I have always tried to ensure when I am talking to clients or the public about what I do, that my language is as free from jargon as possible. This is sometimes easier said than done (and apologies to those with whom I have flaunted some pretty high level brain science chit chat!).
Despite this effort, I have become increasingly aware that even when I avoid using jargon, I'm still using language that comes naturally (and is meaningful) to my colleagues and I, but that makes zero to no sense conceptually to a client. This presents an issue.
So here is my first blog post and an attempt to break down some of the buzzword barriers.
When assessing a child, a mental health clinician or consultant might ask the child's parent or teacher about what 'behaviour/s' the child is displaying or how they 'present'. But what does this actually mean and why does gathering this information matter?
'Behaviour' is generally broken down into two categories: internalising and externalising.
Let's explore these a little.
Internalising behaviours are typically over-controlled and inhibited. Behaviours may include:
Being withdrawn, either physically, by removing themselves from situations, or verbally, in not openly communicating their concerns;
Crying frequently or becoming easily upset; or
Showing excessive worry or nervousness, or speaking persistently with fear or pessimism.
In contrast, externalising behaviours are those that are under-controlled and tend to manifest as challenging and impulsive. As such, they are usually easier to recognise. Behaviours may include:
Speaking or acting aggressively, or with defiance or opposition (e.g., "No!", "I'm not doing that", tantrums kicking furniture, throwing something, swearing, hurting self or others); or
Overreacting when assigned a task or asked a question, especially if it is something they don't want to do or answer.
Evidently, these lists are not exhaustive and it does not take into account the role of temperament (a discussion for another time...).
In terms of what clinicians want to know about 'presentation', what it really comes down to is answering four questions:
How would you expect a 'normal' child of a similar age, gender, and culture to behave?
For how long have you been noticing the child's behaviour/s of concern?
Are these behaviour/s typical or out of character?
Has anything happened recently that could reasonably explain the behaviour/s (i.e., something tragic or challenging)?
Plus, the assessing clinician or consultant will want to know if the concerns raised about the child's 'presentation' are consistent (across settings and situations) and they will do best to achieve this through observations and information gathering (we really are detectives!).
The rationale for these classifications and questions is to assist a parent or teacher in working out what is and isn't normal for the child's own development. Generally speaking, if some behaviours persist for several weeks, that's a very justified reason for an adult to be concerned. But if these behaviours are isolated or are in response to something reasonably traumatising (which, for kids, can be as simple as a change in routine!), the best thing an adult can do is support them until things improve. Or fake it 'til you make it - that almost always works.
If a child you are raising or teaching is experiencing difficulties or showing behaviours of concern, and you think you would benefit from talking to someone about it, please contact Penny for a free and no-obligations consultation.
Penny is the Director of Capacity Therapeutic Services, a service committed to improving children's social and emotional outcomes by building the capabilities of the key adults in their lives. She is a Child and Family Therapeutic Specialist and values any opportunity to help kids and their families to thrive.