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Children and Adolescents with Mental Illness: A Parent's Guide.

Children and Adolescents with Mental Illness: A Parent's Guide. E. McElroy, Editor. Kensington, MD: Woodbine House, 1987. 250 pp., paperback, $12.95. To make the best use of any book on the topics of emotional disturbance, behavioral disorders, or in this case, mental illness, the reader must determine how the author defines the key terms. To their credit, the editor and authors of this book recognize that definition is an important issue and make their referent group clear very early.

In her introduction, Dr. McElroy, an Associate Professor in the Psychiatric Nursing Program at the University of Maryland, writes, "The position taken in this book is that the mental illness affecting your son or daughter is not a family illness. Rather our book makes the assumption that when a youngster has a mental disorder it affects the other family members but is not necessarily caused by them" p. vi). A few pages later, the author of the first chapter adds, "Just remember that the majority of the causes for such illnesses and their treatment are biological, and not due to upbringing" p. 1). This is the point of view maintained throughout the book. Thus, the authors primarily address parents who accept the biophysical hypothesis of the cause of severe mental illness and the related assumption that the primary treatment will involve the use of medication. Psychotherapy is viewed as an important, but definitely adjunct, means of treatment. Education is viewed as very important in the sense that the mentally ill child is educable, but educational programs are not viewed as central to the process of therapy.

Much of the book offers suggestions to parents about how to seek and evaluate treatment options for their child. The suggestions appear sound, and an effort is made to supply background information helpful in understanding why they are made. They are accompanied by stories and statements from parents describing their good and bad experiences with doctors, psychotherapists, psychiatric hospitals, and schools. Some of the accounts of bad experiences are heartrending.

Periodically parents are reinforced for accepting the book's premise that the primary causes of mental illness are biophysical rather than environmental or psychodynamic. For example, the author of the chapter on educational interventions says of the psychoeducational approach, "The problem with this approach is that it, like the ecological model, assumes an incorrect cause for serious mental illness. Both the ecological and the psychoeducational approaches assume that the family plays a major role in causing mental illness. Serious mental illness has a biological basis. While a mental illness can be triggered by stress or the environment, it cannot be caused by it" (p. 123).

This parents' guide assumes that mental illness of the types described is treatable, and that the mentally ill child will eventually be able to resume a relatively normal life. Possible recurrences of severe symptoms are viewed as possible, but parents are encouraged to regard them as temporary setbacks rather than predictions of prolonged incapacitating illness, although one chapter speaks to ways of dealing with the latter possibility. One chapter gives a brief overview of parental and child rights assured by federal law. Others briefly describe the therapeutic and other effects of medications. Possible harmful side effects such as tardive dyskinesia are noted.

Whether one recommends this book to parents or teachers is apt to depend in part on one's theoretical bias. It will be greeted most enthusiastically by those who view the causes of disturbed and disordered behavior as biophysical. In those cases where medication is the treatment of choice, or an important component of a broader treatment plan, this book will help parents understand the progress of their child's treatment and alert them to danger signals. On the other hand, in cases where dysfunctional family relationships make major contributions to a child's maladjustment, the point of view of this book will tend to reinforce resistance by parents to therapy focused on the family system. Resistant or abusive parents may well be encouraged to refuse psychotherapy and continue to shop for doctors who will treat the problem by medicating the child.

At one point, the editor writes, "If you feel that the recommendations of the treatment team are not right for your child, follow your own instincts. You know your youngster better than anyone and you have to live with the consequences of the decisions you make" (p. 86). One is left hoping that the parents' instincts will be sound, since, after all, the child will also have to live with the consequences of their decisions.
COPYRIGHT 1989 Council for Exceptional Children
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Copyright 1989 Gale, Cengage Learning. All rights reserved.

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Author:Wood, Frank H.
Publication:Exceptional Children
Article Type:Book Review
Date:Jan 1, 1989
Words:756
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