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Should you stay together for the kids?

Many bickering couples stay with each other just to keep the family intact. But are you helping or hurting your children? "Today" contributor Dr. Ruth Peters was invited to appear on the show to offer some insight. Here's her advice:Is divorce ever a good option for the children?Yes, it can be, but there are many sides to the issue. Some parenting specialists believe that children living in chaoti
/ Source: TODAY

Many bickering couples stay with each other just to keep the family intact. But are you helping or hurting your children? "Today" contributor Dr. Ruth Peters was invited to appear on the show to offer some insight. Here's her advice:

Is divorce ever a good option for the children?

Yes, it can be, but there are many sides to the issue. Some parenting specialists believe that children living in chaotic or unhappy marriages learn bad parenting techniques, and feel that these kids would benefit in the long run by their parents divorcing. However, one leading authority on the family (Judith Wallerstein, author of “The Unexpected Legacy of Divorce”) disagrees. She theorizes that keeping the family intact is of such import that, even if unhappy or lonely, parents who are able to remain civil (not exposing the kids to fights, coldness or extreme disagreements) provide a better option than divorce. But folks who can commit to living together respectfully when actually desiring to be apart are rare, as this often means putting their own happiness and perceived fulfillment “on hold” until the kids are older or have left the home.

Should parents put the happiness and the welfare of the children before their own?

I believe that your happiness as an adult should not interfere with the welfare of your children, whenever possible. You’re the adult, and they are just kids. The fireworks may have fizzled from your marriage and you may not even find your spouse interesting or attractive. But he or she is the father or mother of your children and you should invest considerable time, attention, soul-searching and honest introspection before making a decision to forever change the dynamics and stability of your marriage and your home. If you haven’t sought counseling (an honest, sincere attempt here, folks!) then do so immediately. Talk with your religious leader, a trusted friend or family member who has evidenced good judgment in their own private life, or a therapist. Sure, marital therapy is often unsuccessful, but just as frequently changes can be made that alter the marital dynamic and the relationship can be more successful and rewarding. In other words, try to fix the situation before bailing out.

Get a reality check!

What are your expectations of a 10-year marriage after two kids, financial difficulties and living in a society where more folks are on their second marriage than their first? Of course there will be stressors. Obviously you’ll have some regrets and wonder why you walked down the aisle in the first place. Life is not the Waltons or the Cleavers … but it’s also not the Hogans or the Simpsons! Reality is usually found somewhere in between, and trust me, your neighbors have issues also, they just have different ones. Consider what you believe to be missing in your marriage and honestly try to determine whether this is something that only a spouse can fill. You may find that adding interests, activities or good buddies to confide in may help to fill the void and allow you to be more positive and fulfilled on a day-to-day basis.

How does divorce negatively affect children?

Everyone usually loses in a divorce in some way. Finances are divided, both parents usually have to work in full-time positions, and children often must attend daycare before or after school hours. Stress increases due to single-parent pressures (not having another adult to help with transportation, cooking, playing with, handling homework, etc.), finances, worries about the future, visitation issues and legal battles. When families split up, often the kids move to a new neighborhood and have to develop new friends and deal with a new school. Promises are broken (planned vacations, cars not becoming available), and there are many difficult adjustments to make.

How does divorce positively affect children?

If the marriage is tumultuous, divorce can be a relief to the kids. If a parent is abusive (physically and/or emotionally), has a substance abuse problem or causes constant chaos within the home environment, children often benefit from the separation. Many children are embarrassed to bring friends into their distressed environment and begin to stay longer at others’ homes in order to avoid the turmoil. When warring parents divorce, they tend to be happier, or at least less miserable. The diminution of stress allows them to spend more quality time with their children, and the family can become a solid unit once again.

If you don’t like the way your spouse is parenting, do you expect greater control following a divorce?

Think, and then think again. There’s not much that you can do, when divorced, about controlling your children’s bedtimes, discipline, values learned and significant others met when your child is spending time with their other parent once a divorce has occurred. Many parents are less than amicable following the legal battle, and decrease communication with the former spouse or purposefully expose the children to people or ideas whom you may not appreciate. If the breakup was amicable, divorced parents can work well together in the best interest of their children and, although rare, these folks should be applauded.

Won’t the kids adjust and adapt quickly to the changes?

Some do, some don’t. Sensitive kids tend to hurt for longer periods of time, often feeling guilty that Mom or Dad is alone at times. Children who are more self-absorbed may not worry as much about the parents’ feelings, but may be resentful about the loss of financial stability and how that affects allowance, clothing and summer camp funds. Kids who have had to relocate tend to be anxious until good buddies are established and they are comfortable in their new schools. The lucky ones, whose parents are amicable, cooperative and focused upon the children’s needs, seem to adjust more readily to the new situation. When children realize that their folks no longer behave in an angry fashion with each other and can share sporting events and school functions without the threat of drama, they begin to relax and to cope better with the two-home situation.

If you decide to proceed with the divorce

Divorce is tough on everyone — Mom, Dad, as well as the kids. But, there are some steps that parents can take to make the situation less confusing for their children as well as for the family as a whole. Although lives are forever changed by divorce, it doesn’t have to be as chaotic or devastating if you try to think clearly, attempt to put the children’s needs at the forefront, and continue to clarify what is happening in your life as well as the kids’.

Breaking the news

After you’ve made the decision to separate or divorce and you want to tell the children, there are some things to take into consideration. It’s best not to tell them too far in advance (two months may seem like forever to a 4-year-old), so that they either agonize endlessly until it actually happens or begin to believe that you’ve changed your mind, when you haven’t. On the other hand, only giving a few days or weeks notice is often not enough time for the kids to adjust to the idea, and certainly not enough time to talk with both parents about their concerns and fears.

Although no one set of rules or guidelines meet the needs or particular circumstance of every family, common sense and knowledge of child development suggest the following recommendations. Keep in mind that not every family will be able to follow all of the suggestions due to specific issues and problems. Just use what makes sense to your situation and is reasonable for your individual family:

General recommendations for telling children about the impending separation or divorce:

1. If possible, both spouses should be together when telling the children of the impending separation or divorce. Let your children see that even though the two of you have differences, you will be working together to get everyone through this trying time. Don’t be afraid to show emotions — even if you’re crying the kids will understand how difficult this is on both of you. However, try to stay on point and to control your behavior so that the kids are not frightened. Giving the kids hugs and kisses, holding little ones on your lap or holding their hands is often tremendously comforting.

If the two of you cannot or will not be announcing the situation together to the children, at least be sure that you are on the same page of the book.  Decide ahead of time the main points that you will be making so that the kids are not confused by discrepancies in the explanation.

2. No matter what the age of the children, do not blame the other parent if possible. Sure, it may be difficult to be civil if you feel that you’ve been wronged, but it won’t help the kids to hear, especially initially, negative comments about the other person. Just digesting the news is tough enough, and having to listen to parents jabbing at each other in the same conversation is cruel.

3. Depending upon the age of the child, give only the necessary information about the reasons for the separation or divorce. Keep it simple, especially for the little ones, and remember to stay on track. You don’t need to present a laundry list of each other’s crimes — just the facts that you haven’t been getting along for some time, that you’ve tried to work things out (perhaps by attending counseling), and that you’re still unhappy in the situation and need to change it.

If the kids seem confused or ask for further information, provide an example or two, such as “Dad and I have been bickering a lot this past year or so … you may have noticed.  We’ve tried to work out our problems by talking with our counselor, but it’s just not getting better. We believe that it’s better for everyone if we live separately.” Most likely the kids have noticed and may not be totally surprised by your decision. They often see, hear and feel more than you bargained for.

4. If a child brings up a parental behavior that they feel is the problem, and if it is, agree that it is part of the problem, but that there are other contributing factors.  In this way you do not lie to the child, but you also don’t begin the accusation process, which may end up with the kids knowing too much about the parental relationship.

5. Be sure to let the kids know that the marriage was based in love, and that they were conceived in love. It’s important for kids to be told by their two most important role models that marriage should be a long-term, stable situation that focuses around the family and the children. Let them know that even though you’ve decided to split up, you’re both saddened by not being able to continue with the family unit as a whole. Reinforce that you’ve tried hard to work it out and that your belief and hope for your children will be an intact family unit for their own adult relationship.

6. It’s not unusual for children to either feel that they have contributed to the problems, or to feel that there is something that they can now do to solve them. It’s extremely important that you address this issue even if the children do not bring it up. Most kids either flirt with this idea or believe it to be true. Tell them in no uncertain terms that this is an adult problem, brought on solely by the adults, and one that can be dealt with by the adults. Confirm that there’s nothing they can do to get the two you back together in the same house, but that they can help both of you out during this time by letting you know their feelings and discussing any concerns that they have.

Also note that it will be helpful if they continue with their daily activities, such as studying and completing homework as well as chores. Let them know that it will make everyone feel better if they keep busy and play with their friends as usual.

7. Along with the confirmation that the separation or divorce is not the fault of the kids, reaffirm that both of you still love them, as always. Mom and Dad may not be in love with each other any more, but explain how that is a different type of love, how loving a child is a “forever thing” but that other types of love may not be so blessed. Don’t expect immediate understanding of that concept — it will take the children some time to realize that although many things will change due to the divorce, your love for them remains unaltered.

8. Finally, to the best of your ability, provide the kids with some information about the immediate future. Keep this short and direct, and as always worded to their age and developmental level. If you know that Dad will be moving out soon, provide an approximate time (“in a few weeks”, “before school starts”, or for older ones “by the end of the month”). 

Tell them what to expect, such as “Dad will be moving to an apartment just a few miles away.  He’ll be picking you up on school days to drive you to school, and I’ll get you from aftercare. You’ll spend time with Dad one or two evenings a week, and will spend the night with him every other weekend. As much as possible your father and I would like you to continue with your after school activities and time with your friends. We’re sure that there will be changes occurring — some that you’ll like and some that you won’t. We’ll work on the things that you want to change the best that we can. It’s important, though, that you tell both of us when something is bothering you so that we can, as much as possible, work together to help you out.”

Age-specific Recommendations:

Most kids relate to the news of the impending separation or divorce in terms of how it will affect them. Do not confuse this with insensitivity on their part, or selfishness. Children, especially the younger ones, are very dependent upon their parents for love, guidance, providing material necessities and structure to their days. If one of you moves out, how will this affect their daily lives? They don’t have the ability to provide for themselves and need reassurance that you will take care of them, just as well as when both parents were living together. Here are some tips as to the particular concerns by age:

1. Preschool: Due to the cognitive limitations of children 5 years old and younger, it’s best to keep the discussion as simple as possible. Describe how you and your spouse have not been getting along and that Mom/Dad will be moving out and living in her/his own house. Tell the preschooler how much both of you loves her and how she will be spending time with both parents, only separately. Describe some of the activities that are special to each of your relationships with her and how you will continue to cuddle, tickle, play games or read to her at bedtime.

Your goal is to inform her of the impending change, but not to dwell on it. Try to comfort her with mention of how many things will stay the same — that’s what she’ll need most, not a discussion of how things will be different. Use your judgment as to whether to inform the child’s preschool teachers — usually it’s a good idea so that they can be extra supportive during this time.

2. Early Grade School: Children in kindergarten, first, and second grades are capable of understanding some of the subtleties of relationships with their friends (“Joey’s mean, I don’t want to play with him anymore!”), but have difficulty understanding how the two most important adults in their lives can’t work things out. After all, they probably have been told many times that “this is an adult issue, I’ll handle it — you don’t need to worry.”  Well, this time the adults didn’t handle it in a way acceptable to the youngster — he’s losing the comfort of having both Mom and Dad living with him in the home. And, he’s probably mad or frightened.  Expect more questions from the early grade schooler than from the preschooler — as fears increase so should questions.

In fact, it’s good to encourage the child to communicate and question as much as possible — holding anger or sadness inside doesn’t lead to resolution and can result in relationship problems during the adult years. As with the little ones, try to focus on what will not change — Little League will continue and the math tutor will be there on Wednesdays. Also, be sure to use the correct language to describe what is happening — “We are going to become separated” or “Mom and I are getting a divorce.” Don’t be afraid to use the words “separation” or “divorce” — that’s reality and leaves no doubt as to what is occurring. Discuss with the child whether he would like his teacher or school guidance counselor to be told of the family situation — often it’s comforting to know that it’s okay to speak to these adults at school if he’s having an emotional day.

3. Late Grade School: Third, fourth and fifth graders are able to understand and to predict behavior much more so than can younger kids. Due to cognitive developments over the past few years they can put two and two together and often are aware of their parents’ problems, even before they are told. They understand the concepts of separation and divorce; in fact some of their friends may come from divorced families. If so, point out how these kids seem to have coped well and how life has gone on for them.

Expect a great deal of sadness with this age group. They are old enough to understand the ramifications of divorce — the loss of their family unit as they have always known it, the changing financial situation, the uncertainty as to the future relationship with the non-custodial parent, and the potential embarrassment they may fear when their friends find out. If you expect these issues to surface you’ll be better able to cope with their questions as well as statements and opinions. You may be informed, in no uncertain terms, that this divorce is the worst thing that they could imagine. Be prepared to listen, and then listen some more. Even if you disagree with the ideas, try to validate the feelings. Now, more than ever, your children need to be able to be open and honest with their feelings, especially the negative ones, and to see that you respect their point of view.

Also expect some worries about living in two houses, sharing holidays, and whether they’ll be able to continue at the current school if the custodial parent has to move.

4. Middle School: Tweens and early teens often react to the announcement of a separation or divorce with a sullen kind of sadness. When asked how your 13-year-old feels you may hear “I don’t know”, whereas your 10-year-old may tell you exactly what she’s thinking. Although the individual nature of each child will dictate their reaction, tweens are already beginning to struggle with peer group difficulties, fitting-in and security issues. A parent leaving the home has a destabilizing effect, especially in the first few years, and tweens can react strongly to fears of losing the stability on the home front at the same time that they may be experiencing insecurity with friends at school.

It’s important, therefore, when telling your tween about the impending separation or divorce that you let her know how difficult this may be for her, and to validate her concerns. She’ll need extra support and reassurance of the love from both of you, so confirm that time spent with both Mom and Dad will be plentiful, consistent, and something that she can count on. To help calm her social fears discuss how she might broach the subject with her friends and their families, and ask whether she would like you to discuss the family situation with the guidance counselor at school. She may bring up concerns about having to change schools, not having enough money to purchase the types of clothing that she likes, or having to miss out on summer camp. Be honest, but let her know that these issues will be dealt with as time passes. The financial details will be worked out and worked on over the next few months between the adults. Encourage her to focus on her feelings and to share them with you as you anticipate the changes that will occur.

5. High School: Teens are quite able to understand the ins and outs of relationships, and may have already anticipated the break up. It’s difficult to not notice Mom and Dad’s bickering or cold war, and no amount of hiding in the bedroom can keep the teen away from parental problems. Depending upon your own child’s individual personality, peer situation and relationship with each of you, the reaction to the announcement may range from “I knew that this would happen, what did you expect, Dad, when you treated Mom like that!” to silence (not wanting to provoke either parent) to “You’re ruining my life—how am I going to tell my friends?”  The kid is not necessarily being arrogant, selfish or insensitive. This is the age of increasing independence, opinions and exquisite sensitivity to what peers think and feel.

Adolescence is also a time for beginning to separate from parents, spending less time with them and more with friends.  If you have a close, confiding relationship with your teen she may express her concerns and fears for both herself as well as for you.  If your relationship has been tense or she’s just a bit on the secretive side, you may not know how she’s really feeling.  But you can bet that she’s sharing her ideas and concerns with her best buddy.  Hopefully that kid has a good head on her shoulders and will serve not only as a confidant but also as a support system for your child.  Expect, in the initial conversation, questions about visitation (not necessarily “When will I get to see you?” but “I don’t have time on the weekends to stay over your house—when will I see my friends?”). 

Assure the teen that whatever schedule is worked out will be a family decision, one that is not only reasonable but that also takes her desires into consideration.  Comfort concerns about financial changes, school moves, driving privileges and other teen activities with “We’ll work things out as best we can…let the dust settle and we’ll see where we’re at”.  As time goes by you’ll be able to tackle problems one by one—you don’t need to have a game plan for everything when you initially discuss the impending separation or divorce with your teen.

Following these guidelines is not a guarantee that the children will be accepting or comfortable with your announcement. But, it does help to set the stage for them to see that although their parents may be splitting up, that you will be co-parenting and working together in their best interest.

Calming the Fears

In talking with many of my divorced clients about their problems and concerns with their children, I often recommend a checklist provided by Isolina Ricci in “Mom’s House, Dad’s House” (Macmillan Publishing Company, l982) aimed at calming their kids’ fears. Check out these fifteen suggestions — following them may make the difference between your children becoming miserable, afraid, and out of control or understanding, accepting and realistic about their home lives and futures:

1. Reassure your children that you love them and will always take care of them and look after their needs, no matter what happens between you and their other parent. You will always be their parent and do what you feel is best for them.

2. Explain that the separation and, later, the divorce are grown-up business between Mom and Dad.  Do not ever imply or state that your children had any responsibility for your fights or for the ending of your marriage, even if in your off-the-wall moments you may feel they did.

3. Tell your children they will now have two homes instead of one and begin to use words like “live with Mom or Dad” instead of “visit.” Tell them how your two homes will work and back it up with action.

4. Reassure your children that although there will be changes in your family life and that it will take time for all of you to get used to these new ways, after a time, things should turn out well. Explain to them that you may all have times when you feel confused, perhaps sad or angry, but that all of you will have happy times too.

5. Show by your actions that you and the other parent can cope, that you are the grown-ups and are in control of what is happening to your family. Regular routine and house and safety rules are important ways to restore order.

6. Listen to your children’s opinions and whenever possible give them options. When children are consulted on family matters they seem happier, and act more confident. You are responsible for the final decisions, but your children should be heard. 

7. Be honest with your children; demystify the process with concrete information about the change that is simple, brief, and appropriate to their age.

8. Never threaten your children with abandonment, even in hopes that it will make them obey you. It is dirty fighting on your part, unnecessarily frightening and can lead them to disrespect you and your tactic.

9. Don’t lead children to believe that you and the other parent will reconcile unless this is a strong possibility. Fostering false dreams of reuniting their parents is not a help to their readjustment to this new life.

10. Find comfortable ways to show affection for your children. Hold them on your lap, or hold their hands, touch them, give them spontaneous happy hugs, have loving eye contact. Words are not enough; follow or accompany them with affection. This human warmth and comfort is a vital physical communication that brings its own special kind of reassurance for both of you.

11. Reconfirm your assurances frequently during the first year and even into the second year after separation. Such reassurances are part of their feelings of security — especially actions and affection that say you are glad to be their parent, that you love them, and that they will be taken care of.

12. Check yourself occasionally to see how heavily you may be leaning on your children for their support. While you have a right to your children’s respect and love, they are not adults and do not have the same emotional resources or experiences that you do. Repeatedly ask yourself, “Who is reassuring whom?”

13. Don’t outlaw crying or honest display of emotions for your children or yourself. Crying is natural and offers release when it is spontaneous and follows appropriately on hurts, frights, or spats.

14. Enjoy your children, have some family fun times.  In the midst of all the do’s and don’ts and new pressures, take time just to relax together or play together. Laughter is a great healer and it nearly always gives a new perspective. The years together will go by quickly enough and these fun times will be part of your treasure.

15. Trust yourself and your instincts. Trust in your children, have confidence in their ability to change and learn. You are the best judge of what is best for you and for your children. If you have restored order in your household, have done your two-home groundwork, and established safety rules and house rules, you have already gone a long way in demonstrating your love for your children and in caring for their needs.

Following the Divorce

Dealing with the other parent following divorce is always a challenge — not only for you but for the kids as well. One of the most important pieces of advice that I give my own clients is to try to keep the children out of the middle. This may entail your checking with your ex-spouse directly for information that the kids could provide, but it keeps the grown-up matters to the adults, away from the kids. Try not to gather information about your ex’s life or circumstances from your children — that’s snooping and it really puts the kids in a bad position.

If your children are reticent about visiting your ex, have them discuss it directly with that person — try to stay out of the middle or you may unwittingly become manipulated into a battle that is not yours. And finally, NEVER badmouth your kids’ other parent — it not only makes you look disrespectful, but remember — your children are “half” you and “ half’ the other parent — when you put the other guy down you’re also lambasting the children. If you must discuss negatives with the children (due to safety issues, for instance), do so in a brief yet factual manner.

Another problem that occurs, especially with older children, is the kid who doesn’t have the interest or the inclination to visit the non-custodial parent. This should be dealt with between the child and that parent, if possible. Your ex has the responsibility and the authority to deal with visitation issues on those days and it may save you some grief if you let the child and that parent work it out. If they can’t, it’s appropriate for the two of them to discuss the issue with a trusted family friend, pastor or a counselor.

Following these guidelines is not a guarantee that life with the kids after divorce will be a cake walk — it’s definitely more difficult when one parent takes the responsibility for getting the kids off to school in one piece, not to mention to ballet and baseball on time. However, divorced parents often do a great job of parenting, especially if they have set up fair rules, are consistent, and trust their parenting instincts!

Resources for divorced parents:

When searching for community resources, the best starting place is often your family pediatrician. Your child’s doctor knows the best that the community offers in terms of counselors, programs, and parent and child divorce support groups. Also, check with your local community mental health center or mental health association. These facilities and agencies offer individual and group therapy as well as divorce adjustment classes for children and adults. Consider a weekend course at your local community college — most have parenting classes available to folks who are considering separation or divorce, and offer a great deal of helpful insight and resources.  Don’t forget your child’s school guidance counselor — often support and adjustment groups are available for the kids. Churches are excellent resources for adult support services, and they may offer groups for the kids too. Pastors, psychologists, mental health workers and social workers are well trained to provide therapy for parents and children entering into the divorce process. Word of mouth is a great starting place, but also check with your physician for names of qualified individuals.

Web Sites Offering Resources Regarding Divorce:

www.divorcesource.com

The general categories offered are: finding divorce professionals, divorce laws by state, national resources (forums and chat rooms), affairs and divorce, cases of interest by state, children and divorce (custody arrangements, forums, message centers), child support, deadbeat parents, divorce dollars and debt, divorce recovery, estate planning and divorce, friendly divorce, grandparent issues, insurance and divorce, lawyer-client relationships, military and divorce, parental alienation, paternity issues, pensions and divorce, surviving divorce, and taxes and divorce.

www.momsonline.com

Part of the Oxygen network, this site is user-friendly and offers down-to-earth advice, suggestions, and resources. Great for those who have specific questions and want advice from parents who have already experienced a separation or divorce.

Books to Check Out:

For Adults:

Isolina Ricci, "Mom’s House, Dad’s House: A Complete Guide for Parents Who Are Separated, Divorced, or Remarried." (Fireside, 1997).

Carla B. Garrity and Mitchell A. Baris. "Caught in the Middle." (Jossey-Bass, 1994).

Neil Kalter.  "Growing Up With Divorce."  (The Free Press, 1990).

Jennifer M. Lewis and William A.H. Sammons.  "Don’t Divorce Your Children."  (Contemporary Books, 1999).

Marc J. Ackerman. "Does Wednesday Mean Mom’s House or Dad’s?"  (John Wiley & Sons, 1997).

Judith S. Wallerstein, Julia M. Lewis, and Sandra Blakeslee. "The Unexpected Legacy of Divorce: A 25 Year Landmark Study." (Hyperion, 2000).

For Pre-School and Grade-School Children:

Linda Walvoord Girard. "At Daddy’s on Saturdays." (Albert Whitman & Company, 1987).

Eric J. Adams & Kathleen Adams. "On the Day His Daddy Left." (Albert Whitman & Company, 2000).

Cornelia Maude Spelman. "Mama and Daddy Bear’s Divorce." (Albert Whitman & Company, 1998).

Nancy Lou Reynolds. "Mom and Dad Don’t Live Together Anymore." (Firefly Books, 1988).

Vicky Lansky. "It’s Not Your Fault, Koko Bear." (Book Peddlers, 1998).

Lois V. Nightingale. "My Parents Still Love Me Even Though They are Getting a Divorce."  Nightingale Press, 1997).

Books for Preteens and Teens:

Angela Elwell Hunt. "Keeping Your Life Together When Your Parents Pull Apart: A Teen’s Guide to Surviving Divorce." (iuniverse.com, April 2000).

Ruth Pennebaker. "Conditions of Love." (Henry Holt and Company, 1999).

Josh McDowell. "My Friend Is Struggling with Divorce of Parents." (Ward Books, July 2000).



Dr. Ruth Peters is a clinical psychologist and regular contributor to “Today.” For more information you can visit her Web site at www.ruthpeters.com. Copyright ©2006 by Ruth A. Peters, Ph.D. All rights reserved.

PLEASE NOTE: The information in this column should not be construed as providing specific psychological or medical advice, but rather to offer readers information to better understand the lives and health of themselves and their children. It is not intended to provide an alternative to professional treatment or to replace the services of a physician, psychiatrist or psychotherapist.