Family Relationships and Behavioural Issues

When there are difficulties with relationships between family members, be it between a caregiver and a child or between siblings, it can cause severe distress in family unit. Relationship issues may also lead to young people acting out leaving caregivers with a sense of not knowing what to do to fix the situation.

Relationship ruptures

Many things can disrupt a relationship including:

  • Caregiver-child personality mismatch
  • Sibling rivalry
  • Separation/divorce or marital discord between caregivers
  • Grief
  • Trauma
  • Caregiver or child mental heath difficulties

Common behavioral concerns

Caregivers often use the phrase ‘walking on eggshells’ to describe how they feel. When asked to describe what they mean, they typically identify one or more of the common behavioral concerns listed below:

  • Temper tantrums
  • Irritability
  • Poor school performance
  • Persistent pattern of defiance towards adults in authority
  • Misinterprets situations as negative
  • Aggression in general or more aggressive toward certain family members
  • Defiance
  • Vindictiveness
  • Lying and theft
  • Stealing
  • Running away
  • High risk taking behaviours such as drug use or causal sex

Assessment

Assessment and management of family relationship problems or child behavioural difficulties, involves a clinical interview with the caregivers to understand current and historical functioning and a separate clinical interview with the child to gain an understanding of their perspective. Once a shared understating of the problem(s) has occurred, goal directed treatment begins.

Treatment

Treatment should be based on a comprehensive understanding of the issue(s) with clear goals in mind. Specifically, treatment might include:

  • Education on the issue(s) and the type of evidence-based treatment that is most fitting
  • Parent training to help elicit positive behaviours and set appropriate boundaries
  • Strategies to manage sibling rivalry
  • Time management strategies
  • Social problem solving skills
  • Pleasant events and social support training
  • Parent support to help caregivers manage their own emotions and unhelpful thoughts