this post was submitted on 10 Feb 2024
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Derry Oliver was in fifth grade when she first talked to her mom about seeing a therapist.

She was living in Georgia with her brother while her mom was in New York scoping out jobs and apartments ahead of moving the family. It was a rough year apart. Oliver, now 17, was feeling depressed. A school staffer raised the idea of a therapist.

Oliver’s mom, also named Derry Oliver, questioned the school’s assessment and didn’t give consent for therapy. “You’re so young,” the mom recalled thinking. “There’s nothing wrong with you. These are growing pains.”

The issue boiled over again during the COVID-19 pandemic when the younger Oliver, struggling with the isolation of remote learning, reached out to her Brooklyn high school for help. School-based mental health professionals like social workers can provide some counseling without parent permission. But in New York, referring a student to more intensive therapy almost always requires a parent’s agreement. In Oliver’s case, that led to more conflict.

...

As schools across the country respond to a youth mental health crisis accelerated by the pandemic, many are confronting the thorny legal, ethical, and practical challenges of getting parents on board with treatment. The issue has become politicized, with some states looking to streamline access as conservative politicians elsewhere propose further restrictions, accusing schools of trying to indoctrinate students and cut out parents.

Differing perspectives on mental health aren’t new for parents and kids, but more conflicts are emerging as young people get more comfortable talking openly about mental health and treatment becomes more readily available. Schools have invested pandemic relief money in hiring more mental health specialists as well as telehealth and online counseling to reach as many students as possible.

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[–] FlyingSquid 70 points 9 months ago (2 children)

I understand that kids can need therapy for all sorts of reasons and that parents don't always agree even if schools suggest it.

I have a totally different problem with this issue- namely that school counselors think they are therapists.

My daughter got doxxed by two other girls who also prank called her multiple times.

The school's solution? Group therapy with the girls at school with the counselor.

One of the many reasons I'm glad my daughter is in online school now. She was so bullied that even the bullied kids bullied her and the school's solution was always counseling. Which, of course, made it feel like the bullying was partially her fault. She developed severe anxiety and started having all kinds of self-destructive thoughts. She's only 13.

And no, online school is not the same as being homeschooled. She has live (videocoference) lessons with licensed teachers where she can ask and answer real-time questions and she gets assignments graded by those same teachers. Her textbooks are from Pierson like every traditional public school's textbook since Pierson has a monopoly. The school is run by the state, so it isn't even a private school.

I do have to stay with her and keep her on track and help her with her assignments if she doesn't understand something, but I am not her teacher or considered her teacher or expected to be a teacher and there are plenty of times I have to tell her I'm as confused as she is and we need to talk to one of her real teachers about it.

And we are so lucky to be able to have the ability to go down to a single income and barely squeak by because she is still severely damaged from this months after we pulled her out of her public middle school, but she's building up some self-esteem and is actually willing to go out and do activities and socialize and make friends, which she was totally unwilling to do while in public school. She actually has more friends now than she did when she was in that school, including kids who are still going to that school who have made big apologies to her for going along with everyone else. She's magnanimous to give them another chance. One of them is also now in online school because she became the most bullied kid when my daughter was pulled out.

Does she get therapy? Yes. We put her in therapy and a big reason was because the school didn't do shit besides making her sit down with the bullies in a bullshit group therapy session so they could all apologize to each other.

And that is what concerns me about schools suggesting therapy. They are doing it as a way of solving bullying in a form of victim-blaming.

TL;DR - I do not trust schools to understand the root of a child's mental health problems when the root could be something at school they aren't doing shit about.

[–] [email protected] 15 points 9 months ago (1 children)

Thank you for being such a wonderful parent, listening to your daughter, and taking all of these proactive steps to help build her back up. I agree this is not therapy and it's devastating to hear that the school thought this was appropriate. Placing her in group therapy with the offenders implies she was somehow responsible for being a victim. As a former child and daughter who struggled to be heard, especially at 13, I really appreciate you for hearing her now and doing something about it now. This makes such a difference.

[–] FlyingSquid 7 points 9 months ago (1 children)

I appreciate it, thank you, but I just feel lucky that we had the option to do something about it. The real problem is there are so many kids with parents who aren't able to pull off what we are financially. Those are the ones I'm concerned about, especially now that schools think they can do therapy.

I got bullied quite a bit in school myself, and the school was not especially helpful, but at least my counselors never tried to make me sit down with the bullies and have everyone apologize to each other and talk it out. It's worse now.

[–] FollyDolly 3 points 9 months ago (1 children)

If my parents had done that for me it would have been amazing. Thank you for doing that for your daughter.

[–] FlyingSquid 3 points 9 months ago

Yeah, me too unfortunately. Thanks.

[–] jadedwench 5 points 8 months ago (1 children)

Thank you for being an awesome parent! I buried a lot of trauma from elementary, and having their "guidance" counselor forced on me made it worse. This person actually told me I was a compulsive liar and went on and on and on. A lot of bad shit happened to me and I have had issues with pretty much every female therapist of any sorts.

There was also a sort of traveling counselor who would visit the elementary schools sometimes, but was based out of one of the middle schools. He was awesome and had real credentials. I was so happy he was at the middle school I went to and that I could talk to him sometimes. He was very short, gentle, and did everything he could to put himself on the same level as the kids he was trying to help. If you just needed a safe space to quietly play with dumb toys you were "too old" to play with, his office was open.

Anyways, give your kiddo a hug for me, if they are cool with that. Don't ever let her forget her self worth. Keep reminding her that she has a voice and that you can really say no to things.

The best complement I ever received was that I was a force of nature.

[–] FlyingSquid 2 points 8 months ago

Thanks. And yeah, our counselors were awful when I was a kid too, but at least they didn't try to make me get along with the people bullying me!

As far as reminding her she has a voice, I've been doing that for a long time, but it took getting her out of that hell to give her the courage to tell some kids from that school who were harassing her while she was out roller skating to fuck off. Which I'm very proud of her for.

[–] MrJameGumb 41 points 9 months ago (2 children)

This is not that unexpected of a response. People like to say things like therapy for kids "isn't needed" but what they really mean is "I don't want my kid to see a therapist because a therapist is going to blame me for everything"

[–] [email protected] 22 points 9 months ago (2 children)

people also have a weird aversion to it. I have a friend struggling to have a baby who is suffering deeply due to two miscarriages — won't do anything about their mental health despite sending me messages at 4am about how they're drowning in grief.

[–] [email protected] 9 points 9 months ago (1 children)

I always thought the aversion was the cost of therapy combined with zero guarantees of being ‘better’ after

[–] [email protected] 6 points 9 months ago (1 children)

I think that’s my personal hold up; I got as far as a free consultation. After seeing the benefits of hiring a dietician to help manage my energy levels, I’m less reluctant because (shockingly) people who do things professionally actually know their stuff.

[–] [email protected] 1 points 8 months ago

Therapy is self driven from my experience, so unless your ready to come with receipts and do your homework, there will be little value.

[–] afraid_of_zombies 5 points 9 months ago

Human fertility is the best argument us atheists have that there is no one managing the universe. Perfectly wonderful couples slowly going insane trying to have a child and people who should never ever even think about having kids have 7 of them.

[–] afraid_of_zombies 7 points 9 months ago (1 children)

I am a parent. At least if the therapist is blaming me for everything it is a fixable problem. I can change my behavior.

[–] [email protected] 6 points 9 months ago (1 children)

You are a vanishingly small minority methinks.

[–] GladiusB 1 points 8 months ago* (last edited 8 months ago)

I am a parent too. I have reservations because I don't want my kid to feel like he's special for the wrong reasons. Like he has something wrong with him that the other kids don't have. Because when we were considering it, he was having outbursts that were concerning.

He has stopped having those and the ex left the abusive ex boyfriend that caused his outbursts (color me shocked). I still have concerns with the counselor being how they were being towards me, the father. But whatever. My kid knows what's up.

[–] [email protected] 28 points 9 months ago (1 children)

if they get therapy, they’ll realize I’m an abusive parent.

[–] RGB3x3 1 points 8 months ago

Likely. So many conservative parents end up with kids that hate them because their entire personalities become hateful. They think everyone and everything that isn't straight and conservative is out to get them and take away their rights.

[–] redempt 27 points 9 months ago (1 children)

children deserve self determination just as much as anyone else. kids can't even get their own medical issues addressed if their parents think they don't need / deserve it, it's nuts.

[–] ChonkyOwlbear 1 points 8 months ago (1 children)

100%. People shout all the time about parents rights, but few care about the rights of children.

[–] redempt 2 points 8 months ago

"parent rights" is just a dog whistle for "I think children are property not people"

[–] [email protected] 20 points 9 months ago (1 children)

Republicans: School Shootings are a MENTAL HEALTH ISSUE! Also Republicans: THERAPY IS BAD! JUST DEAL WITH IT! HERE'S A GUN!

[–] [email protected] 4 points 8 months ago

I always hated this "paradox". I could never vote for people like this. I dislike dems restrictions on guns but I HATE that there is a solution that everyone agrees with long term benfits that simply cannot be funded. Worst part is if dems pushed for it GOP would still impead it out of spite. Like the whole party just wants to watch the world burn or something.

[–] [email protected] 16 points 9 months ago (2 children)

Personally, I feel like it would be great to normalize therapeutic supports to such an extent that we can let go of the idea they represent something being "wrong" with anybody. We have collectively developed this bizarre sense that we shouldn't need each other, that you should have to face your challenges on your own.

If you are personally in the position where therapy is accessible to you, I encourage you to go for it - even if there is "nothing wrong with you" (lol) - and then recommend it to others, talk about how it helps you grow and learn, etc. The mental health world is still fraught with challenging, dangerous stigmas and the best way to improve that is to show others that it's the stigmas that are dangerous, not the supports.

[–] cheese_greater 3 points 9 months ago* (last edited 9 months ago) (1 children)

I think it goes deeper than that. There's this lack of awareness and also enforced denial of people's needs with interpersonal weapons like guilt, shame, physical violence, and making one's survival contingent on codependance and on towing the line even if it doesn't work and its not yours and particularly where a seperate person's lifestyle and control depends on their forced captivity on anyone else

[–] [email protected] 1 points 9 months ago

We are definitely struggling against an unhealthy culture that makes this extraordinarily challenging. I think there is a misunderstanding where we think accepting greater support will decrease our personal autonomy and risk us being too reliant on others. However moving towards healthy interdependence should - and can - be an experience that actually frees the individual to experience more opportunity, greater stability, enhanced relationships, etc.

[–] [email protected] 2 points 8 months ago

I've definitely thought about casting therapy in the same terms as exercising. Hitting the gym is good for your physical health, seeing a therapist is good for your mental health. Problem is, I don't want to make it something people start bragging about, the way some people excessively work out. Then again, that's a much better problem than the one we have now.

[–] [email protected] 14 points 9 months ago (1 children)

Not all parents are smart, reasonable, informed people.

[–] Potatos_are_not_friends 4 points 9 months ago (1 children)

My wife works in the baby delivery unit. She meets hundreds of new moms a year.

A very large percentage are not equipped to be parents at all.

[–] GladiusB 1 points 8 months ago

You grow into it. I guarantee every single parent you ask will tell you they were not ready for something as a parent. It also varies from kid to kid. Not every kid has the same things to learn since we are all different people.

[–] RestrictedAccount 10 points 9 months ago* (last edited 9 months ago) (1 children)

This sounds great except when those kids have permanent records of a history of mental problems. (Not true, but how it will be interpreted by others)

They can’t get clearances

Insurance will hold it against them

If they ever get charged with something it will be used against them

All it will take is for all the schools in the world to have perfect cyber security for all time and new laws for my concerns to be mooted

[–] [email protected] -3 points 9 months ago (2 children)

Therapists do not make official diagnoses, so it won't be on their medical record

[–] acetanilide 4 points 9 months ago (1 children)

Yes they do. at least where i live.

[–] [email protected] 1 points 9 months ago (1 children)

Where on earth do you live that a simple conversation with a patient is enough for a medical diagnosis? Most usually require a form of observation

[–] acetanilide 2 points 9 months ago

In the US, when using insurance, a preliminary diagnosis is usually required on the first visit in order for the claim to be approved.

Many therapists not submitting to insurance don't bother with a diagnosis, however some will still diagnose regardless. Additionally, if a patient requests a diagnosis for various reasons, they may give one.

There are restrictions as to which level/license can be allowed to diagnose, usually specific diagnoses are restricted however certain insurances (especially government insurance plans, like Medicare and Medicaid) will not allow certain licenses to diagnose.

For example, an LMFT (licensed marriage and family therapist) may not be allowed to diagnose A if the patient uses Medicare but a LPC (licensed professional counselor) is (I might have those backward). Still other diagnoses require more advanced degrees (usually a PsyD/PhD aka psychologists) to run the tests required for said diagnosis.

It also depends on the setting. In a hospital setting, usually the psychiatrist (MD/DO) will diagnose while the therapist will not.

[–] [email protected] 3 points 9 months ago

Guess what happens if you admit to being suicidal with a therapist?

[–] afraid_of_zombies 8 points 9 months ago

Mental health I argue is more important than physical health. Death is a given eventually, happiness is never a guarantee. I would rather have both obviously.

[–] [email protected] 5 points 9 months ago

I am surprised no one has mentioned cost yet. If a school suggest parents send their kids to therapy, but the bill is completely on the parents and they can't afford it, that's a pretty short conversation.

[–] JustZ 1 points 9 months ago (2 children)

Everyone should be in therapy.

[–] matjoeman 5 points 9 months ago

Sounds nice but therapy is so expensive.

[–] cheese_greater 4 points 9 months ago* (last edited 9 months ago) (1 children)

Not that everyone wouldn't benefit from having a wall to bounce ideas off of, but the thing I've noticed about much of the therapy I've experienced was the lack of focus on addressing (enforcing respectfully but in a non-negotiable way) needs as an effective and commonsense proxy for wellness.

There is so much people-pleasing and self or forced martyrdom that really must be addressed. There's no drug or habit or professional that can save you if your life is chronic hell the moment the door locks clicks and there's an external locus of coercive control coming from within the house or that lives on through ones nervous system as a background process that you can't put a name to and how to shutdown

[–] JustZ -1 points 9 months ago

There's huge difference in quality and approach from one therapist to another. I would avoid therapy with a licensed clinical social worker or certified counselor or that sort of thing, The absolute best practitioner in my experience will be someone that went to medical school, an MD or DO, or a PhD in psychology from a good school. A good behavioral therapist will draw out these processes and help close them down. I like to think of them as browser tabs.

[–] [email protected] -2 points 9 months ago (2 children)

Society needs to discuss the ethical dilemma of medical treatment without a parent's consent. Minors cannot give consent for any medical treatment.

[–] randon31415 6 points 9 months ago (1 children)

That does not mean that we should withhold medical treatment from minors absent parent's consent. I am pretty sure if a student got shot at school, you wouldn't be for calling parents before giving medical aid - nor withholding aid if the parents say "just let them bleed out".

The issue is here that people don't see mental health treatment as necessary as physical health. There are mental heath situations as dire as being shot.

[–] [email protected] 3 points 9 months ago

There's an ethical difference between emergency medical care and non-urgent but necessary medical care. You can't honestly compare treating a gunshot wound to therapy, and emergency mental health treatment usually involves hospitalization. That's not the kind of care that this article is talking about.

[–] [email protected] 0 points 9 months ago (2 children)

Minors can very much consent to medical treatments, even more so once they reached their teens. It's their own body and their own health.

[–] [email protected] 2 points 8 months ago* (last edited 8 months ago)

Not in the USA. Providers are allowed to give emergency care, but anything else requires parental approval. Individual states may have exceptions passed into law (e.g. MN allows treatment of minors w/out parental knowledge for the areas of substance abuse and reproductive health, although not for abortions).

To be clear, I agree with your moral argument, but you are legally incorrect (in the USA, at least).

There is also the problem of bad faith actors. The US has a terrible track record with involuntary care, or just straight up lying and using people as human guinea pigs (the Tuskagee Airmen are just the tip of the iceberg). I would love to think that things are better now, but we have to accept a non-zero percentage of medical providers would absolutely do horrible shit if they could get away with it. We have relatively decent safeguards in place, but we could probably use more.

[–] [email protected] 1 points 8 months ago

Incorrect. Minors cannot give consent, but older minors can assent to medical care, which is basically going along with it without complaint.