In court last week, during the murder trial of Rebecca Riley’s mom, Carolyn Riley, the prosecution presented evidence that questioned mom’s truthfulness. They questioned whether Carolyn lied when she told investigators how much medicine she had given to Rebecca the day before Rebecca died. To support their case that the mom doesn’t tell the truth, they introduced evidence that Rebecca’s parents tried to get the school counselor to help them get reimbursed for allegedly lost gift cards, which in fact the parents had already used.

The issue of parent’s truthfulness – what’s true and what isn’t – comes up often in the practice of child psychiatry. On a day-to-day basis, we rely on parent reports to help us make diagnoses and evaluate the outcome of treatment interventions. As child psychiatrists, we must rely solely only our own judgment – rather than extensive police investigations – to determine how much weight to give to the information we receive from parents or from any informant about a child.

My default position, and my typical experience, is that parents are reliable and accurate informants; although, like all humans, they may perceive situations and events differently. This is why getting information from multiple sources is important. The fuller a picture I can obtain, the better I can help the child and family.

In some situations, I hear very different versions of events from various people in the loop. One such situation is when the parents disagree about the child’s need for help – one parent may see no difficulties, while the other parent sees alarming symptoms. This is usually due to genuine differences in perspective (or in when and how symptoms present), but sometimes one or the other parent may be exaggerating or minimizing in serious ways that could impede treatment of the child. In such situations I try to keep a watchful eye on all information and obtain even more outside information –such as from school – to help in my assessments.

Parents who are involved in separation or divorce proceedings often highlight the differences between their perspectives as part of the bigger conflict – and sometimes as a way to obtain some legal outcome that they are pursuing.

When versions of events vary dramatically between home and school, this requires careful consideration. Children can present differently in school and at home – but this can also be a red flag for inaccurate or inconsistent reports from parents – or alternatively from the schools.

As a professional, I anticipate working as a team with a child’s family and presume that we are working on information that is accurate. However, I cannot rely only on one source of information – and in some cases I will need to get collateral information from many places to piece together a story that truly reflects the child.

The Riley case underscores the need for professionals to obtain as full a picture as possible to reduce the risk of operating on false or misleading information – from any source.

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From Psych Central's website:
PsychCentral (February 2, 2010)

Tweets that mention Parental Truthfulness in Childhood Bipolar Diagnosis | Bipolar Beat | Candida Fink, M. D. | Bipolar Beat -- Topsy.com (February 7, 2010)

    Last reviewed: 2 Feb 2010