With the high incidence of divorce and changing patterns of families in the United States, there are increasing numbers of stepfamilies. New stepfamilies face many challenges. As with any achievement, developing good stepfamily relationships requires a lot of effort. Stepfamily members have each experienced losses and face complicated adjustments to the new family situation.

When a stepfamily is formed, the members have no shared family histories or shared ways of doing things, and they may have very different beliefs. In addition, a child may feel torn between the parent they live with most (more) of the time and their other parent who they visit (e.g. lives somewhere else). Also, newly married couples may not have had much time together to adjust to their new relationship.

The members of the new blended family need to build strong bonds among themselves through:

• acknowledging and mourning their losses
• developing new skills in making decisions as a family
• fostering and strengthening new relationships between: parents, stepparent and stepchild, and stepsiblings
• supporting one another; and
• maintaining and nurturing original parent-child relationships

While facing these issues may be difficult, most stepfamilies do work out their problems. Stepfamilies often use grandparents (or other family), clergy, support groups, and other community-based programs to help with the adjustments.

Parents should consider a psychiatric evaluation for their child when they exhibit strong feelings of being:

• alone dealing with the losses
• torn between two parents or two households
• excluded
• isolated by feelings of guilt and anger
• unsure about what is right
• very uncomfortable with any member of the original family or stepfamily

In addition, if parents observe that the following signs are lasting or persistent, then they should consider a psychiatric evaluation for the child/family:

• child vents/directs anger upon a particular family member or openly resents a stepparent or parent
• one of the parents suffers from great stress and is unable to help with the child's increased need
• a stepparent or parent openly favors one of the children
• discipline of a child is only left to the parent rather than involving both the stepparent and parent; or
• members of the family derive no enjoyment from usual pleasurable activities (i.e. learning, going to school, working, playing or being with friends and family)

Child and adolescent psychiatrists are trained and skilled at providing comprehensive psychiatric evaluations of both the child and family.

Most stepfamilies, when given the necessary time to work on developing their own traditions and to form new relationships, can provide emotionally rich and lasting relationships for the adults, and help the children develop the self-esteem and strength to enjoy the challenges of life.

Additional/related Facts for Families, #24 "Know When to Seek Help for Your Child," #1 Children and Divorce," #52 "Comprehensive Psychiatric Evaluation," #8 "Children and Grief," and #66 "Teens with Stress." Your Child (1998 Harper Collins)/Your Adolescent (1999 Harper Collins)

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The American Academy of Child and Adolescent Psychiatry (AACAP) represents over 7,000 child and adolescent psychiatrists who are physicians with at least five years of additional training beyond medical school in general (adult) and child and adolescent psychiatry.

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