to who she “might be in the future” is a much more empowering and effective therapeutic (cognitively speaking) stance. And so, I am here to say that I am more than happy to continue my work with Marsha, but there needs to be a collective understanding that counseling is a process that deserves time, patience and respect for the unknown. There is no therapeutic technique guarantee and if any professional in psychology/counseling believes contrary to this, they are being prideful along with providing a disservice to their clients. The most important part of my work is to “do no harm” with any given client. But one thing I will say with confidence is that Marsha’s voice matters and it is imperative that her family believes this and acts accordingly, with compassion. You as Marsha’s role model, to include her father and Margie, have the most significant impact in her life that in my professional opinion goes beyond professional assessing, diagnosing and treating.
Thank you for your time and please let me know how you would like to proceed regarding my work with Marsha and your family as a whole. For now, to be respectful of your current position, I will be canceling my conference call with Dr. Ross. All in all, I wish Marsha and your family the very best!
Sincerely,
Dr. Monée N. Merriweather
POSTED BY DR. MONÉE N. MERRIWEATHER AT 8:49 PM NO COMMENTS:
WEDNESDAY, MARCH 31, 2010
