August 2003

 Q: My family has been going through a series of difficult events recently. My husband lost his job, and we had to move home to live with my parents. During that same time, my father-in-law became very ill and died, and my husband left to be with his mother for a while in another state. Our oldest child is in pre-kindergarten, and her teacher in her new school says that she is not able to make "lasting relationships" with her peers. At first, I was amused by her comment, but the teacher has been pressing me to get a psychological evaluation for my child. At home, she is the same lively interactive child she has always been and is adjusting well to life with her friends in our neighborhood. I feel like we are talking about two different children. I guess you should know that mental health issues run in our family. Do you think I should seek the help of a therapist as her teacher suggests?

Thank you for your inquiry. Your question reflects your concern for your daughter and desire to do what is right for her. You, your husband, and your children are going through multiple individual and group changes. You are right to move with caution.

First, it is important to know the extent of family involvement in your child's new school. Is it sporadic, limited to planned meetings and random contact, or is there an opportunity for you to volunteer for a while in your child's classroom or even sit in on school committees and workshops? Your child may feel more comfortable when she sees that you are welcomed in her new (and strange) environment and that you find it a fun place to be.

You might ask yourself the following questions about the classroom: What are the strengths of this classroom and teacher? How does this classroom "feel"? Is it a happy place? Does the teacher have stresses that result in her being less attuned to issues of safety or the emotional needs of the children? This teacher may be new, too new to be well prepared for the increased emotional vulnerability of your child. At home, surrounded by her things, her siblings, and her mother, who is attuned to her, she might feel comfortable and safe in spite of the recent changes and absence of her father.

Before you engage a private therapist to do an outside evaluation, I would recommend that you ask the teacher if there is someone on the school staff assigned to provide her with a consultation on your child. If there is, the school is a more natural setting than an outside clinic setting.

You can expect the consultant to partner with you and your child's teacher to examine the needs of the environment, the teacher, your child, and your family. This approach should be constantly evolving as the needs of the environment, teacher, child, and family change over time. Your involvement in this process with the teacher, the consultant, and your child will ensure that a wide array of systemic and individual needs is addressed. Whether or not further evaluation, beyond the school's capacity, is needed will become evident as well.

I offer one last word of support. Your child has many abilities-physical, social, and psychological. Often when a family becomes vulnerable, the family members describe how they "defer development in the name of crisis."   Once the crisis has passed, they are able to resume their normal roles, responsibilities, and functions. Even when mental health issues "run in (a) family," not everything is a mental health issue. Sometimes, it is simply an issue of deferring one's developmental process to get through the crisis.