New Patients - What to Expect
Evaluation by a child and adolescent psychiatrist is appropriate for any child or adolescent with emotional or behavioral problems. Most children and adolescents with serious emotional and behavioral problems need a comprehensive psychiatric evaluation.
Comprehensive psychiatric evaluations require several hours over two or more office visits for the child, parents and family. The psychiatrist and, in some cases, a clinical social worker will do the psychiatric evaluation. With the parents' permission, other significant people (such as the family physician, school personnel or other relatives) may be contacted for additional information.
The comprehensive evaluation includes the following:
- Description of present problems and symptoms
- Information about health, illness and treatment (both physical and psychiatric)
- Parent and family histories
- Information about the child's development
- Information about school and friends
- Information about family relationships
- Psychiatric interview of the child or adolescent
- If needed, laboratory studies such as blood tests, x-rays, or special assessments (for example, psychological, educational, speech and language evaluation)
Dr. Rieche then develops a formulation. The formulation describes the child's problems and explains them in terms that the Parents and child can understand. Biological, psychological and social parts of the problem are combined in the formulation with the developmental needs, history and strengths of the child or adolescent.
Time is made available to answer the parents' and child's questions. Parents often come to such evaluations with many concerns, including:
- Is my child normal? Am I normal? Am I to blame?
- Am I silly to worry?
- Can you help us? Can you help my child?
- Does my child need treatment?
- What is wrong? What is the diagnosis?
- What are your recommendations?
- How can the family help?
- What will treatment cost, and how long will it take?
Parents are often worried about how they will be viewed during the evaluation. Dr. Rieche and his staff are there to support the family and to be partners, not to judge or blame. They listen to concerns, and help the child or adolescent and his/her family define the short and long term goals of the treatment. Parents should always ask for explanations of words or terms they do not understand.
When a treatable problem is identified, recommendations are provided and a specific treatment plan is developed. This plan may include medications, referral for individual, group or family therapy, skills training for the child or adolescent, skills training for parents, coordination with school officials, referral to another physician for medical evaluation, or other interventions which may assist the child or adolescent and the family to resolve current problems.