Child & Adolescent Psychiatry

A child psychiatrist is different from a psychologist or therapist because they have undergone extensive medical training and are licensed medical doctors or psychiatric nurse practitioners that can prescribe medications. These professionals have not only completed medical or extensive nursing school but also a residency in general psychiatry followed by a fellowship in child psychiatry. Since they are doctors and psychiatric nurse practitioners, they understand the biological aspects of mental illness, including brain function, genetics, etc. A child and adolescent psychiatric can diagnose mental health disorders, provide therapy, and prescribe medication.

A child psychologist has undergone training and typically hold a doctorate degree (PhD or PsyD) in psychology. They are not medical doctors and therefore are not allowed to prescribe medications. The focus is on testing, diagnoses, and providing therapy including CBT, DBT, and play therapy. The main focus in on assessment and therapy but these professionals often collaborate closely with a psychiatrist if medications are needed as part of treatment.

A therapist typically holds a master’s degree and is licensed to provide treatment in specific areas such as the case with a Licensed Marriage and Family Therapist (LMFT). These professionals are not medical doctors and cannot prescribe medication. Rather, they offer counseling and therapy to help clients address emotional, behavioral and relational issues.

A parent might consider taking a child to a psychiatrist when emotional, behavioral, or developmental challenges are affecting daily life, relationships, or school performance—and when those challenges don’t seem to improve with time or basic support. It can also be important if your child’s struggles are causing significant distress for them or your family. Some situations where a child and adolescent psychiatrist can help include when  your child:

• Shows persistent sadness, anxiety, or excessive worry
• Has sudden behavior changes that are out of character
• Has trouble focusing, following instructions, or managing impulses
• Experiences severe mood swings or intense irritability
• Shows signs of trauma such as nightmares, withdrawal, or regression
• Talks about self-harm or expresses hopelessness
• Has difficulty making or keeping friends
• Exhibits obsessive behaviors or unusual fears
• Ongoing behavioral conflicts at home or school
• Physical complaints (stomachaches, headaches) with no clear medical cause

Trusting your instincts as a parent is important—if something feels “off” or your child seems to be suffering, early evaluation can provide clarity and support. A child and adolescent psychiatric provider can assess whether treatment is needed, help create a care plan, and coordinate therapy, school support, and (if appropriate) medication.

These professionals are trained to treat a variety of conditions including anxiety disorders, mood disorders (depression, bipolar disorder), attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), trauma and stress related disorders (PTSD), easting and obsessive-compulsive disorders. In addition to diagnosis and ongoing management, child psychiatrists also monitor physical, social, and family factors that may contribute to symptoms.

Child and Adolescent psychiatric providers all have the same training and education that adult psychiatrists possess; however, they have extensive experience and knowledge in assessing and diagnosing children and adolescents. All psychiatrists are interested in the presenting concerns and symptoms that may be occurring. They will ask questions about onset, frequency, duration, and any themes or patterns that may have been noticed. They will be inquiring about medical history, family history, and medication history. They will also explore social stressors or events. They will ask about school, work, family relationships and dynamics, and social friendships. They will inquire about any substance use or abuse and explore a wide variety of mental health issues from depression, anxiety, ADHD, OCD, trauma, eating disorders and much more. Of great importance is also obtaining some background on development. Child and adolescent psychiatrists have to factor in developmental milestone being attained, and the age of the client and how they are developing socially, emotionally, physically, and mentally. These are key considerations in assessment and diagnosis.

Your child and adolescent psychiatrist is very interested in parent’s input when making assessments and diagnoses. Many children and even adolescents are not always the most self-aware and often struggle to articulate their experiences objectively to others. Despite parents’ great love and concern for the child, they do bring great observation of the issues and concerns as they interact routinely and are capable of shedding light on behaviors they see with their child. Similarly, teachers and other care providers may be solicited to provide additional observational information to help create a clear picture of what may be going on with the child or adolescent. Your child and adolescent psychiatrist will likely want to speak alone with your child for some portion of the meeting, with the parents alone for a portion, and will likely wrap up with everyone when discussing diagnosis and treatment options to ensure that everyone hears the same information and everyone is on the same page.

Believe it or not there are some rather basic and simple factors that can help in narrowing the selection process of finding a child and adolescent psychiatrist. Most people will want to utilize their health insurance plan to cover some portion of the expense for seeing a child and adolescent psychiatric provider. Accordingly, one of the first things to determine is whether a given provider is in your insurance network. This may eliminate some providers and narrow the search right away. In fact, you can actually contact your insurance plan and talk with a representative who can provide you with a list of child and adolescent psychiatrists, that are in your network, within a specified geographic area. Most people prefer convenience, so selecting providers in a 10–20-mile radius will also help narrow the selection pool. Given the scarcity of child and adolescent psychiatric providers in most communities, you may be surprised that these couple of narrowing processes may already have reduced your list to just a handful of providers. Thereafter, you might start making some inquiries into the child and adolescent psychiatrist’s office to see if they are accepting new patients and what days or times, they might have available. This too can further narrow the potential list.

Child and adolescent psychiatric providers are already specialists who have extensive training and expertise in mental health issues, diagnosis, and treatments. Nonetheless, even these specialists often have specialties. For instance, if you are concerned and believe your child may have a specific mental health condition such as obsessive-compulsive disorder, ADHD, panic disorder, emerging bipolar disorder, or autism to name just a few; you might start looking at bios online for various providers who may be particularly skilled and well-studied on such conditions and treatments. Most clinics have website bios you can reference to garner knowledge about some of their training and experience. Hopefully by now you have narrowed your search to just a few providers. The next step will be getting an initial diagnostic consultation. Keep in mind, you can determine you and your child’s comfort level with the provider and their assessment and recommendations, based on how the session goes. You could certainly get a second opinion as well if you have any reservations or doubts. You want the best for your children so be sure you are being thoughtful and methodical about getting to the right provider to help them.

A child and adolescent psychiatrist is trained in the medical model which evaluates medical causes, genetic contributions, and biochemical imbalances that may be driving the diagnosis. That said, they have a profound appreciation for developmental aspects that may be contributing to mental health issues. Children and adolescents lagging or who are ahead developmentally are sometimes at risk for mental health issues which must be taken into consideration when formulating treatment plans. Additionally, environmental stressors such as bullying, recent moves, parental divorces and any number of other environmental events could also play a role in your child’s mental health issues. Your child and adolescent psychiatrist may recommend counseling or therapy in lieu of, or possibly as an adjunct, to medicinal treatments. There are dozens of variables that need to be taken into consideration such as family history for certain conditions like depression or anxiety or testing results for things like ADHD or autism before coming to the best course of treatment for your child. This intricate and complex process is often best formulated by specialists such as child and adolescent psychiatrists.

Children aged four to ten are often more anxious about seeing doctors. Even though child and adolescent psychiatrists are very different than seeing the pediatrician, your child does not know that. Many children know that when they go to their pediatrician for their well-child visits, they often get immunizations and booster shots. Nobody likes getting shots, but children are especially sensitive to the prospect and can become downright terrified. When you tell your child they will be seeing a doctor, it is particularly important to make sure they understand this is a different kind of doctor. Reassure them that a child and adolescent psychiatric provider will not be giving them any shots and won’t even be poking or prodding them at all. Let them know this is just a talking doctor who is going to ask them lots of questions, and they will only need to sit there, listen, and answer some questions.

Giving your child a general construct for the nature of the appointment can also be helpful. If there is concern about depression or anxiety, remind them that they have been feeling scared about things (the dark, school, when parents leave, etc.) or how they have been really sad lately, crying a lot, and not wanting to do much. Let them know that this doctor is here to help them with their worries or sadness and work together to have less of those feelings and more times when they are happy. If your child understands the reason for the appointment and can see some possible benefit coming out of it, they are more likely to be cooperative and open.