Key relationships, especially intimate adult partner relationships and parent/caregiver-child relationships, have a significant impact on the mental health of the individuals in the relationships. These relationships can be health-promoting and protective, neutral, or detrimental to mental health outcomes. Relationship problems that cannot be resolved by friends, family, or clergy require professional intervention by psychiatrists, clinical psychologists, social workers, and other mental health professionals.

What are relational problems that involve children? 

Some of the main diagnostic categories for relationship problems involving children include:

• Parent-Child Relational Problem
  Typically, the parent-child relationship problem is associated with impaired functioning in behavioral, cognitive, or other affected areas. Examples of behavioral problems include inadequate parental control, supervision, and involvement with the child; parental overprotection; excessive parental pressure; arguments that escalate to threats of physical violence; and avoidance without resolution of problems. Cognitive problems may include negative attitudes toward the other’s intentions, hostility toward or scapegoating of the other, and unwarranted feelings of estrangement. The problem may result in feelings of sadness, apathy, or anger about the other individual in the relationship.
  
  
• Sibling Relational Problem
  This diagnosis is used when a pattern of interaction between siblings is associated with significant impairment in individual or family functioning. The relationship problem may also affect the course, prognosis, or treatment of a sibling’s mental or other medical disorder. Siblings in this context include full, half-, step-, foster, and adopted siblings.
  
  
• Upbringing Away from Parents
  This diagnosis is used when a child struggles with issues caused by being raised away from parents. The separate upbringing may also affect the course, prognosis, or treatment of a mental or other medical disorder. The child could be under state custody and placed in kin care or foster care. The child could also be living in a nonparental relative’s home or with friends. Problems related to a child living in a group home or orphanage are also included in this category.
  
  
• Child Affected by Parental Relationship Distress
  This category is used when parental relationship conflict or distress negatively affects a child in the family. The discord may also negatively affect the child’s mental health or other medical disorders.

What relational problems involve couples or families?

Relationship Distress with Spouse or Intimate Partner
This diagnosis is used when there is distress within an intimate (spouse or partner) relationship or when the quality of that relationship is affecting the course, prognosis, or treatment of a mental or other medical disorder. Partners can be of the same or different genders. Typically, relationship distress is associated with impaired functioning in behavioral, cognitive, or other areas of life. Examples of behavioral problems include conflict resolution difficulty, withdrawal, and overinvolvement. Cognitive problems can include chronic negative attitudes toward the other’s intentions or dismissals of the partner’s positive behaviors. Problems may result in chronic sadness, apathy, and/or anger about the other partner.

Disruption of Family by Separation or Divorce
This diagnosis is used when partners in an intimate adult couple are living apart due to relationship problems or are in the process of a divorce.

High Expressed Emotion Level Within Family
This diagnosis refers to hostility, emotional overinvolvement, and criticism directed toward a family member. This category is used when a family’s high level of expressed emotion is the focus of clinical attention or is affecting the course, prognosis, or treatment of a family member’s mental health or other medical disorder.