psychiatrist's assessment

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Mamaof5

Guest
I'm rather disturbed by how "blame like" this assessment is on us as parents. He hasn't even met us face to face and only via teleconference once and yet he's calling us defensive and my husband guarded and quiet. So much so as to say a parenting capacity test should be done. Err...no thank you, you don't even know us and you've only "met" us once.

Why do these assessments always seem to blame the parents for the psychological issues of the child? Why does it feel, when I read this assessment, that I'm being blamed for my son's ADHD, learning difficulties and ODD?

Mind you there were some pretty bright spots in the assessment as well. What the heck does "somewhat directive parenting" techniques mean? What is a GAF rating? (He's rated Big B at 65 if that helps the question - no I don't mind sharing that information either).

What's Axis 1, 2, 3, 4 and 5 - are these just point form analysis? Or are they point form in what should be addressed? This is the first time I've ever done an assessment where I got to read the report instead of being told point form what the report amounted to (and that was only occupational therapy specialist when he was a baby for being a preemie).

So any insight or similar experiences for anyone to share?
 

klmno

Active Member
Blaming a parent seems to be common, unfortunately. But put it down for a day or so and read it again after cooling off and maybe it will come across as pointing out your difficult child's issues and just suggesting that maybe the style of parenting could help him better- I don't know but that is sometimes the case. As far as the GAF and axis, others can explain this in more professional terms but for a general, layman's overview it is something like this- Axis 1 will list any psychiatric disorder/diagnosis; Axis 2 lists personality disorders; either Axis 3 or 4 lists any physical health problems and the other lists stressors or things that might be "triggers" or just contributing to the problem (like a recent death in a family, previous molestation, legal problems, etc). The GAF is level of functioning with 0 being non-functional and 100 being perfect so I doubt anyone is ever 0 or 100. 65 means there are current functioning impairments, but some of our difficult child's have gone as low as 35 or lower so don't worry about that- it actually helps in getting services.
 

smallworld

Moderator
From Wikipedia:

Multi-axial system


The DSM-IV organizes each psychiatric diagnosis into five levels (axes) relating to different aspects of disorder or disability:
  • Axis I: Clinical disorders, including major mental disorders, and learning disorders
  • Axis II: Personality disorders and mental retardation (although developmental disorders, such as Autism, were coded on Axis II in the previous edition, these disorders are now included on Axis I)
  • Axis III: Acute medical conditions and physical disorders
  • Axis IV: Psychosocial and environmental factors contributing to the disorder
  • Axis V: Global Assessment of Functioning or Children's Global Assessment Scale for children and teens under the age of 18
Common Axis I disorders include depression, anxiety disorders, bipolar disorder, ADHD, autism spectrum disorders, phobias, and schizophrenia.
Common Axis II disorders include personality disorders: paranoid personality disorder, schizoid personality disorder, schizotypal personality disorder, borderline personality disorder, antisocial personality disorder, narcissistic personality disorder, histrionic personality disorder, avoidant personality disorder, dependent personality disorder, obsessive-compulsive personality disorder, and mental retardation.
Common Axis III disorders include brain injuries and other medical/physical disorders which may aggravate existing diseases or present symptoms similar to other disorders.
 
M

Mamaof5

Guest
Thanks, and it was the only comment in the whole thing (the defensive\husband quiet and guarded) that was "negative". I quote negative because maybe I am being a bit touchy about it today. I'm tired today because I toss and turn when hubbs does a night shift at work and he's doing another one tonight too. It's sweeping all the sand they laid down over the winter months for snow fall to clean it up and it takes 8 hours to do one major establishment (ie: the hospital he did last night, 8 hours starting at 10pm last night).

That and difficult child was really, really off today and we met (hubbs was able to come to the appointment) the new counselor today too. 2 hours of talking about difficult child 1 and a bit about difficult child 2. I always feel so judged at those things, stared at...it's err uncomfortable in ways. You're right though, I'll put it away for a day or two and come back to it. Over all the psychiatrist did find difficult child charming and witty! That's my boy!!!
 

Marguerite

Active Member
I know this gets up your nose. It would get up mine. But form my long-term experience of "blame the victim" attitudes in many parts of the medical profession, I strongly recommend you go through with the parenting capacity test.

Look at it this way - if the test is really not needed, then it will completely clear you guys of blame. And you will have done it, gone through with it and have it to point to if any doctor in the future says, "You guys are part of the problem."

But if the doctor turns out to have a point, then you will know and you will be able to deal with it and get it out of the way. And maybe improve things to a slight extent, depending on how much your parenting style is a factor (if at all).

If you don't do the test but instead walk away and change doctors, you will find at some future stage, this will happen again. And again. And keep happening, until you deal with it. And every time you change doctors, you go back to square one, which means the first few appointments each time will be reinventing the wheel.

It's cheaper to do what this guy wants. When you come through it with flying colours, you go back to him and say, "NOW can we get serious about helping this kid?"

Marg
 

totoro

Mom? What's a difficult child?
I have had psychiatrist's treat husband and I like we were the problem, we were too accommodating! At the time the kid was manic, hallucinating and delusional with suicidal tendencies!
Other times we were told flat out that a 6-7yo was too young to have Bipolar Disorder. I would sit and say did you watch the video we gave you? The one with K begging to be lit on fire? The one with her sobbing to die? The one with her attacking us for hours???? Did you read the report from the very well respected psychiatrist in Chicago who witnessed her hallucinating???

Needless to say we left 3 psychiatrist's because they questioned us a bit too much. Not in a positive possible growth way! LOL

I even sat and listed my shortcomings in the beginning!!! I happily can admit I hoover at times...
If you think your psychiatrist is just trying to help I would stay, but if you keep getting no warm and fuzzies I would tell the psychiatrist and see if you can work it out.
 

mog

Member
unfortunately we too have experienced something similar. I don't understand how they can say the child is or not bipolar when they talk to them for 15 minutes and talk to us on the phone for 10. Then they "know" the correct diagnosis. Yeah I feel like it is all a big joke. Sorry
 
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