ABSTRACT
Reviewing the studies in the preceding section should help to amplify the issue of listening carefully to the whole patient system when a psychologist is assessing a child who has a parent with SMI. Importantly, given the two ways a clinician is most likely to encounter children with a mentally ill parent-indirectly by working with a client diagnosed with SMI and learning that she/he has a child, or directly when the child is referred with her/his own problems-neither the parent nor the child should be viewed in isolation. The child’s presentation must be heard and understood in the context of the parent’s illness.Attending to the child’s developmental level and needs as these have been affected by the parent’s illness is essential. Issues of gender, cultural norms, and additional social support are individual difference factors that also need to be heeded. For instance, a mother’s two-month hospitalization for depression may have quite a different impact on her 3-year-old daughter compared with her 15-year-old son. Many assessors rely on internal norms and then draw upon additional resources (e.g., models proposed by Erickson, Freud, and Piaget) to understand age ranges associated with the development of certain skills and aptitudes. These practitioners can then better appreciate what developmental tasks may have been compromised or neglected by the presence of SMI in the family. Recognizing the challenges within this specific family system, and for this particular child, is paramount.In preparing to assess the needs of a child dealing with a mentally ill family member, it is helpful for clinicians to have a number of different clinical “amplifiers” to stay attuned to the particular melodies, harmonies, and discords present. We have found it helpful to frame the assessment in terms of understanding the interactions among three different cycles of development: individual (child), family, and the course of illness itself (see Rolland, 1988, 1994; and Marsh, 1998, for specific application to mental illness). Although clinicians are accustomed to hearing their clients on multiple levels (e.g., developmental, family system, and a comprehensive psychological test battery), we hope to enhance the assessment process with
the addition of two important elements: a “hearing aid” that tunes the clinician into the specific impact that a parent’s mental illness may have on children in both the short term and over time, and a “microphone” to amplify attention to assessing resilient coping processes.
