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Monday, 3 March 2014

ALTERNATIVES TO PSYCHOTROPICS FOR CHILDREN -"The One-On-One Program: A Remarkable Alternative to the Psychiatric Drugging of Our Youth." By Jeffrey Rubin - Courtesy of the dxsummit.org website

The One-On-One Program: A Remarkable Alternative to the Psychiatric Drugging of Our Youth
Jeffrey Rubin       February 27, 2014   

Today, when parents express a concern about their youth’s behavior, mood or attention span to a physician, typically within a matter of minutes this expressed concern is translated into a mental illness conceptualization using the DSM.  The parents are then sent on their way, prescription in hand.

For those of us who believe that there is something seriously wrong with this DSM medical model approach, the question that naturally arises is, what’s the alternative?  In an earlier DxSummit post I provided an alternative that would replace the DSM’s pathologizing of individuals with a more scientific approach of classifying expressed concerns. But once we finish with the classifying, what alternative to the psychiatric drugging of our youth can we offer?  Counseling and psychotherapy are often the main proposed alternatives mentioned. Although helpful for many cases, my post today puts forth a vision for an alternative when something more is required.
The One-On-One Program

The best way to introduce the One-On-One Program is with two brief parables.  They will help to give the reader an intuitive understanding of how the program can address some of the most challenging concerns that many parents and community members face on a daily basis. 
The Parable of Tony

Our tale begins when Tony is 12-years old. One day Tony’s mother, Nora, busy at work, is called by the police.  Apparently Tony, just outside of the neighborhood afterschool center, was being teased by the other kids as being a baby.

 “Baby, baby!” they taunted him over and over again. 

When he chased after them, they ran inside the center, shut the glass door behind them, and while holding the door shut, they continued to taunt him through the door.

 “Baby, baby!” image1

“Let me in!” Tony cried!  “Let me in!”

“Tony is a baby!  Tony is a baby!”

At this point, Tony picked up a rock and smashed the glass door.

When Nora and Tony get home from the police station, she starts hollering.  “You know I have to work until six, Tony!  Now the afterschool center says you’re not permitted to return!  From now on, after school you’re to go straight home!  If you get into trouble, I’ll beat the living daylights out of you!”

A few weeks go by and then once again Nora gets a call from the police.  This time a gang in the neighborhood had enlisted Tony to be a lookout while they slipped into homes and stole anything that looked valuable.  Tony explained afterwards that the gang members agreed to stop doing mean things to him if he cooperated with them.

Although threatened by a judge that another offense would lead to a stay at a juvenile detention center, Tony claimed that he thought that would be cool.  Nora began to feel helpless.

When the school counselor called to report that Tony was having trouble at school, she asked him what she could do under the circumstances.

“Isn’t there someone from your family who can watch him after school lets out?” he asked.

“To get a job, I had to move here,” she replied.  “My family lives hundreds of miles away.  I can’t afford to hire someone to work with him one-on-one every day after school.”

“We have a program at our high school called the One-On-One Program,” said the counselor. “I can find a high school student who could help you out.  You’d have to pay him something based on a sliding scale basis.  For your income bracket it would cost you about the same amount that you paid for the afterschool center that Tony got thrown out of.”

“That’d be great!” Nora replied.

Nick, 17-years old, began to meet Tony every day after school at his high school.  They began with a mile walk.  Then together, both worked on their homework for a half hour.  Nick used the rest of the time he spent after school with Tony to find some skill that he could help Tony develop.

What a difference this plan made!  Nick found the way Tony looked up to him very rewarding and he got a great satisfaction knowing he was helping.  The mile walk each day did Tony and Nick’s health a world of good.  By doing his homework each day, Tony’s grades improved.  His teacher also reported that the afterschool attention he was getting clearly improved his conduct in the classroom.  He was no longer wildly driven to get her attention and he was far less likely to blow up in anger.

For talent development, Tony showed an interest in chess, so both boys began to play every day after school and his mother bought a book to help improve their game.

image2As helpful as the plan was for Nick and Tony, perhaps helped most of all was Nora.  The stress from getting called at work by the police department completely went away.

Tony now got home a full forty minutes after her.  During that time, Nora closed her eyes, and often fell asleep for a half hour.  By the time Tony got home, Nora had enough time to get supper on the stove.  When Tony would join her in the kitchen to tell her how his day had gone, she enjoyed the interaction, whereas before she felt drained and found she quickly became annoyed.

“The plan restored me to sanity!” she often would tell her friends.  “I have so much more patience with Tony!” she cried when her own mother called one day to ask how things were going.

The next school year, Nick went away to college, so Nora was concerned about finding someone to replace him.  But Tony heard that his junior high had started an afterschool chess club.  He wanted to give it a try.

To his delight, Tony found that after a whole year of playing chess with Nick five times a week, he had become pretty good. He was able to beat several of the players, and most of the other players were about at his skill level.  Even the best players respected Tony’s skills because he knew enough to make it a challenge to win.

Best of all, several of the players began to call Tony to play chess on the weekend or to go to a movie with a few of the other guys.  Soon, he had, for the first time in his life, some real friends.
Parable Discussion

For some, once a week counseling can make a significant difference.  But in some cases, children see a counselor once a week and then go home to parents who are so stressed out at work that they frequently lose their temper.  The resulting angry parent-youth interactions may very well offset any gains that may occur during counseling.

Other children have parents working two jobs to make ends meet. When these children go home after school they rarely find needed one-on-one time.  Some of these children then seek closeness with street gangs who can provide daily close human contact, but at the expense of criminal behaviors.

In addition to the acting out type of problem that is characterized in the parable of Tony, there is another type of problem that professionals sometimes come to realize requires something more than what they can currently provide in a weekly hour session.
The Parable of June

June is 11- years old and wearing a cute pink dress. She has been brought to see Dr. Goleman, a psychologist in his mid-forties.  Wearing gold rim glasses, and a white collared shirt, Dr. Goleman is leaning forward on his desk, clearly very concerned.  

“Do you know why your mother asked me to meet with you, June?” Dr. Goleman asks.

“I’ve been awfully sad, and she hates it when I cry out that I hate myself,” June replies.  “I can’t help it.”

“Wow!  Do you know why you are feeling so blue?”

“I’m terribly lonely.”

“Lonely?  Hmmm.  You go to school where there’re lots of kids your own age.  You could go to the afterschool program where you don’t have to be lonely.  Your mother told me that you refuse to go there.  What’s up with that?”

“At school and at the afterschool center I feel lonelier than when I’m alone.  The kids make fun of me there and when a teacher tells the other kids to include me I can tell they wish they weren’t stuck playing with me.”

“I see,” replies Dr. Goleman.  “Sometimes, June, it feels lonelier when you are with people than when you’re alone.  Do you also feel lonely when you are alone?”

“Terribly.”  Tears begin to form in June’s eyes.

“I can see that you are feeling sad now,” says Dr. Goleman softly.

“I get like this a lot.”

“Are there any times when you don’t feel lonely?”

“Yeah, when my cousin Marissa comes for a visit.  She’s a few years older than me, but she really likes talking to me.  And I play the flute and she plays the piano, so we play duets together, and we love being together.  It’s just that she lives up in Rochester and so I only see her once every month or two.”

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