The world of Mental Health treatment divides into two categories: Child and Adult. Some mental health professionals straddle the line and serve both but most ultimately "choose a side," preferring to work with one population over the other. A family therapist or technician providing in-home services will obviously interact with a variety of age groups in a single session, but in that case a child is always the 'identified client.'

It is further helpful to clarify that here, Mental Health services applies to the treatment of those who have been diagnosed with mental disorders (usually as defined by the DSM-IV TR) or who are seen as being at-risk. To receive reimbursements from the government or from insurance companies, an official diagnostic label usually must be given to a particular client, or 'consumer.' Besides MH, there are other branches of human health services including DD 'developmentally disabled,' SA 'substance abuse,' SO 'sex offender,' and services specializing in geriatric populations.

The reason that mental health professionals prefer to work with one group over another is simple: children and adults require radically different treatment approaches. You may think there is not a significant difference between a 17-year-old client and an 18-year-old client emotionally or mentally. The differences are mostly tactical and logistical. I will attempt to clearly summarize the key differences in providing mental health services to the two groups now.

CHILDREN:

Up until the age of 18 (with a few exceptions), children with so-called mental illnesses or emotional problems answer to a legal guardian in some form. That guardian may be the child's biological or adoptive parent(s), an aunt or grandmother, or Social Services. This fact immediately adds another layer of depth to the counseling process, and means that the client is not able to make legal decisions for themselves.

A client may be forced to move, to change schools, to enter into special treatment programs, to live in a group home or hospital, and can even be ordered out of his or her parents' custody by a judge. Additionally, the school, the juvenile court, and any other number of 'stakeholders' such as the organizing agency for foster care may be intimately involved in the planning of the child's care. Alas, as children are cute and cuddly, there tend to be more community and government resources available for them.

The primary focus of mental health services for children is behavior change. A child's behaviors are getting them into trouble in society or 'causing problems' in the home environment. Popular diagnoses include ADHD and ODD (Oppositional Defiant Disorder). A child would rarely voluntarily seek mental health services for themselves.

On the plus side, children have a great deal of resiliency, especially at younger ages. If dealt with appropriately, they can bounce back from all kinds of abuse. They usually react well to incentives, such as a reward-based program, and show a great capacity to learn. Of course, a mental health technician must deal with a whole family and social system that can be at odds with any given treatment program.

ADULTS:

Adults consist of anyone from the legally emancipated age of 18 up until 122 years (according to the Guinness Book of World Records). In that, the generational experiences and life stages of adult clients dramatically differ. Some adults still live with their parents. Some are in college. Some are newlyweds. Some have been divorced 7 times. Some have great-grandchildren. The tapestry of lives lived can be fascinating and educational.

An obvious difference from children is that adults are their own guardians, unless somehow deemed mentally unfit to care for themselves. Whereas the focus of working with children is behavior change, with adults it becomes a matter of emotional change. Adults have had longer to ingrain certain habits and defense mechanisms and after a certain age their brains stop growing. Through psychotherapy, CBT (cognitive behavioral therapy) and DBT (dialectical behavioral therapy), inward ways of processing information and interpreting the world are addressed. Events buried deep in the past can be examined, dealt with in safe, therapeutic environments, persons of note can be confronted and amends can be made.

The most popular diagnosis for adults today is Bipolar Disorder, formerly known as Manic Depression. Other diagnoses may include Major Depressive Disorder, PTSD, some personality disorders, and many others.

Many adults who seek mental health services may need assistance in navigating through legal issues, custody issues, financial or health issues. But it is they who are the ultimate authority in their lives and decisions - no government agencies! Also, adults generally want their lives to be better as they seek out services.

Mental Health professionals who primarily work with children can at times have distorted views of 'mentally-ill' adults. Certainly more stigma exists, as seeking help with a troubled child is supported by society. While it is true that less preventive work can be done with an adult who has a mental illness, they have just as much right as anyone to receive help. Furthermore, an adult will be functioning at a higher intellectual level than a child and can therefore be able to integrate and process more complex concepts and therapeutic interventions in their treatment.

Treatment with psychiatric drugs remains prevalent with both adult and child populations in this country.