Table of Contents

Who are Child and Adolescent Psychiatrists?

A child psychiatrist is a medical doctor (MD) who specializes in diagnosing and treating behavioral disorders in children and adolescents but may treat adults as well. Some child psychiatrists also serve as expert witnesses in court cases or provide consultation to address major health crises, such as the impact of the COVID-19 epidemic on suicide rates.

What Does a Child Psychiatrist Do?

A child psychiatrist uses their knowledge, specialty training, and experience to offer treatment solutions,  including medication and other treatments. A child psychiatrist often completes a medical evaluation and consultation to help determine whether there are any general medical conditions that can mimic behavioral conditions, to help a child and/or adolescent with their unique challenges. Child psychiatrists take many factors into consideration— including biological, developmental, family dynamic, cultural, social, educational, and psychological influences—to help children and their families identify their struggles with educational achievement, interpersonal relationships, stress, abuse, natural disasters, politics, and crises related to violence in and around their communities.

Child Psychiatrists vs Child Psychologists

The difference between a child psychiatrist and a child psychologist is that a child psychiatrist is a medical physician who completed medical school and holds a medical doctor license in the state where they practice. Child psychiatrists are also board certified by the ABPN (American Board of Psychiatry and Neurology) for treatment of children and adults. A child psychologist can have a PhD or PsyD, which enables them to diagnose mental health disorders and provide testing.  A child psychiatrist serves as the treatment team leader and is responsible for ruling out common medical and/or neurological conditions that can present as anxiety and depression. For example, they might evaluate for thyroid conditions or vitamin deficiencies or refer patients to other doctors to help rule out a seizure disorder that is known to cause psychological conditions that plague children. The primary difference between psychiatrists and psychologists is that psychiatrists are physicians and can thus provide a more complete medical evaluation and follow up, including medication management. However, like psychologists, psychiatrists can also provide talk therapy.

When to See a Child Psychiatrist vs a Child Psychologist

A psychologist can help a child to work through difficult situations, provide neuropsychological testing to assist with 504/IEP recommendations, help a child learn coping skills to manage strong feelings like anxiety and depression, and help families to communicate and get along better. A psychologist typically cannot prescribe medication. Most child psychiatrists see children to establish and manage the medication portion of their treatment. Usually, a child will need to see a psychologist for weekly therapy in addition to their visits with a psychiatrist.

Your child might benefit from seeing a psychiatrist if:

  • They have been in therapy for a while and are still struggling to manage their symptoms.
  • You aren’t sure if medication is right for your child, and you’d like to talk about your options with someone knowledgeable.
  • You need someone to help you find out if there are medical conditions and/or neurodevelopmental conditions that are affecting your child.
  • Your child’s pediatrician, therapist, or another professional in their life has suggested that medication or a visit with a psychiatrist might be helpful.
  • You need someone to help you find the right medication and dosage for your child and keep an eye on any side effects.

Why Should a Child See a Psychiatrist?

A child may benefit from seeing a psychiatrist if they’re struggling with anxiety, depression, anger, or disruptive life changes. All children have ups and downs in their feelings and behavior as they grow up. When the issues are relatively minor, speaking with family, friends, your general practitioner, or your child’s school counselor can sometimes be enough to resolve these issues. For more serious or persistent mental health issues, there are a range of professionals who can help.

Your doctor, counselor, or healthcare provider may recommend that your child see a psychiatrist if they:

  • Struggle to complete ordinary tasks or to enjoy their daily lives
  • Express suicidal ideas or have self-harmed
  • Are likely to need medication as part of their treatment
  • Require admission to a hospital
  • Hallucinate (seeing or hearing things that are not there) or delusions (fixed ideas that are not true)
  • Have complex needs that require a team of doctors and other professionals
  • Continue to have problems despite help from other mental health professionals

Unforeseen events, such as the COVID-19 pandemic, can affect a child’s mental health and thus may be another cause for seeing a child psychiatrist. A large-scale research survey conducted by LifeStance in 2022 found that the top reasons American parents sought therapy for their children during the COVID-19 pandemic included:

• Child’s lack of socialization (47%)
• Child showing signs of depression or anxiety (45%)
• Child losing interest in their favorite activities (40%)


What Can Child and Adolescent Psychiatry Treat?

Child and adolescent psychiatrists can help children and their families manage a broad range of situations and conditions including:

  • Depression
  • Early-onset Psychosis
  • The Death of a Loved One
  • Anxiety Disorders
  • Eating Disorders
  • Moving/Starting at a New School
  • Bullying
  • Parental Separation or Divorce
  • Self-Harming
  • Schizophrenia
  • Bipolar Disorder
  • Oppositional Defiant Disorder (ODD)
  • Obsessive-Compulsive Disorder (OCD)
  • Attention-Deficit/Hyperactivity Disorder (ADHD)
  • Post-traumatic Stress Disorder (PTSD)
  • Trauma or Stress-Related Disorders
  • Tourette Syndrome
  • Autism Spectrum Disorders
  • Drug and Alcohol Issues

Medication Management

A crucial element of a child’s care is proper medication management. Your child’s psychiatrist can recommend the type of medicine, dosage, and schedule for the child’s treatment.

What Happens During Online Child and Adolescent Psychiatry?

An online child psychiatry session can be similar to an onsite visit to a doctor but is conducted via a video screen on a phone, tablet, or computer. Some studies show that, in certain situations, online psychiatry can be as effective as care delivered in person, and may even be superior to in-person sessions for children with particular issues such as attention- deficit hyperactivity disorder. Parents, teens, and family practitioners generally report high satisfaction with remote consultations and appreciate their convenience and privacy.

During your first session, the psychiatrist will ask you about your child’s medical history, developmental history, educational history, any past psychiatric history, diagnostic exams, traumatic history, Administration for Children’s Services (ACS) involvement, parental conflict or divorce, legal history, family medical and psychiatric history, current psychological or behavioral symptoms, and the factors that may be causing or making those symptoms worse. Using all the information they have gathered, the psychiatrist will create a detailed evaluation followed by a treatment plan that might include further testing, medical specialty consultation, laboratory tests (including urine drug screens), therapy and/or medications.

How to Prepare for a Child Psychiatry Appointment

The first few appointments are the time for you, your child, and the doctor to get to know one another. The psychiatrist will ask about the child’s history from birth to the age when symptoms began. You should bring any past evaluations for the child, IEP/504 school accommodation forms, any past discharge papers from psychiatric hospitalizations/ Emergency Rooms/ Intensive Outpatient (IOP)/ Partial Hospitalization Programs (PHP), and/or the contact information necessary for the psychiatrist to request these records. It is helpful to have the pediatrician’s information available and information about any lab work that has been completed.

Most importantly, it is essential that you provide the physician with the name and contact information for every party that may have legal rights to consent for treatment. These rights are often specified in court orders, ACS, and/or adoption papers. Your child will undoubtedly have questions, concerns, and maybe even fears: What kind of doctor is this? Will I get shots? Will it hurt?

Talk to your child and ask them how they are feeling, and if they have any questions. Be sure to share what you are learning about the process as you go. It’s important to remember that trying anything new can be stressful for a child.

Help them understand that visiting a psychiatrist is often the first step towards them feeling happier and doing better in their daily lives.

 

Citations:

2022 State of Youth Mental Health Report (Mar. 29, 2022). 2022 State of Youth Mental Health Report. https://lifestance.com/blog/mental-health-statistics-2022/

Bulkes NZ, Davis K, Kay B, Riemann BC. Comparing efficacy of telehealth to in-person mental health care in intensive-treatment-seeking adults. J Psychiatr Res. 2022 Jan;145:347-352. doi: 10.1016/j.jpsychires.2021.11.003. Epub 2021 Nov 3. PMID: 34799124; PMCID: PMC8595951.