When I became a licensed psychologist many years ago there was profound bias against media roles for professionals in our field. Reasons for this bias ranged from a belief that such roles were self-serving ("They're giving psychology away") to the view that readers needed to be protected from cursory remedies that might be more damaging than helpful. Radio shows and newspaper columns that responded to questions that required clinical assessment and therapeutic interventions were considered unethical. The upshot was that advice columns were left to nonprofessionals or those lacking adequate credentials. For the most part, qualified clinicians continue to remain righteously silent.
Phil McGraw is not, as the book's blurb boasts "one of the world's foremost experts in the field of human functioning." He is, however, a well-credentialed and effective media star who serves a very useful purpose. His television program, like his book, reaches millions of people who have parenting problems and who would not otherwise seek professional counsel. McGraw claims that this book is responsive to the needs for assistance and information that emerged in a survey of 17,000 parents.
McGraw's message is largely unassailable: Don't make the mistakes your parents did. Take control, set limits, understand that your family should have central importance in your life. Raise children with structure, respect, appropriate expectations, equitable treatment, consistency, and love. His book presents communication techniques, cognitive reframing, negotiation skills, step-by-step action plans, and actual language that parents can use. He teaches parents how to eliminate negative behaviors by using common behavior modification techniques. The book is largely a model of good sense, told in language that readers can understand with examples to which they can relate and viable solutions that they can implement themselves.
For ordinary families that have the usual range of childrearing problems, this book can be very valuable. However, there is one gross defect. As he did in a Family First-related television show, Dr. Phil tends to underplay the significance of early interventions for some obvious prodromal signs of decompensation. There is a table of "hot warning signs of crisis," categorized as behaviors that endanger self or others, depression, drug abuse, and the like. Many items in this table are predictors of severe psychiatric disorders. McGraw's warning signs include suicidal ideation, memory loss, nightmares, emotional numbing, and even a child's stockpiling of guns, poison, or sleeping pills. Yet his list of resources for parents mentions only spiritual leaders, teachers, other family members, the child's pediatrician, a school psychologist or counselor, and the local mental health association. Psychiatrists are identified primarily as helping the parents deal with the crisis rather than as providing early intervention for the child. There is a legitimate emphasis on coping strategies, but missing are the clinical resources essential for diagnosis and treatment. McGraw's suggestion that these behavioral disturbances are temporary crises that can be alleviated simply by a family's changing its behaviors or dealing with school counselors detracts from an otherwise helpful book.