My daughter is 14 and has a diagnosis of attention deficit disorder. At least we now have some explanation for her problem behaviour at home and at school. Although everyone's patience has been severely tested, people at the school and the Child and Adolescent Mental Health Service (CAMHS) have been very supportive.
But my daughter refuses to take medication and misses some of her appointments at CAMHS. She still tries to provoke me and cause arguments. House rules are fairly relaxed now, because it’s summer time and we could all do with a break. We’ve also had some family come to stay over and, if I give her space, we get along and the visits have mostly been enjoyable for everyone.
But what will happen in September when she has to go back to school and I have to insist on rules? I can't go through another year like last year.
A diagnosis of a condition such as attention deficit disorder can be helpful for parents, young people and professionals alike.
Parents and young people can welcome a diagnosis because it can lead to a better understanding of what is happening when a child seems out of control. Living with someone with mental health difficulties can also place a huge strain on family and couple relationships. This is not the fault of anyone.
But the strain on relationships associated with living with someone who has emotional, behavioural and/or mental health difficulties may not be openly discussed. Instead, the focus may be mostly on finding an assessment and intervention that can guide CAMHS practitioners and family in developing a treatment plan. A diagnosis can also lead to more resources at school such as a Special Needs Assistant.
But we can sometimes confuse understanding with excusing. A diagnosis can help us understand, for example, why it might be more difficult for a young person to manage emotions or to develop conflict resolution skills. But a diagnosis does not excuse behaviours such as constant rude name calling, taking money without permission and threatening to hurt you when you try to set down rules as a parent. Young people with diagnoses can and do develop the abilities to manage their emotions and to resolve conflict without threatening others when they are given the clear message that they can do so.
While a diagnosis can explain why someone might find these skills more difficult to develop, it does not excuse her/him from learning and practising these skills.
It is also important that they receive the kinds of additional support that can help – you have done this by seeking help and you have secured the support of staff at the school and at CAMHS.
Share your concerns about September with the CAMHS practitioner working with you and attend the appointments, even if your daughter refuses to attend. Now, when things are calmer, it is also a good idea to prepare for September.
Parents who live with the kind of parent-child tensions you describe often reduce their interaction with their child to the bare minimum. This is understandable when any interaction with your child can lead to shouting matches and to threats.
You could increase your interaction with your child in other ways, such as sending her texts or making short calls (or leaving voice messages) telling her you love her and hope she is having a good day.
This is called increasing parental presence. It increases the likelihood that when your child thinks about you, she will think about something other than the last fight you had.
You could also demonstrate your love and respect for her by offering to do the kind of things you know she would like (e.g. cook or order in her favourite meal). If she rejects them, do not insist that she accepts your offer. These are called acts of reconciliation.
When your daughter tries to provoke you, resist the understandable instinct to go on the offensive. Instead practice some de-escalation skills, listen to your daughter, tell her you will think about what she has said and that you will get back to her – and do get back to her later with your own considered response.
Remind your daughter that you love her and about what you have enjoyed over the summer. Then ask about her thoughts about September. You could ask her for her suggestions about how to resolve the tensions you both expect when September, school and routines reassert themselves.
If your daughter cannot discuss these tensions with you or if you feel fearful, then it might be helpful to include other steps from an approach known as Non Violent Resistance which was developed in Israel by psychologist Haim Omer and his colleagues for work with parents when children and young people use abusive and/or violent behaviour. Some practitioners in CAMHS, Parentline (Locall 1890 927 277) and Tusla have received training in NVR.
You can find some useful resources on www.rcpv.eu, www.cpvireland.ie and www.newauthorityparenting.ie
Dr Declan Coogan is a lecturer with the MA in Social Work Programme at NUI Galway. An experienced social worker (CORU) and psychotherapist (FTAI), he adapted the NVR model for use with families in Ireland and developed an NVR training programme for practitioners. His book Child to Parent Violence and Abuse- Family Interventions with Non Violent Resistance will be published by Jessica Kingsley Publishers later this year