THE CHILD AND
ADOLESCENT PSYCHIATRIST

Articles for Parents
All Family Resources
Alphabetical List
  1. Children and Divorce
  2. Teenagers with Eating Disorders
  3. Teens: Alcohol and Other Drugs
  4. The Depressed Child
  5. Child Abuse - The Hidden Bruises
  6. Children Who Can't Pay Attention
  7. Children Who Won't Go to School
  8. Children and Grief
  9. Child Sexual Abuse
  10. Teen Suicide
  11. The Child with Autism
  12. Children Who Steal
  13. Children and TV Violence
  14. Children and Family Moves
  15. The Adopted Child
  16. Children with Learning Disabilities
  17. Children of Alcoholics
  18. Bedwetting
  19. The Child with a Long-Term Illness
  20. Making Day Care a Good Experience
  21. Psychiatric Medication for Children and Adolescents Part I: How Medications Are Used
  22. Normality
  23. Mental Retardation
  24. Know When to Seek Help for Your Child
  25. Who can be contacted to seek Help for Your Child
  26. Know Your Health Insurance Benefits
  27. Stepfamily Problems
  28. Responding to Child Sexual Abuse
  29. Psychiatric Medication for Children and Adolescents Part II: Types of Medications
  30. Children and AIDS
  31. When Children Have Children
  32. 11 Questions to Ask Before Psychiatric Hospital Treatment of Children and Adolescents
  33. Conduct Disorders
  34. Children's Sleep Problems
  35. Tic Disorders
  36. Helping Children After a Disaster
  37. Children and Firearms
  38. Bipolar Disorder (Manic-Depressive Illness) in Teens
  39. Children of Parents with Mental Illness
  40. The Influence of Music and Music Videos
  41. Substance Abuse Treatment for Children and Adolescents: Questions to Ask
  42. The Continuum of Care
  43. Discipline
  44. Children and Lying
  45. Lead Exposure
  46. Home Alone Children
  47. The Anxious Child
  48. Problems with Soiling and Bowel Control
  49. Schizophrenia in Children
  50. Panic Disorder in Children and Adolescents
  51. Psychiatric Medications for Children and Adolescents Part III: Questions to Ask
  52. Comprehensive Psychiatric Evaluation
  53. What is Psychotherapy For Children and Adolescents?
  54. Children and Watching TV
  55. Understanding Violent Behavior in Children & Adolescents
  56. Parenting: Preparing for Adolescence
  57. Normal Adolescent Development - Middle School and Early High School Years
  58. Normal Adolescent Development - Late High School Years and Beyond
  59. Children Online
  60. Obsessive-Compulsive Disorder in Children and Adolescents
  61. Children and Sports
  62. Talking to Your Kids About Sex
  63. Gay And Lesbian Adolescents
  64. Foster Care
  65. Children's Threats: When are they serious? 
  66. Helping Teenagers with Stress
  67. Children and The News
  68. Tobacco and Kids
  69. Asperger's Disorder
  70. Posttraumatic Stress Disorder (PTSD)
  71. Multiracial Children
  72. Children with Oppositional Defiant Disorder
  73. Self-Injury in Adolescents
  74. Advocating for Your Child
  75. Pets and Children
  76. Helping Your Teen Become a Safe Driver
  77. Grandparents Raising Grandchildren
  78. When a Pet Dies
  79. Obesity in Children and Teens
  80. Bullying #80
THE CHILD AND
ADOLESCENT PSYCHIATRIST

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

--------------------------------------------------------------------------------

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

All Family Resources wishes to thank the (AACAP) for giving us permission to use this article.

The American Academy of Child and Adolescent Psychiatry (AACAP) represents over 6,900 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.

Facts for Families is developed and distributed by the American Academy of Child and Adolescent Psychiatry (AACAP). Facts sheets may be reproduced for personal or educational use without written permission, but cannot be included in material presented for sale. To order full sets of FFF, contact Public Information, 1.800.333.7636.  Free distribution of individual Facts sheets is a public service of the AACAP Special Friends of Children Fund. Please make a tax deductible contribution to the AACAP Special Friends of Children Fund and support this important public outreach. (AACAP, Special Friends of Children Fund, P.O. Box 96106, Washington, D.C. 20090).
   
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