Parents often call their experiences with the children’s mental health system “war stories.” Others talk about being “in the trenches” or describe how they “battled” the school system or “fought” to get services. Other parents, listening to these accounts, nod their heads in agreement. Many feel as if they really are at war or at least engaged in a prolonged battle.
We all organize our social experiences using “frames.” According to sociologists, a frame is a model used to interpret events or experiences. We then depend on that model to understand and respond to new events. Families are thrust into the world of children’s mental health feeling unprepared and overwhelmed. We try to understand not only the “system” we must navigate but also interpret our experiences in a way that makes sense and helps us strategize. A great many families find that a framework using combat terms resonates with them and matches their experiences.
In the theory of framing, there are 3 tasks which help mobilize us. First we diagnose (we identify the problem and figure out who or what is to blame). The second step is to predict or figure out what we will do (we suggest solutions and strategies). The last step is motivational framing (where we have a call to action).
When my child was seven, I had an experience that that mobilized me in just this way. My son was terrified to leave the house (which made going to school nearly impossible and most days were filled with either rages or suicide threats). My school system agreed he needed to be evaluated and the school psychologist ran a battery of tests. I was sure that she would see that he was in terrible emotional shape and would help figure out what he needed. We went over the test results and she noted that he had a “very high IQ.” She smiled at me and I smiled at her, sharing that he had this wonderful strength. She then looked me straight in they eye and remarked, “His father must be very smart, I would guess.” While my jaw dropped, she went on to say that his intelligence would overcome any emotional challenges and she was not recommending any services.
Like many parents, my approach and understanding of the system changed radically in the next few days. I had expected to create an alliance with the school psychologist and instead found we viewed things very differently. I needed to figure out strategies to get my son the supports he needed. Most of all, I shifted from expecting consensus to gearing up for advocacy. And that was successful for me.
Framing is a powerful tool for each one of us, whether we use it consciously or not. When we frame our experiences, it can affect the outcome. This is one of the reasons families use the concepts of gearing up for battle or defending their children. It empowers us, creates focus and we all feel as if we are comrades in arms.
With the new Children’s Behavioral Health Initiative, Massachusetts is changing how we deliver services to children with mental health needs and their families. The new approach is based on collaboration, coordination and the creation of a team for the child and family. Words of war won’t fit as well in this model. However, any new “frame” must reflect the realities that families experience and seem relevant to our values. If not, it simply won’t be adopted.
Can we transform our framing? Only time will tell.