Treatment of Childhood Disorders: Evidence-Based Practice in Christian Perspective – Sarah Hall and Kelly Flanagan

Treatment of Childhood Disorders Hall Flanagan
Treatment of Childhood Disorders: Evidence-Based Practice in Christian Perspective by Sarah E. Hall, Kelly S. Flanagan
Published by IVP Academic on April 27, 2021
Genres: Academic, Non-Fiction
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Caring for the mental health of children and their families is complex and challenging--and meaningful. For Christian clinicians who work with childhood disorders, however, few resources exist to address such treatment from a research-based Christian integration perspective. Treatment of Childhood Disorders fills this gap by combining biblical and theological understanding with current psychological literature on empirically supported treatments for children. Sarah E. Hall and Kelly S. Flanagan present an integrated approach based in developmental psychopathology, which offers a dynamic, multifaceted framework from which to understand the processes that affect children's development. In this unique textbook, Hall and Flanagan consider a variety of disorders commonly diagnosed in children and adolescents, including anxiety, depression, ADHD, and autism spectrum disorder. After discussing prevalence, risk and causal factors, patterns throughout development, and assessment, they focus on evidence-based practices that have been found to be effective in treating the disorders. Each chapter also features ideas for Christian integration in treatment and an extended case study that brings the content to life.

I should begin this review by saying that I’m a pastor, not a psychologist, therapist, or counselor. However, I believe that it is important for clergy to understand mental health because, in their pastoral or even personal roles, they will have the need to come alongside families dealing with mental health issues. Particularly if you work with children in any way—as a teacher, pastor, coach—this is a useful text for understanding what some of the children in your group might be experiencing.

Treatment of Childhood Disorders is divided into four parts: foundations, internalizing disorders (depression, bipolar, anxiety, and PTSD), externalizing disorders (disruptive behavior and ADHD), and other disorders (autism, anorexia/bulimia, and gender dysphoria). The first part sets the groundwork for the book’s structure and perspective. The final three parts give comprehensive overviews of the history of various disorders, their origins, and their treatments. Each of these sections ends with a fictionalized vignette that puts into practice what treatment might look like.

This isn’t a layperson-level work. It’s a textbook intended for academic use and study. Despite that, Hall and Flanagan write in a way that is engaging, clear, and direct. Again, if you work with children, this an important text because you’ve undoubtedly ran across children under your authority who are dealing with these issues. From the list above, in my decade as a coach and pastor, I can tell you that I can place a name of a student to each and every one. We cannot afford to be ignorant in these matters. We must have a clear understanding in Christian perspective to help our students flourish.

I was particularly interested in the section on autism, as my young son is autistic and there are currently differences of opinion between the autistic community and medical practitioners regarding some practices and therapies in the treatment of autism. Since this is the area I am most familiar with, it’s the area I felt most qualified to offer critique on what constitutes a “Christian” perspective. The normative treatment for ASD (autism spectrum disorder) is called ABA (applied behavioral analysis). Many adults with autism consider ABA therapy to be abusive and focused on compliance with “normal” society rather than viewing the autistic individual as a unique person. Further, recent studies have suggested that ABA is mostly unsuccessful in its stated goals. Treatment of Childhood Disorders discusses ABA in a clinical fashion, as it should, because it is the historic and prevalent treatment. They also outline DSP (developmental social-pragmatic) interventions, which is a newer approach that is more respectful and understanding of the autistic individual.

At the end of the chapter, Flanagan and Hall write that any treatment of autism must 1) value children as gifts, 2) respect children as persons, and 3) view children as agents. Under this paradigm, I would find little to commend in ABA therapy. Flanagan and Hall have it absolutely right. Children should be viewed this way. Yet, because ABA is so prevalent, they work to fit the ABA paradigm into their model. They seem to struggle with some of ABA’s methods while commending its supposed results—as if the ends justify the means. This is a textbook and thus, I understand, must be neutral, but overall Hall and Flanagan are more deferential to ABA than I would prefer and seem to have a more positive view of ABA’s results than some experts. (For me, the question becomes whether or not all autism should be placed under the label of “disorder.” Is all autism disordered? Or is it simply a social disability, part of God-ordained diversity? These are questions that Hall and Flanagan do not address.)

The other chapter that is potentially controversial is the concluding chapter on gender dysphoria. Unlike the other chapters, which run 40-50 pages, the discussion here is a svelte 20 pages. Hall and Flanagan expertly review the literature, then evaluate the topic using the three-framework model developed by Mark Yarhouse. This model suggests that we can understand GD as a disability (or a sin, as advocated by some Christian fundamentalists), as diversity (as advocated by most “liberals”), or with integrity (understanding that the issue is complex and nuanced, which is what Yarhouse advocates). This chapter is basically a truncated version of Yarhouse’s Understanding Gender Dysphoria, which he amends, in part, with his more recent Emerging Gender Identities. Like the chapter on autism, the question I would like to see answered that remained unanswered was whether or not all gender identity issues are dysphoric and disordered. Flanagan and Hall, probably correctly, shy away from any controversial or strong statements toward any “side,” but in so doing offer a fairly anemic take on GD that, while admittedly better than most Christian perspectives, doesn’t offer much in the way of practical advice.

Overall, Treatment of Childhood Disorders is a good textbook. I do have some criticisms and disagreements with it that I hope are valid, but want to acknowledge that it is a well-written, competent, well-researched source. It provides comprehensive introductions to major childhood disorders in a way that even laypeople can understand and follow. It’s perfect for the undergraduate level therapist/counselor or the graduate level pastoral counseling class.