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Questions
and Answers.
The child and adolescent psychiatrist is a physician who specializes
in the diagnosis and, if indicated, the treatment of disorders
of thinking, feeling and/or behavior affecting children, adolescents,
and their families. A child and adolescent psychiatrist offers
families the advantages of a medical education, the medical
traditions of professional ethics, and medical responsibility
for providing comprehensive care.
Practice
The child
and adolescent psychiatrist uses a knowledge of biological,
psychological, and social factors in working with patients.
Initially, a comprehensive diagnostic examination is performed
to evaluate the current problem with attention to its physical,
genetic, developmental, emotional, cognitive, educational,
family, peer, and social components. The child and adolescent
psychiatrist arrives at a diagnosis and diagnostic formulation
which is shared with the patient and family. The child and
adolescent psychiatrist then designs a treatment plan which
considers all the components and discusses these recommendations
with the child or adolescent and the responsible adults. An
integrated approach may involve individual, group or family
psychotherapy; medication; or consultation with other physicians
or professionals from schools, juvenile courts, social agencies
or other community organizations. In addition, the child psychiatrist
is prepared and expected to act as an advocate for the best
interests of children and adolescents. Many child and adolescent
psychiatrists perform consultations in a variety of settings
(schools, juvenile courts, social agencies).
Training
Child
and adolescent psychiatric training requires 4 years of medical
school, at least 3 years of approved residency training in
medicine, neurology, and general psychiatry with adults, and
2 years of training in psychiatric work with children, adolescents,
and their families in an accredited residency in child and
adolescent psychiatry.
In the
general psychiatry training years, the physician achieves
competence in the fundamentals of the theory and practice
of psychiatry. In the child and adolescent psychiatry training,
the trainee acquires a thorough knowledge of normal child
and family development, psychopathology, and treatment. Special
importance is given to disorders that appear in childhood,
such as pervasive developmental disorder, attention-deficit
hyperactivity disorder (ADHD), learning disabilities, mental
retardation, mood disorders, depressive and anxiety disorders,
drug dependency and delinquency (conduct disorder). The child
psychiatric trainee applies and develops psychiatric skills
by treating youngsters and their families.
The evaluation
and treatment of inpatients and outpatients is important throughout
the training, with a concentration on delivery of appropriate
treatment within the family's financial and psychological
means. An experience in consultation to other physicians,
mental health professionals, schools, and community agencies
is an important part of training.
Certification
and Continuing Education
Having
completed the child and adolescent psychiatry residency and
successfully passing the certification examination in general
psychiatry given by the American Board of Psychiatry and Neurology
(ABPN), the child and adolescent psychiatrist is eligible
to take the additional certification examination in the subspecialty
of child and adolescent psychiatry. Although the ABPN examinations
are not required for practice, they are a further assurance
that the child and adolescent psychiatrist with these certifications
can be expected to diagnose and treat all psychiatric conditions
in patients of any age and to contribute in many ways to serve
the welfare and interests of children and their families.
The child
and adolescent psychiatrist, as any other physician, continues
to study and learn about the new advances in the specialty
by reading scientific literature and attending conferences
to be able to apply new knowledge effectively in daily diagnostic,
therapeutic, and consultive work.
Finding
a Child and Adolescent Psychiatrist
Child
and adolescent psychiatrists can be found through local medical
and psychiatric societies, local mental health associations,
local hospitals or medical centers, departments of psychiatry
in medical schools, and national organizations like the American
Academy of Child and Adolescent Psychiatry and the American
Psychiatric Association. In addition, pediatricians, family
physicians, school counselors, and Employee Assistance Programs
(EAP) can be helpful in identifying child and adolescent psychiatrists.
QUESTIONS
AND ANSWERS
About Child and Adolescent Psychiatry
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Not all
children grow from infancy through their adolescent years
without experiencing some bumps along the way. While every
child is unique and special, sometimes they encounter problems
with feelings or behaviors that cause disruption in their
lives and the lives of those around them. Child and Adolescent
Psychiatrists are physicians specifically trained to treat
children and adolescents with these problems.
1. Why do parents and families bring their child or teenager
to a child and adolescent psychiatrist?
Parents
and families often worry when their child or teenager seems
to have a problem which causes them to be sad, disruptive,
rebellious, inattentive, unable to cope with things, or to
get involved with drugs and alcohol. They may be concerned
about their child or adolescent’s development, eating
and /or sleeping patterns, and how they are getting along
with family, friends, and at school. Many families first discuss
their concerns with a family physician, school counselor,
or clergy. Following this, the family may be referred to or
seek out a Child and Adolescent Psychiatrist. The Child and
Adolescent Psychiatrist is uniquely qualified to understand
the full range of factors associated with emotional difficulties
and mental disorders that can affect children and adolescents.
2. Are parents and families responsible for their child's
problem?
Parents
and families often have this worry. Some families even delay
seeking help for their child for fear that they will be blamed.
Feeling responsible for the child's problems or distress is
a normal sign of caring and attachment. There can be multiple
causes for many of the problems that children and adolescents
experience. Sometimes the cause of a problem is not known,
but all disorders are treatable. A Child and Adolescent Psychiatrist
will help parents and families understand that they should
not blame themselves for their child or adolescent's problem
and resolve the feelings of "Why me? Why my child?."
3. What about stigma?
Parents
and families are sometimes concerned about their child being
labeled with a psychiatric disorder. Just as children and
adolescents may become physically ill, they may experience
emotional and behavioral problems. Many problems can be completely
overcome and symptoms can almost always be improved with treatment.
Once a child starts to improve, many parents feel good telling
their friends and relatives: "Yes, my child did have
a significant problem, but we got the help we needed."
4. What kind of evaluation is offered?
As a physician,
the Child and Adolescent Psychiatrist begins by carefully
listening to your concerns about your child and the family.
The Child and Adolescent Psychiatrist also reviews the full
medical history with parents, and frequently will ask to obtain
additional information from other members of the family, the
school, child or adolescent’s personal physician, and
other significant adults in the life of the child or adolescent.
The Child
and Adolescent Psychiatrist talks with parents and families
about how to anticipate and answer their child or adolescent's
questions about the psychiatric examination. The meeting with
the child or adolescent may involve talking, drawing, or playing
with toys to help your child or adolescent's doctor better
understand what is going on. Questions may be asked about
the child or adolescent's view of the problem, as well as
how the child is getting along with family, friends, teachers,
and students in school. An assessment is made of the child
or adolescent's strengths as well as their problems.
5. What if a physical problem is causing the symptoms?
As a physician,
the Child and Adolescent Psychiatrist is trained to recognize
physical disorders that may be affecting how people think,
feel, and behave. In addition, the Child and Adolescent Psychiatrist
considers how emotions, feeling, thinking, and behaving may
influence your child or adolescent’s physical health.
As a physician, the Child and Adolescent Psychiatrist is qualified
to take medical responsibility for the plan of psychiatric
treatment and will consult with your child or adolescent’s
family physician to develop a comprehensive treatment plan.
6. What kind of treatment is offered?
The individual
plan of psychiatric treatment will take into account your
child or adolescent's problems as well as the strengths that
are identified in your child's personality, your family, the
school and other community resources. Child and Adolescent
Psychiatrists use a variety of treatment techniques; e.g.,
psychotherapies, behavior therapies, medications, interventions
with the school and family, etc.
The Child
and Adolescent Psychiatrist will discuss your child or adolescent’s
treatment plan with you and your child. This discussion includes
the advantages and disadvantages of various treatment approaches
as well as availability of programs and services in your community.
7. How long does psychiatric treatment usually take?
Some children
and adolescents will respond to short-term treatment (for
example, up to 12 sessions). When the disorder(s) has persisted
for a long time or is complicated, a longer term of treatment
may be needed. A few disorders which are chronic, may require
continuing care. You should discuss the duration and goals
of treatment with your Child and Adolescent Psychiatrist after
the initial diagnostic evaluation.
8. How much does psychiatric treatment cost?
The fees
of the Child and Adolescent Psychiatrist are based on both
the complexity of the treatment and the amount of time involved.
Fees vary in different parts of the country. Psychiatric treatment
sessions may be scheduled on a regular basis and length of
sessions can vary depending on the treatment plan. Issues
regarding finances and payment plans should be discussed openly
and frankly with the Child and Adolescent Psychiatrist from
the beginning of treatment.
9. Will my health insurance plan cover the cost?
You must
read your contract or call your insurance plan office to find
out the details about health insurance benefits and the extent
of psychiatric services covered by your plan. Most health
plans cover some portion of evaluations, consultation and
treatment services provided by a Child and Adolescent Psychiatrist.
However, benefits and coverage for mental health treatments
are frequently limited or restricted by insurance plans. If
your health insurance plan does not cover these services and
if finances appear to be a barrier in seeking necessary psychiatric
services, you should discuss this matter frankly with the
Child and Adolescent Psychiatrist.
10. Will information and treatment be confidential?
Most state
laws protect the confidentiality of communication between
patients and physicians. Child and Adolescent Psychiatrists
will not discuss information about you and your child or adolescent
with others without your consent except as required by law.
11. Who is a Child and Adolescent Psychiatrist?
Child
and Adolescent Psychiatrists are physicians who specialize
in evaluating, diagnosing, and treating children and adolescents
with psychiatric disorders which cause problems with feeling,
thinking, and behavior.
They are
specially trained and qualified to treat infants, children,
adolescents, and adults as individuals, couples, families,
and groups. They practice in a variety of settings, including
independently in offices, on the staffs of hospitals, clinics,
HMO's, etc.
12. What training does a Child and Adolescent Psychiatrist
have?
A Child
and Adolescent Psychiatrist has 9 to 10 years of special training.
Child psychiatric training includes: 4 years of medical school
after which the Doctor of Medicine (M.D.) degree is awarded;
1 year of supervised general medical practice in an approved
residency program in a hospital, 2 or 3 years of supervised
training in general psychiatry in an approved residency, and
then 2 additional years of supervised training working with
children, adolescents, and their families in an approved Child
and Adolescent Psychiatry residency.
The Child
and Adolescent Psychiatrist is a physician licensed to practice
medicine. After completing the above training, the Child and
Adolescent Psychiatrist is eligible to take an examination
to become Board certified in General Psychiatry by the American
Board of Psychiatry and Neurology. After successfully completing
this examination, the Child and Adolescent Psychiatrist becomes
eligible for an additional examination to become Board certified
in Child and Adolescent Psychiatry.
13. How can I find a Child and Adolescent Psychiatrist?
Ask your
pediatrician family physician, school counselor, or clergy
for a referral to a child and adolescent psychiatrist; Or
look in the Yellow Pages listing of PHYSICIANS and SURGEONS
under PSYCHIATRY (CHILD). You may also contact a community
hospital, state or county medical society, the Division of
Child and Adolescent Psychiatry in any medical school or university.
Article #00 Updated 5/98
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