|
Choosing
a Mental Health Professional for Your Child or Teenager
Every child
experiences emotional and physical illnesses from time to
time. With the physical illnesses, parents know where to
take the child. When the problem is emotional and becomes
overwhelming to both the child and family, where do you
go for professional attention? As a parent, you are well
versed in the standard routine doctor visits for everything
from vaccinations to earaches.
Just like physical
problems, the prognosis is better when the mental health
problem is treated early. It is estimated that over 15 million
children and teens have a mental health or substance abuse
problem. Sadly, only one in five of the children with a
mental health problem gets treated - a figure far smaller
than the number of children being treated for a medical
ailment.
Back
to Topics
When
should you seek help
Many physical and emotional
signs suggest a possible mental health problem. Problems
can range from those of serious concern, for example, when
a child or adolescent has lost touch with reality or is
in danger of harming himself to a change in eating or sleeping,
feels frustrated. Any problem that is personally bothersome
warrants evaluation. Look for the WARNING
SIGNS >
Back
to Topics
Where
do you start
Looking for information can
be a crucial first step. Parents may not be sure their child
has a mental health problem, not know exactly what it is,
or wonder whether it is serious enough to seek help. All
of these questions can be discussed with a professional.
To find a professional:
1. Talk things over
with the child's pediatrician, school teacher, or guidance
counselor. Not only do they know you and your child well
but they should also be involved in any assessment of
the problem.
2. Get a recommendation from a trusted friend or family
member.
3. Check with a clinic affiliated with a local hospital
or medical school.
4. Contact national or local professional organizations.
Back
to Topics
Obstacles
to getting help
A variety of
obstacles may get in the way of seeking mental health treatment
- all of them can and should be overcome. Some of the roadblocks
are real; some are due to common myths and misinformation
about what it means to need help and what will happen. The
following are some typical concerns and solutions.
"I'm
embarrassed and uncomfortable about the problem"
Solution Feeling uncomfortable talking about personal problems
is not uncommon. This can stem from feeling guilty and blaming
oneself or believing certain issues should remain private.
As a way to avoid addressing a problem, parents may ignore
it, hoping the child will "outgrow" it. Like many things
in life, individuals often imagine far worse than is the
reality. Mental health professionals have experience with
the issues, are familiar with your concerns, and are trained
to put parents and children at ease.
"My
child won't go" Solution Children and teens
rely on and require the confident, clear thinking of their
parents to get them involved in treatment. Talking directly
and honestly with the children can also allay their concerns
[note put a link here to the CSC letter]. Forcing someone
into treatment is usually unsuccessful. But an attitude
of concern that transmits understanding of how difficult
it is to accept help will be appreciated. It may be useful
to point out how the problem interferes with enjoyment of
life. If parents have a positive attitude about getting
help they will enable their child to follow suit. Approaching
the issue as everyone's problem and involving everyone in
the solution will foster cooperation.
"I
don't know how I would fit it in" Solution
it is important to make time available for treatment and
to adjust your family's schedule. Be realistic about the
logistics of getting to treatment. If the best professional
is an hour away you must decide whether you are willing
to make the necessary arrangements or prefer to ask the
professional for a comparable referral nearby, thus increasing
the likelihood of your engaging in treatment.
"I
can't afford treatment" Solution There are
a variety of lower cost clinics, often through graduate
training programs or hospitals. Unfortunately most insurance
companies do not yet reimburse or pay for mental health
services on par with services for physical illness. Most
providers however, cover some form of treatment. Insurance
companies also usually have a list of approved providers
in your network. If you find someone who is not covered
by your insurance plan, or whose fees are beyond your means,
it is worthwhile to ask the professional if he/she has a
sliding scale, and/or ask your insurance provider if it
can make a one time exception and add the professional to
the provider list for your individual case.
"If
I need help it must mean I'm a bad parent"
Solution Unfortunately, mental illness is stigmatized in
our society. Media images and news stories may portray distorted
images of those with a mental illness as being violent and
out of control and parents as being uncaring and uninvolved.
But mental illness is real, it can be treated and should
be considered similar to any illness. Certainly no one would
avoid treatment for diabetes or cancer, but the same person
might feel ashamed of having a mental illness. The greatest
harm comes from leaving mental illness untreated.
"I
heard that treatment lasts forever" Solution
Certain myths generated by popular culture are outdated.
Treatment only lasts as long as is necessary. The goal of
any mental health treatment is for the individual to function
independently and to feel successful and fulfilled in life.
Different problems require different types of treatments
for differing amounts of time. Certainly the sooner treatment
is begun the better - the sooner the improvement and the
better the prognosis.
"All
they do is give drugs" Solution Medication
is only one option among many for certain disorders. A wide
variety of treatments is available. The use of medication
is dependent upon the individual, the problem, and his/her
preferences. Once options are explained, any treatment decision
is best made between the professional and the parent. Some
treatments are carried out alone, some in combination with
medications. With children, the treatment can involve talking
and/or playing as a way of understanding the child's concerns
and working out solutions.
"Other
people will find out and think there's something wrong with
me or my child" Solution A therapist and
a client engage in a confidential relationship. Licensed
professionals are bound by both a code of ethics and state
laws that allows information told to a therapist to be kept
confidential between the client and therapist. A mental
health professional's main goal is to protect both the physical
and emotional well being of the client. In certain situations,
however, action must be taken or information revealed. In
the interest of client and public safety, mental health
professionals are obligated to report any instances or information
they have about abuse of children, the elderly, mentally
or physically handicapped. In addition, action must be taken
when there is a risk of danger to the self or others, e.g.
by suicide or by threats on someone's life. Other instances
in which certain information can be revealed include giving
specific information to an insurance company as stated by
their policy, to collection agencies, when involved in legal
matters concerning the person's mental health, and when
involved in legal complaints against the professional.
Back
to Topics
What
types of mental health providers are there and how are they
different
Types of
Mental Health Care Providers
Four professions recognized
as mental health providers are psychiatrists, psychologists,
marriage and family therapists, and licensed clinical social
workers. Although the four fields have different approaches
to treating mental illnesses, they may overlap in the kinds
of mental illnesses they treat. Any of these therapists
is qualified to help a client with most types of mental
difficulties, such as depression, anxiety, or anger management.
Only psychiatrists are able to prescribe medications.
Make sure the one you select
has dealt with suicidal tendencies.
- Psychiatrists have an M.D.
degree and can provide therapy in addition to prescribing
medication
- Psychologists have a Ph.D.
or Psy.D. degree and can provide therapy in addition to
conducting psychological tests.
- Social Workers have a masters
degree and are identified by the LCSW license
- Marriage and Family Counselors
usually have a masters degree and are identified by the
MFCC license
- Licensed Professional Counselors
(LPCs), mental health practitioners, pastoral counselors,
or school guidance counselors. These counselors usually
have less training and are not monitored by professional
organizations. There may be more risk of safety and confidentiality
issues. Other possible licensed professionals include
Pastoral Counselors and Mental Health counselors.
- Some professionals, without
state licensure, may be certified by their own professional
organization.
Back
to Topics
How
to Select a Provider
- Professional's credentials
and training: consider the training of the professional
and inquire as to his/her experience or expertise with
the problem. If the professional is licensed in your state
make sure the professional has the appropriate credential.
- Experience: the professional
should have experience with children and expertise with
the particular problem of concern.
- Involvement: it is
important to understand how parents are involved in the
child's treatment.
- Type and format of treatment:
parents and children should understand the scope of the
treatment, the procedures used and the frequency and duration
of the sessions.
- Cost, insurance policy:
it is the parents' responsibility to know their own financial
resources and any insurance requirements and limitations
- Location, ease of accessibility:
treatment must balance convenience with availability of
the professional.
Back
to Topics
How
to find out about a provider - status of their license,
education, complaints
State
of Arizona Board of Psychologists Examiners
This website contains a list of licensed Arizona psychologists,
status of their licensure, and whether any disciplinary
action has ever been taken against them.
Arizona
Board of Behavioral Health Examiners (Licensed Professional
Counselors-LPC)
Certification for LPCs in Arizona is voluntary and is not
required to practice any of the professions covered by counselors.
Many professionals request certification to demonstrate
that they have met Board standards for education, experience,
and competence. In addition, certification is increasingly
required by licensing agencies, employers, insurance programs,
and consumers of behavioral health services.
Arizona
Medical Board (Psychiatrists)
Psychiatrists are medical doctors and must be licensed by
the Arizona Medical Board. This site includes the psychiatrists
by specialty (children, adolescents, adults, etc.) Information
included on this site is in which city and state they were
licensee; where they received their medical and psychiatric
training; and the status of their license (active, cancelled,
revoked, etc.).
Here are
some specific questions you can ask
1. Are you a licensed? How
many years have you been practicing?
2. What are your areas of
expertise -- for example, working with children and families?
3. What kinds of treatments
do you use, and have they been proven effective for dealing
with my kind of problem or issue?
4. I have been feeling (anxious,
tense, depressed, etc.), and I'm having problems (with
my job, my marriage, eating, sleeping, etc.). What experience
do you have helping people with these types of problems?
5. What are your fees? (Fees
are usually based on a 45-minute to 50-minute session.)
Do you have a sliding-scale fee policy? How much therapy
would you recommend?
6. What types of insurance
do you accept? Will you accept direct billing to/payment
from my insurance company? Are you affiliated with any
managed care organizations? Do you accept Medicare/Medicaid
insurance?
Back
to Topics
How
do I decide if this is the right professional
Once a parent has decided on
a therapist, it is important for the child or teen and parents
to feel comfortable with the treating professional or agency.
Having confidence in the person is essential for establishing
a positive working relationship and important when facing
difficult moments or decisions. Parents often benefit from
having an initial consultation or one or two sessions before
making a decision about ongoing treatment. The "fit" must
be right in order to establish a good working relationship.
What may work for one person may not feel right for another.
However, if the parents or child feel uncomfortable after
a few sessions, this should be discussed in order to assess
the source of the problem. For example, is the difficulty
due to embarrassment about discussing the problem, a child
who is resistant due to being angry at the parents for suggesting
treatment, or is it incompatible styles between the professional
and the client?
Back
to Topics
What
are the types of non-medication treatments
Some of
the more common non-medication treatments include:
1. Cognitive
behavior therapy: this helps the child learn new ways
of thinking and behaving.
2. Verbal
psychotherapy: one's current problems are discussed, perhaps
in light of past difficulties, and options for coping
with different feelings and behavior and for engaging
in different relationships in more effective ways are
developed.
3. Marital
or family therapy: the professional helps members of the
couple or family understand how their behaviors affect
one another and the children, and provides instructions
and strategies for making changes.
4. Group
therapy: issues are explored within a group setting with
individuals who share similar problems.
5. Interpersonal
psychotherapy: feelings and responses are explored within
the context of different interpersonal or social relationships
and situations.
Back
to Topics
What
is the role of the parent
The initial session or two,
with the parents and/or the child, is usually used to evaluate
the problem. This is typically done by interview and may
also involve questionnaires. In the case of a child, the
professional will need information from the parents about
the family history, home environment, child's physical and
emotional development, friendships, and may consult other
relevant medical and educational professionals for information.
Soon after the evaluation phase, the professional should
discuss the assessment and outline a plan of treatment.
Parents should be informed about their role in treatment,
preferred method of communication with the professional,
schedule for feedback and updates, coordination with outside
resources or professionals, strategies for helping their
child participate in treatment, alternative treatments,
risks and goals.
Successful therapy usually
requires an investment of time and energy on the part of
both the professional and the client. The therapist may
act as a guide, instructor, cheerleader, sounding board,
and confidante. However, the parents and child must also
participate and take responsibility for putting the learning
into practice. It is important for everyone involved to
monitor change and progress.
Back
to Topics
Information for this page
came from: Robin F. Goodman, Ph.D., Clinical Associate Professor
of Psychiatry, NYU School of Medicine, Director of Bereavement
Programs and www.AboutOurKids.org.
American Psychological Association
|
