Assessment for attachment, cognitive, behavioral, or emotional struggles usually occurs with a licensed psychologist, neuropsychologist, psychiatrist, or neurologist, depending on the need. Assessment can usually be covered by insurance. Ask your provider ahead of time in order to cut down on potential costs.

• Psychologists and psychiatrists often use  interviews with parents and children, as well as computer-based assessments to obtain measurements and compare them to a general population norm. The process of diagnosis can take several meetings.

• Licensed therapists can also diagnose individuals in most states, however, most are trained to be hesitant to engage in diagnosis beyond basic problems such as anxiety and depression. Certain diagnoses such as ADHD and Bipolar Disorder require additional assessment by a licensed physician in order to rule out potential hormonal or medical contributing factors.

• A licensed therapist may be a good first step toward obtaining diagnoses, as therapists will be able to provide several hours for initial assessment while informally observing behaviors. Once initial assessment is completed, your child's therapist may refer your child for full psychological or neurological assessment. Ask your child's therapist if they have training in assessment and are able to screen for various problems using well-known and accepted screening assessments.

Family Assessment

• For children and teenagers, a licensed Marriage & Family Therapist (LMFT; COAMFTE) or Marriage, Couple & Family Counselor (LPC, MCFC; CACREP) may be better-equipped to assess parenting and family dynamics and their contributing role in your child's struggles.

What If My Child is Unwilling to Participate?

• If your child is unwilling to be assessed, then the next best step may be taking them to a local psychiatric unit for evaluation. Most  psychiatric hospitals can handle acute cases, diagnose, and provide appropriate medication in a short period of time. If possible, be ready with a plan to place your child in longer-term care when necessary.

• Residential treatment centers, wilderness therapy programs, and therapeutic boarding schools will often provide psychological assessment on campus or with a psychologist. Some programs can also provide neurological and medical assessments.

What is the Value of Diagnosis?

Many parents express fear that a diagnosis will label their child in a negative light or allow their child to 'play the victim' in their struggles. Diagnosis can induce a sense of shame in families and individuals who exist in cultures that do not appreciate difference, ridicule appearances of weakness, or devalue the struggles of being human.

1. Diagnosis should be the result of many perspectives. Diagnosis requires specific training, experience, and a consensus from many inputs, not just one clinician's or doctor's perspective. Be willing to seek second, third, and fourth opinions.

2. Diagnosis helps us gain understanding as caregivers. Our children are not their diagnoses, and with few exceptions, the struggles of their diagnoses do not reflect on us as their parents or on our families. Destructive behavior is often an outward expression of inward pain, such as anxiety, depression, loneliness, overwhelming boredom, emptiness, or shame. Understanding the root of our children's pain, allowing for difference, and adjusting our expectations as caregivers are the first steps toward positive change.

3. Diagnosis helps professionals understand and communicate core concerns to one another. The helping community develops  evidence-based treatments to alleviate unnecessary suffering by identifying clusters of symptoms and giving them a name. Some diagnoses, such as schizophrenia, bipolar disorder, and ADHD, are genetically-inherited differences related to brain growth and development which can be treated with stimulant medications, mood stabilizers, or anti-psychotic medications. Other diagnoses become more apparent over time due to a combination of stress and genetic predisposition, such as addictions, anxiety disorders, panic disorders, eating disorders, or PTSD.

4. Diagnosis helps professionals target intervention. Each diagnosis requires specialized training and intervention to address. Most well-seasoned helping professionals understand that for certain diagnoses, well-accepted interventions will provide little relief. For example, trauma ought not be addressed with just cognitive-behavioral therapy (CBT), because trauma is held and experienced in the body, and CBT is only a cognitive or 'thought-centered' intervention. As a result of this limitation, clinicians may use alternative options such as Trauma-Focused CBT (TF-CBT)  or Parasympathetic  Activation (Polyvagal), which provide interventions for trauma that focus on releasing tension in important parts of the body. At minimum, these interventions should be done with a helping professional who has received training in trauma and know how to stabilize the individuals they are helping.