Decision Making: When Are Kids Old Enough?

June 12, 2013 Heiddi Zalamar, LMHC, MA

Decision making

Making decisions is always on the mind of a parent with a child who has mental illness. What school will they go to? Will it meet their needs? What medications can we try? Which ones will work? Which ones don't? What does the therapist, teacher, psychiatrist, pediatrician say? Everyday, we as parents (in general) make decisions in the best interest of our children. But, when does that transition from us to our children? When do they start making decisions about their own lives?

My Decision-Making Process

From the time I could remember, I've always been the one making decisions regarding Bob. Childcare, education, medical needs, extra-curricular activities - it was all me. Though Bob's father was around, he backed off and left the decision making to me. So, I'm very comfortable doing it. If something needed to be done, I mulled it over weighing the pros & cons and chose something.

Inspired by a Reader

Last week, I wrote about Bob's medication not working. I received a comment that got me thinking. A retired teacher wrote about not letting Bob have the final word on therapy & medication. (Check out the link above so you can see.) My reply was simple - Bob doesn't have the final say. While my response was simple, my post was not.

Note: I asked Bob in February about several notes I found in his book-bag about missing assignments. He was honest and stated that he forgot about them. He also said he felt that the medication wasn't working as well as it used to. When I suggested going back to the psychiatrist for an increase, which would also include therapy, Bob said no. He wanted to try using some of his coping skills to remember his work. I felt his reasoning was sound. After all, I wasn't the one with ADHD. But, I only agreed to this on the condition that if he continued to have trouble remembering, back to the psychiatrist we would go. As of last week, that's our plan. But the comment stayed with me.

When ARE they old enough?

Many of the comments I've read in response to Angela's posts (previous blog author) have been about parents trying to do everything in their power to help their children. Even when those children become adults. And I truly feel for each and every one. However, as a professional in the field kids and teens need to practice decision-making to then take over when they hit 18.

Everyday, I work with children, teens and parents around mental health issues. A plan is made, decisions are made and goals are set. In my experience, individuals in treatment do better when they can make choices. If they can make decisions even little ones, they buy into therapy and medication treatment faster than if someone else had 100% control. This includes minors. With young children, parents need to take the lead on decision-making. When kids are pre-teens and teens though (ages 12 & up), I feel that they need to have input in their treatment.

I ask both parents and kids several things upon arrival - why are they in the clinic, what they feel is the problem and what they'd like to work on. These questions help me work to incorporate not only what the parent wants, but what the kids want, too. I find that kids and teens will be more invested in treatment if some of their concerns are addressed. And treatment time can be reduced when a kid or teen feels understood especially if a parent can give up a slight bit of the decision-making (even as little as 5%). When this happens, change can happen faster and with everyone cooperating.

It also allows the child or teen the ability to practice good decision-making, which in turn builds up positive self-esteem and confidence. In this way, when a teen hits 18 and is legally able to make most decisions, both the teen AND parent can feel comfortable with the process.

Parenting a child with mental illness is tough. Parenting an adult with a mental illness is tougher still because the parent's decision-making is limited due to age (18 & up). We all suffer grief when our children don't do well regardless of whatever decisions we make. But, at some point, we parents need to let go of the reins bit by bit. It is about practice. I know that I won't be there forever for Bob. He'll grow up and live his life. While he practices with some decisions now, the goal is for him to make his own decisions as an adult.

photo credit: Lori Greig via photopin cc

APA Reference
Zalamar, H. (2013, June 12). Decision Making: When Are Kids Old Enough?, HealthyPlace. Retrieved on 2024, June 22 from

Author: Heiddi Zalamar, LMHC, MA

June, 19 2013 at 6:50 am

I agree kids should make at least minor decisions but my issue comes when my son wasn't dx'd until he was 16 (MDD, Borderline Personality, and anxiety) and is now almost 18 (in 4mos) and he WON'T make decisions. He simply doesn't do anything and lets the chips fall where they will. He is on medication and in therapy but its only getting him day to day.

In reply to by Anonymous (not verified)

June, 19 2013 at 4:13 pm

Hi Lisa,
Thanks for coming for a visit and sharing your thoughts. Sorry to hear about your son's lat diagnosis. I imagine that he has many challenges because of the combination of disorders. But, with your support and his continued treatment, I believe there is hope for him. :) Thanks again and please come again soon.

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