INITIAL CONSULTATION & ASSESSMENT
Child Psychiatrists: The initial assessment is a 2 hour comprehensive evaluation- the first meeting is with the parents only, for 60 minutes. The second 60 minute meeting is with the parents and child, focused on obtaining an accurate psychiatric diagnosis and identifying symptoms for treatment.
Child psychologist: The initial evaluation visit will be 60-90 minutes. During that visit, Dr. Brazendale will determine the appropriate psychological testing that is needed for your child. She will be able to give you a clear estimate for time and cost of testing that is recommended. The time needed for testing depends on the specific tests that are needed for your child.
CHILD and ADOLESCENT SPECIFIC CARE
Our doctors take a family-centered approach to working with children and adolescents. Following the comprehensive Initial Assessment, follow up appointments are typically 45 minutes in length. At each visit, we will meet with the parent and child separately as well as together. By having longer appointment times, there is ample time to hear concerns from parents as well as the child or teenager. Our physicians consider developmental stages and work with the family to create a specific treatment plan that works for the whole family.
Our physicians use an evidence-based medicine approach for psychiatric medication management. They provides extensive education regarding symptoms and diagnosis, treatment plan and medication regimen. Our physicians' treatment philosophy involves using the least amount of psychotropic medications necessary for treatment. Not all child and adolescent patients are started on medication. Before psychotropic medications are initiated, target symptoms, outcomes, medication side effects, risks/benefits and alternatives are discussed at length. Patients are typically seen for medication management more frequently if a medication is started.
IN OFFICE VISITS- Please check with your doctor regarding in office availability
Our doctors prefer in person visits at their office with you and your child during the evaluation period and for follow-up visits. While connecting through the privacy and convenience of telepsychiatry is available, child and adolescent visits may be in person or virtual. There are times that an in person visit is necessary for diagnostic clarity or due to prescribing laws. These visits are scheduled on an individualized basis and will be coordinated with your convenience, as well as best practice, in mind.
Psychotherapy is a first line intervention for treatment of children and adolescents. Your doctor may refer you for child and family psychotherapy if you do not already have one established. Here are a few options that may be offered:
Cognitive Behavioral Therapy (CBT): Cognitive behavioral therapy (CBT) is a treatment approach that helps you recognize negative or unhelpful thought and behavior patterns. Many experts consider it to be the gold standard of psychotherapy. CBT aims to help individuals identify and explore the ways your emotions and thoughts can affect your actions. It is especially helpful for anxious children. While the sessions may be focused on the child's symptoms, the parents are also actively involved in sessions.
Child Parent Psychotherapy (CPP):
CPP is a type of therapy that takes a family systemic approach and sessions include children and their parents. This model is an evidenced-based, psychodynamic type of therapy that focuses on working with parents to help their children's mental health. This model has been found to be very effective for many childhood disorders, including anxiety, separation anxiety, school avoidance, and depression in children. The treatment is based in attachment theory but also integrates psychodynamic, developmental, trauma, social learning, and cognitive behavioral theories. Therapeutic sessions include the child and parent or primary caregiver. The primary goal is to support and strengthen the relationship between a child and his or her caregiver as a vehicle for restoring the child's cognitive, behavioral, and social functioning. Treatment also focuses on contextual factors that may affect the caregiver-child relationship. This type of therapy helps to heal the family as a unit, and removes the burden and stigma from the individual child. They utilize an approach that appreciates the complexities of children's lives and well-being, including the family dynamics, school setting and deeper psychodynamic factors.
Parent Child Interaction Therapy (PCIT):PCIT is an evidence-based treatment for young children with behavioral problems.
PCIT is conducted through "coaching" sessions during which the parents and child are in a playroom while the therapist is in an observation room watching the parents interact with their child through a one-way mirror. Parents wear a "bug-in-the-ear" device through which the therapist provides in-the-moment coaching on skills they are learning to manage their child's behavior. PCIT is done across two treatment phases. The first phase of treatment focuses on establishing warmth in the parent child relationship through learning and applying skills proven to help children feel calm, secure in their relationships with their parents, and good about themselves. The second phase of treatment will equip parents to manage the most challenging of their child's behaviors while remaining confident, calm, and consistent in their approach to discipline. In this phase, parents will learn proven strategies to help their child accept limits, comply with directions, respect house rules, and demonstrate appropriate behavior in public.