Although it is not the most politically correct term for the condition, mental retardation (MR) is still has significant presence in the populations we counselors intend to serve. It is well documented that individuals with MR are at higher risk for comorbid mental illness of virtually all flavors…
Despite our best efforts to serve this needy population, interdisciplinary approaches that are considered ideal are still infrequently deployed due to cost and time constraints. I am surprised and disappointed that this kind of consideration isn’t arranged for everyone dually diagnosed with MR and a comorbid mental illness. I believe if we engaged TEAMS of psychologists, social workers, teachers, and communities agencies at every level of care and integrated it into a cohesive whole, the individuals we serve would receive a higher level of care for a LOWER COST!
A natural extension of the interdisciplinary approach is the involvement of the family in the decision-making process. (Netherton, Holmes, & Walker, 1999, p. 19) The importance of the family can not be overstated… absolutely critical and nothing less. I think this approach is too often implied and too rarely explicit. Three key tenets to working with families are not to be overlooked:
1) The team must be receptive to including families in the decision making process.
2) The team must consider the level of knowledge and understanding of the family related to the disability of the child and/or the service and treatment options.
3) Once the family has an adequate understanding of the condition and service and treatment alternatives, they may need to be nurtured through the team decision making process. (Netherton et al., 1999, p. 21)
We, as practicing clinicians and psychotherapists, could take a number of different roles in the team environment. As facilitators, we should frequently be asking parents what their perspective is, constantly seeking feedback and nurturing their freedom of autonomy. It is absolutely critical that the family “buys in.” I believe that if we nurture their ability to participate, that “buy in” is much more likely. As educators, we can also serve parents by helping them making informed decisions regarding every phase of the plan.
I think every expectant parent comes to the table with hopes, dreams, and expectations of who their child will become. Because many of these children will never grow up and meet the expectations of their parents, we can play a role in assisting them in coping, or simply modifying or altering those expectations to coincide with the realities of raising a child who may never be cured of mental retardation.
As the plan unfolds, we as councilors can play a role not only in the development of the primary client, but we can play a developmental role in the lives of the family members. If the family experiences feelings of shame, guilt, or even a certain sense of grief can be dealt with in a variety of different formats; including group therapy, family therapy, individual therapy, or even couples therapy for parents.
In summary, I hope we can come to consensus that psychologists should play a significant role in the planning and execution of any developmental plan involving a child with mental retardation. I would advocate that, aside from the primary care givers and family, our ability to offer assistance at different points of entry uniquely positions us to fill the much needed gaps in the overall individual treatment plan.
Netherton, S. D., Holmes, D., & Walker, C. E. (1999). Child and adolescent psychological disorders: A comprehensive textbook. Oxford, NY: Oxford University Press.