The Three ‘C’s - Choices
of Co-working for and with Child Clients who have Mental Health Needs.
Inspired by two
recent statements by people at the cutting edge of their own professions I decided to try and apply their radical thinking to my main area of professional
interest, at the moment, the controversial mass psychotropic drugging of our children in school,who have behavioural difficulties.
Surgeon and writer
Dr Atul Gawande has delivered the inspiring
2014 Reith lecture series on BBC Radio 4 in the last weeks. One phrase that
resonated with me was his assertion that we collectively need to move from ‘the
age of the molecule’ to ‘the age of the system.’ He went on to state that in
his view wonder drugs like penicillin have driven us to search for ‘magic
bullet’ cures for almost every human condition . Complex problems need systemic
responses he feels not ‘wonder drugs’. I passionately feel that a child’s
behaviour and response to the complexities of their environment is such a situation.
My second inspiring
quote this week was as follows,“In recent years, psychiatry has embraced what a
former president of the American Psychiatric Association has despairingly
called a ‘bio/bio/bio’ model.” Professor Allen Frances – Psychiatrist. Huffington
How does this
affect the choices that exercise our professional minds when working with
children and adolescents who are presenting in a distressed state?
of a Formulation for a Child’s Mental Health Needs.
This is when more than one
skilled health care professional contributes to a ‘bio-psycho-social
formulation’ of a child’s emotional and health needs. Contributions are equally valued by the team working with the child and a formulation is arrived at
which looks at Holistic world that the youmg person inhabits and hopefully helps them and their parents to better accept
the outcome of the professionals’ deliberations.
2) Collusion with a ‘Medical Model’ or any other
Uni-theoretical Formulation of a Child’s Mental Health Needs
This is where there
is a ‘pecking order’ of professionals working with a client exists and their
contributions are not considered to be of equal value by the team working on
the child's problems. Consequently often a ‘bio-bio-bio model’ of formulation, for example, predominates the shared thinking process. Other perspectives are consequently
ignored or minimized and the client may not even be made aware of their existence.
This type of formulation is often delivered as a scientific ‘faits accomplis.’
3) Challenge of the ‘Bio-Bio-Bio’ or Other
Dominant Formulation of a Child’s Mental Health needs
This is where one
on more health care workers decide that they are not professionally comfortable
with the predominant process of formulation that they perceive themselves to be
professionally party to accepting. Following consideration of their Ethical
Code of Practice e.g. the HCPC Duties of a Registrant, and following a
supervisory conversation they decide to contact the perceived ‘lead
professional’ to share their concerns and elicit a dialogue with that person, which is in the best interests of the child, with whom they both work. This is
the process that I have developed by discussion with colleagues and is called the Practical Professional Protocol, it was published in the BPS DECP Debate (December 2014) to facilitate Safeguarding of Children.It is also available on the American Psychological Association - Division of Humanistic Psychology website : dxsummit.org - under my name.