> My experiences also suggest that a lot of this is fixable, without drugs or therapy, if you can help the family disengage from long-standing patterns of interaction and help the child in question understand where their dysfunctional behaviors came from in a non-blaming manner and give them some better answers and/or just breathing room to change on their own without interference.
Helping the family change how they interact with their children is therapy!
But it was often accomplished in one or a few emails, not months or years of intensive effort.
Someone would join the list and complain about the intractable, crazy making behavior of their impossible child. I would write a reply and say something like "That's a common issue with gifted kids. It's due to boredom and is easily solved by keeping them adequately occupied." They would go "Oh. My. God. That makes so much sense! Just before the last incident, he did actually say out loud 'I'm bored.'" and a long-standing, intractable pattern of problem behavior that had stubbornly resisted all prior intervention would largely disappear overnight once the parent made sure to keep their kid adequately occupied.
Or a parent of a particularly hard case would exchange a few emails with me for a week or two and then report back to me months later that all these terrible, intractable issues had magically changed and it had involved almost zero effort on the part of the parent who had spent years sinking enormous time, money and effort into resolving these problems, all to no avail until they spent a little time talking to me.
If it was therapy, it was like an *easy button" version of it, very unlike the roughly 3.5 years of intensive therapy I pursued in my youth to get my personal issues to simmer down to a dull roar before really resolving things around the age of forty when I got divorced and yadda.
Helping the family change how they interact with their children is therapy!