As a psychological detective who appreciates the human mind is the most complex organism on planet earth, I have increasingly realized how unhelpful mental health diagnoses are. This is especially true when I evaluate children.
The problem is that many mental health professionals (MHP’s) like psychiatrists, psychologists, and social workers see diagnosis as the ultimate goal of psychological evaluation, just like physicians do. But there are massive differences between psychology and medicine, and herein lies the problem.
Physicians evaluate and treat a human anatomy and physiology that is relatively consistent across billions of people. In stark contrast, MHP’s are always dealing with the unique personality each child brings in the door.
Think of it this way: from a medical perspective 10 children with a torn patella tendon will get an MRI and look virtually the same, with minor differences in severity. But 10 children with ADHD will behave in distinctive ways. This is because a diagnosis like ADHD is experienced, expressed and controlled through the unique lens of each child’s personality.
But even though there is a staggering amount of psychological uniqueness to each child, many MHP’s narrowly operate – as if they are a physician – by conducting brief evaluation and making diagnosis as the end all be all goal. Meanwhile, great child psychological assessment requires a rigorously thorough approach. For an MHP evaluation to be truly helpful, the unique factors affecting how each child is uniquely affected by the ADHD must be mapped so the *dynamics* affecting the child is clearly understood. This is why I develop a mind map as part of my evaluations, which clarifies key dynamics that need to be corrected to improve functioning. No psychologist can effectively treat ADHD without knowing more than just a checklist of symptoms.
The bottom line is when you are trying to find a MHP to conduct an evaluation of your child, you need to interview potential evaluators very carefully. Because a vast majority of MHP evaluation reports I have seen read like a superficial detective story, written by a lazy detective. Meanwhile, You need to find someone who will dig deeper, to get to the factors driving the behavior. Isn’t that what separates the great detectives from the rest?
My ultimate goal in evaluating a child is not diagnosis, though that is one component. Rather, my end goal is to do three things:
1) identify the key factors affecting a child’s functioning
2) capture the predominating patterned ways these factors interact
3) use the knowledge from #1 and #2 to create a completely customized treatment plan
The best treatment plans rely on a factor driven approach, not a diagnostic approach. To competently accomplish goals 1-3 during a child evaluation, I interview the people who have the most intimate knowledge of that child. This includes teachers, coaches, academic advisors, relatives, and anyone else who might help me uncover a full list of factors holding that child back from reaching their true potential. Don’t settle for an MHP who thinks they have a crystal ball allowing them to diagnose your child from their office chair only.
If you do not want to settle for what I call a “drive by”, shallow evaluation, here are questions you need to ask the potential child evaluator:
–Is diagnosis your end goal? Great MHP detectives do not stop with a label, so find an evaluator who says they go beyond diagnosis.
–Who will you interview? Just like a great detective would, make sure they will be interviewing a wide group of “witnesses“ who know your child well. Often children have different personalities that only situationally manifest. Find someone who will capture all the personalities.
–What techniques will you use to help my child so I understand how they are experiencing, expressing and controlling any problems they are having? Great MHP detectives recognize that great evaluations help you see the child from the outside in (behaviorally) and the inside out (experientially).
Remember: you can always ask the potential evaluator to see a copy of a recent report they did. If they refuse to do this, move on.
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