Longtime child and family psychologist, Nancy Michel, is interviewed here by psychologist, Simon Hearn.
Simon: How did you get into working with children and families?
Nancy: I’ve always enjoyed working with children. I find them intriguing. As a psychologist, it’s a nice place to be, working with people who have a long life ahead of them, and there’s a lot of potential to use the changes they make through counselling.
Simon: You’ve been doing this a long time.
Nancy: Twenty-three years.
Simon: What are some of the most common problems?
Nancy: There’s such a range. Sometimes I encounter something that’s really different or exceptional. For example, three times in 23 years I’ve worked with selective mutism, that is with school aged children who refuse to speak outside their homes. But I commonly see a range of adjustment problems, occurring at home or school. Parents or teachers are sometimes confused by a child who’s not functioning as well behaviorally, socially or emotionally, as they would expect. Sometimes I see kids who are anxious, depressed, or experiencing significant social difficulties and are themselves asking to see a counsellor. Some children are experiencing difficult family situations or have suffered trauma, the death of a family member, a severe accident or sexual abuse. The majority of my work is with school age kids–elementary to junior high.
Simon: Is there an average length of time that you work with children?
Nancy: Often the family has been considering counselling for months. By the time they come in, there’s something significant they want to change, or they want to work through. So usually I see a family and child for a minimum of four to six sessions. Sometimes it’s longer than that, like several months, and in exceptional situations over a much longer period.
Simon: Do you think Ritalin is over-prescribed?
Nancy: Ritalin is often an important component of treatment for Attention Deficit Disorder. The experts have said for a long time that it’s a critical part of treatment for kids who have moderate to severe A.D.D./A.D.H.D. But it’s just one part of the treatment. Initially we’d want to explore other kinds of treatment, such as adjusting the child’s environment so it’s appropriately structured and the child understands limitations and expectations. Through behavioral structuring the child clearly can be supported in dealing with impulsivity, distractibility and a short attention span. Children can be taught cognitive skills of self-monitoring and self-talk (i.e., talking themselves through challenging situations), which can help them stay on task. However, sometimes medication is critical to the success of those other approaches. Medication is important to try when the other treatment methods don’t work alone. The cost of not trying medication, where indicated, can sometimes be devastating to the child’s development, sense of self, identity and adjustment as he faces the challenges of his A.D.D./A.D.H.D. temperament. However, it may be over-prescribed, as suggested when you read the statistics, for kids who aren’t properly diagnosed. The diagnosis of A.D.D./A.D.H.D. should be made in a very thorough manner, across environments, with observations of the child in varied settings, using parent and teacher reports, and reviewing the child’s developmental history.
Simon: What about society generally? Are there positive trends in child rearing and the way kids are being thought about and worked with by parents? Are parents getting more sophisticated and skilled?
Nancy: That’s a good question. Perhaps parents today compared to 25-30 years ago are more aware of their children’s emotional and psychological needs. I think there’s a lot of really good parenting and a significant portion of our population are very attentive and conscientious parents that I certainly respect and feel inspired by. I think kids, including my own kids, are really vulnerable today. Just consider the rate at which kids are being inundated with information, the barrage of things that they see on TV and in movies, like the incidence of violence. I think it’s important for parents to understand and know what their values are and to think in terms of what kind of values they want to impart to their kids. I think there is a lot of really good, thoughtful parenting and those kids are going to be well nurtured. But kids are so very impressionable. Right now there’s a lot of attention on kids who are totally peer-oriented at the expense of any parental influence in their lives. The influences of peer and media culture can be balanced where parents are significantly involved with their kids early on, giving direction to them, just being there with them, and establishing strong, trusting relationships. Changes in our culture are happening so rapidly that the family needs to provide a foundation that allows the child to develop and thrive as a unique person in a complex society.
Simon: I think the media does devalue parenting and often even conveys the message that somehow kids are wiser than adults.
Nancy: Hopefully kids’ images of a mother or father are not only dependent upon the media. It’s important for parents to be aware of what their children are viewing and to encourage their children to question the authenticity of what they see and hear. Kids are so dependent on strong relationships with their parents. Even where parents live separately, children can maintain strong and nurturing relationships with both parents.
Simon: It used to be said that most kids’ behavior problems could be traced to problems in the parents’ marriage. That’s an old style type of thinking. What do you think of that now?
Nancy: To understand children’s behaviors, how they act and adjust, you have to look at several factors including their temperament, that is the biological basis for their behaviors; their skills and abilities; and their learned experiences. Trauma will certainly influence children’s behavior. Ongoing problems in the marriage can be experienced as stressful and in some circumstances even traumatic to the child. However, more generally the parents’ relationship can be considered one significant dimension of the child’s environment and experience.