The Quick Fix Revisited

By
David Aronsohn, Psy.D.
Doctor of Psychology
Licensed Marriage and Family Therapist

Parents feel an overwhelming responsibility for their children and have an emotional bond that transcends words. Feeling the hugs of your child, seeing their smile, or sharing in their accomplishments, touches the soul. When a child faces life with tears in their eyes, has difficulty controlling their behavior, or keeping friends, the result is that the child may give up because they perceive the pressure is too great. Eventually they believe that anything they do will not be good enough, or will result in some type of punishment, or failure. This can be devastating for the child, as well as the parent. These are the times that test the fortitude of parents.
Not wanting the child to feel the emotional pain and fear of their predicament, as parents we have a tendency to look towards a quick fix to address the problem. This is further complicated as we have become a society that demands immediate solutions to our problems. However, sometimes the most immediate intervention to a problem may not be the best, long-lasting, or complete solution. As vested, loving and committed parents we also sometimes have difficulty handling our own stress, especially as it is exacerbated and as it relates to our children. Seeking the most immediate remedy is an understandable first reaction.
In recent times there has been a marked increase in the amount of children and adolescents that are being diagnosed with psychiatric conditions such as attentional issues (ADHD and ADD), Bi-polar and depressive mood disorders. The reason for the increased diagnoses is a polarizing and hotly debated issue. Some note that this rise in the number of children being diagnosed is due to a greater awareness of the presenting problems, more astute professionals and the use of specific diagnostic measures in the assessment of the problem that help in clarifying co-morbid (coexisting) conditions and rule/out conditions, (what initially may have been a consideration at the time of assessment that are eliminated as more data is gathered and assessed), as well as differential diagnoses which consider other possible treatment and diagnostic criteria in order to make a more accurate diagnosis.
On the opposite side of the spectrum are those who feel the there is a rush to diagnosis at the expense of effective parenting and less intrusive treatment approaches. There are also some parents that feel overburdened school systems are less tolerant to behaviors that are more challenging and are quick to recommend, or sometimes even mandate that there is a quick and immediate fix to the problematic behavior

In May of 2004 it was announced that children’s medications, specifically targeted for behavioral conditions, for the first time, were being prescribed more often than antibiotics and asthmatic medications which were previously the most prescribed drugs for children. This was on the heels of a March 2004 announcement where the Food and Drug Administration (FDA), formally requested that ten manufacturers of anti-depressant medications, post additional warnings on their product, noting that their use may result in increased risk for suicidal behaviors, (CNN Online, March, 2004). Though the pharmaceutical companies continue to cite the positive clinical trials associated with their medications, this was a formal request forwarded from the federal agency. Though the warning was a general advisory, it noted that many of the medications mode of action, initially resulted in adverse behaviors that were contrary to treatment goals, or exacerbated the presenting symptoms of the patients taking the drugs. This was subsequent to the British ban on the majority of antidepressants last winter, barring Prozac, on any children under age eighteen.
Proponents for early pharmacological intervention, even in children, cite newly released government study noting that “Prozac is more effective for kids than cognitive behavioral therapy, though when combined the Prozac and therapy are the most effective of all”, (Time Magazine, June 2004). The magazine further cites the director of developmental studies at McLean Hospital in Massachusetts who states that there have not been enough clinical studies regarding antidepressant for children to make any definitive statements. In conclusion the article also notes that while “70% of the children get better on Zoloft, 60% improve on sugar pills,” (placebos). (Time,2004).
Advocates also note that medications historically designed to treat specifically designated conditions are now being used to treat comorbid (coexisting conditions) and conditions that were previously not noted to be part of the treatment indications of that particular medication. Among a variety of medications and their application, this includes the use of seizure and antidepressant medications now being prescribed to treat mood disorders and attentional problems (ADD/ADHD). Ironically, the use of anti-depressants has also now been used to treat conditions not related to psychiatric conditions. Research has demonstrated that some anti-depressants, especially tricyclics such as Imipramine are an effective course of treatment for incontinence, migraine headaches and even in treating pain patients suffering from lower back pain.
Those who are opponents of medication for children note the lack of long-term clinical trails for non-adults, potential significant side effects and the potential rush to judgment by some paraprofessionals, teachers and even pediatricians that have expertise in their field, but may have little training in the appropriate assessment measures and treatment strategies for the actual clinical problem.
There is also criticism by many professionals opposed to the “quick fix” of medication as they feel such intervention should be considered only after other less intrusive measures are attempted such as parent counseling, behavioral training and minimizing the exposure to significant stressors and stimuli, such as excessive media, computer and video games. This is not to say that outside professional intervention, that includes, at times, medication, is not a beneficial step, or that parents who choose medication for their children are bad parents. In some cases this may be a necessary and effective intervention.
Another reason parents seek a quick fix to a long-term problem, is due to their own level of stress. This may be the result of conflict within the relationship, or stressors that influence the parent’s ability to address and navigate their child’s issues. Life stressors, coupled with difficult behaviors can understandably lead to a great deal of disequiilibrium and conflict within a family. This can lead to a cycle of blame. The school blames the parents, while the parents blame each other. Then the children either directly, or indirectly blame themselves. As a result the parents may become overrun with emotions that distorts their perception of the world. This is analogous to someone under the influence of alcohol. They may be able to interact with the world at large, but their rational decision-making is impaired, their emotions are distorted and they make their decisions under the influence of the alcohol.
Parents who act under the influence of outside pressures, anger, or stress may not be as equipped to formulate the most effective long-term strategy to minimize, or eliminate the problematic behaviors. This can lead to a quick fix, whereby medication is used as a stand-alone intervention. However, ideally this treatment strategy is executed only after parents are versed in alternative interventions, beneficial and detrimental side effects of the medications and informed what assessment tools were used (and what they mean), as well as who (with what expertise) performed the assessment. It may also be necessary to talk to their clinician about a treatment strategy beyond the quick fix. The medication may be used to navigate through a period of crisis, or be part of a long-term treatment plan to recalibrate a physiological problem. However, it may be most effective coupled with adjunct therapies such as behavioral intervention, which can address specific behavioral problems and intervention strategies. Couples counseling may also be of benefit in order to address distorted emotions, parental stress, conflict, or inconsistencies in parenting styles, as well as increase the overall competence and expertise of the family system.

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Your questions and comments are welcome via e-mail or by letter at Creative Child Magazine at 2505 Anthem Village Drive. #E619, Henderson, NV 89052. David Aronsohn maintains a private and corporate consultation practice out of Westlake Village, CA. 818/735-0428
Disclaimer-The advice is this article is not meant to act as professional advice, or counseling for your particular set of circumstances. It is designed for general knowledge. It is recommended that if you feel you need individual assistance for you or your family, you seek the advice and intervention of a licensed professional that can provide help for your particular set of circumstances.