By Katharina Manassis MD FRCPC
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Extra resources for Case Formulation with Children and Adolescents
Moreover, the parent often brings the child to the practitioner with certain unspoken expectations. These expectations may or may not coincide with the practitioner’s formulation and treatment expectations. One common expectation is that, similar to a family doctor, the mental health practitioner will diagnose a problem within the child, and the solution to the problem will be something that the mental health practitioner does to or with the child. Even though they rarely say so, these parents are thinking, “Here’s my child, Doc.
Alternatively, a detailed teacher report may be helpful in challenging parents who minimize their children’s difficulties. It is also often useful to investigate whether a child has had a recent physical examination by a pediatrician or family doctor. Undiagnosed physical illnesses sometimes contribute to or even cause mental health problems, an issue that is detailed further in Chapter 3. For example, children or adolescents who are anemic, have low thyroid levels, or have recently contracted infectious mononucleosis may present with symptoms of depression.
Parental disagreements about the nature of children’s problems are often a clue to other types of family conflict. Therefore, it would have been helpful to interview Malcolm alone and ask him about how people in his family get along. The practitioner also could have made an effort to reach Malcolm’s father and obtain his perspective on the family. It is even possible that most of Malcolm’s symptoms relate to worry about his conflicted family or (in the case of child abuse or domestic violence) traumatic memories affecting his ability to attend at school.
Case Formulation with Children and Adolescents by Katharina Manassis MD FRCPC