From medical categorical approach to holistic contextual and systemic approach to diagnosis and treatment of social interaction problems and disorders of children and adolescents

Abstract

This article presents a critical view of the widespread medical categorical approach to social interaction problems and disorders, which reinforces some false beliefs about this area and contributes significantly to the stigmatization and exclusion of these children and adolescents. We counter this with a holistic contextual and systemic approach, supported by numerous studies, which emphasizes the interplay of biopsychosocial factors. These factors can act as risk factors (as promoters and perpetuators) of problems and disorders or as support factors as we look for sources of strength and support in changing interaction problems. Research shows that there are multiple factors (risk and support factors) that influence different forms of antisocial behaviour, that they often act indirectly and are interconnected and intertwined in a complex network. The diagnostic approach and treatment should not be based on symptoms alone, but could be better described as research systemic. If we consider diagnosis as a research process, it is therefore in constant evolution and change, as some hypotheses are confirmed and others refuted over time. The expert is only one of the participants in this process, because the process means joint discovery and co-creation. And of course there is not just one expert, but most problems require multi-perspective approaches and the contribution of a group of experts. The multidisciplinary approach makes it possible to start from several theoretical paradigms, which promotes the conceptualization of problems from different angles. Similarly, the professional approach to change cannot and should not be focused solely on the child (and occasionally the parents) or on finding simple solutions (which the medical model offers). Help is always contextual and depends on many different factors and options that vary according to the needs of the individual child or young person.