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The Child and Adolescent Psychiatrist

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The Child and Adolescent Psychiatrist No. 00 May 2008 The Child and Adolescent Psychiatrist The child and adolescent psychiatrist is a physician who specializes in the diagnosis and 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 are 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 family. An integrated approach may involve individual, group or family psychotherapy; medication; and/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. Child and adolescent psychiatrists perform consultations in a variety of settings (schools, juvenile courts, social agencies). Training Child and adolescent psychiatric training requires four years of medical school, at least three years of approved residency training in medicine, neurology, and general psychiatry with adults, and two years of additional specialized 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 psychiatry trainee applies and develops psychiatric skills by treating children, adolescents and their families in a variety of settings. Definition of a Child and Adolescent Psychiatrist, “Facts for Families,” (5/08) Definition of a Child and Adolescent Psychiatrist, “Facts for Families,” (5/08) 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 competently. The child and adolescent psychiatrist continues to study and learn about new advances by reading scientific literature and attending conferences. New knowledge is then applied to diagnostic, therapeutic, and consultative 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. See also: Facts for Families: #24 Know When to Seek Help for Your Child, #25 Know Where to Seek Help for Your Child, #52 Comprehensive Psychiatric Evaluation. Your Child (1998 Harper Collins)/Your Adolescent (1999 Harper Collins). # # # If you find Facts for Families© helpful and would like to make good mental health a reality for all children, please consider donating to the Campaign for America’s Kids. Your support will help us continue to produce and distribute Facts for Families, as well as other vital mental health information, free of charge. You may also mail in your contribution. Please make checks payable to the AACAP and send to Campaign for America’s Kids, P.O. Box 96106, Washington, DC 20090. The American Academy of Child and Adolescent Psychiatry (AACAP) represents over 8,500 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© information sheets are developed, owned and distributed by AACAP. Hard copies of Facts sheets may be reproduced for personal or educational use without written permission, but cannot be included in material presented for sale or profit. All Facts can be viewed and printed from the AACAP website (www.aacap.org). Facts sheets may not be reproduced, duplicated or posted on any other website without written consent from AACAP. Organizations are permitted to create links to AACAP’s website and Definition of a Child and Adolescent Psychiatrist, “Facts for Families,” (5/08) specific Facts sheets. For all questions please contact the AACAP Communications & Marketing Coordinator, ext. 154. If you need immediate assistance, please dial 911. Copyright © 2012 by the American Academy of Child and Adolescent Psychiatry. No. 01 March 2011 Children and Divorce One out of every two marriages today ends in divorce and many divorcing families include children. Parents who are getting a divorce are frequently worried about the effect the divorce will have on their children. During this difficult period, parents may be preoccupied with their own problems, but continue to be the most important people in their children's lives. While parents may be devastated or relieved by the divorce, children are invariably frightened and confused by the threat to their security. Some parents feel so hurt or overwhelmed by the divorce that they may turn to the child for comfort or direction. Divorce can be misinterpreted by children unless parents tell them what is happening, how they are involved and not involved, and what will happen to them. Children often believe they have caused the conflict between their parents. Many children assume the responsibility for bringing their parents back together, sometimes by sacrificing themselves. Vulnerability to both physical and mental illnesses can originate in the traumatic loss of one or both parents through divorce. With care and attention, however, a family's strengths can be mobilized during a divorce, and children can be helped to deal constructively with the resolution of parental conflict. Talking to children about a divorce is difficult. The following tips can help both the child and parents with the challenge and stress of these conversations: • Do not keep it a secret or wait until the last minute. • Tell your child together with your spouse. • Keep things simple and straight-forward. • Tell them the divorce is not their fault. • Admit that this will be sad and upsetting for everyone. • Reassure your child that you both still love them and will always be their parents. • Do not discuss each other’s faults or problems with the child. Parents should be alert to signs of distress in their child or children. Young children may react to divorce by becoming more aggressive and uncooperative or by withdrawing. Older children may feel deep sadness and loss. Their schoolwork may suffer and behavior problems are common. As teenagers and adults, children of divorce can have trouble with their own relationships and experience problems with self-esteem. Children will do best if they know that their mother and father will still be their parents and remain involved with them even though the marriage is ending and the parents won't live together. Long custody disputes or pressure on a child to "choose" sides can be particularly harmful for the youngster and can add to the damage of the divorce. Research shows that children do best when parents can cooperate on behalf of the child. Parents' ongoing commitment to the child's well-being is vital. If a child shows signs of distress, the family doctor or pediatrician can refer the parents to a child and adolescent psychiatrist for evaluation and treatment. In addition, the child and adolescent psychiatrist can meet with the parents to help them learn how to make the strain of the divorce easier on the entire family. Psychotherapy for the children of a divorce, and the divorcing parents, can be helpful. For additional information see Facts for Families: #8 Children and
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