Monday, February 25, 2013

Finding professional help

I have a sweet and cooperative child that has had anxiety and anger bursts as long as I can remember. Reading your blog has brought an extreme amount of relief knowing that I am apparently not alone.

I am searching for a psychologist in the Houston area that possibly could help. Would you have any recommendations as I would obviously prefer to visit with one familiar with anger overload?

Hi, I am in the Chicago area and don't have a specific recommendation in Houston.  However, I would make these suggestions.  You want someone who has worked with parents and children on anger issues.  With younger children (pre-teens), it is especially important that the mental health professional meet with the parents at times (either along with the child or separately) and not just see the child.  Since many children do not yet recognize when they are getting frustrated and are likely to "blow-up" if no one intervenes, it is important that parents be ready to deal with potentially difficult situations. Parents need to have in mind several strategies to use in anger-provoking situations.  Parents can then apply a strategy and sometimes prevent blow-ups, or guide their children so that anger can be more easily controlled.   Also, I find it is real helpful if parents can review anger arousing situations with their children after everyone has calmed down, rather than wait until the next therapy session, by which time the child may have forgotten what happened.  Many of the strategies that I outline in my book involve the parents taking the lead.

So if the therapist wants to just meet with your child and not with you, ask why.  If there has been a trauma in your child's life, it might make more sense to meet primarily with your child, but if your child has experienced anger overload over the years and there is no clear precipitant, then it is unlikely your child will learn to develop better self-control without your help.

You might want to ask your child's teacher or pediatrician for suggestions of therapists in your area.  Also, you could ask if the mental health professional in your area has either heard of anger overload or of the diagnosis called  disruptive mood dysregulation disorder (or DMDD).  In the new diagnostic manual (for mental health professionals)  that is coming out in a few months, there will be a diagnosis  DMDD that is similar in many ways to anger overload.   Anger overload is a phrase I coined twelve years ago to capture the extremely angry outbursts some children (and teens) have when they are disappointed or frustrated . The main difference between anger overload and DMDD is that for anger overload the child does not necessarily exhibit irritable mood in between outbursts, whereas for DMDD, there is a continual mood issue.  But in both cases angry outbursts occur regularly.  So if the therapist is familiar with DMDD and how to treat it, the therapist should be able to help with anger overload.  I hope this is helpful, Dr. David Gottlieb

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