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  • Home
  • Blogs
    • Child Development
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    • Child Development >
      • Child Sexual Abuse
      • Choosing a Therapist
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      • Guiding Your Toddler's Development
      • Parenting Guide to Toddler Eating
      • Parenting Guide to Toddler Sleeping
      • Parenting Guide to Toilet Training
      • What's on Your Toddler's Mind
      • Why Size Matters
    • Adolescent Development >
      • Surviving Adolescence
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      • Finding Happiness in Parenthood
      • In Pursuit of Happiness
      • Midlife Crisis: Middle Aged Myth or Reality
      • Playtime for Grown Ups
      • Sex After Forty
      • Understanding Masturbation
      • With a Little Help from My Friends
      • Why Cougars Seduce
  • Books in print
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    • Child Development >
      • Choosing a Therapist audiobook
      • The Golden Age of Childhood audiobook
      • Guiding Your Toddler's Development audiobook
      • Parenting Guide To Toddler Eating audio book
      • Parenting Guide to Toddler Sleeping audio book
      • Parenting Guide to Toilet Training audio book
      • What's on Your Toddler's Mind audio book
      • Why Size Matters audiobook
    • Adolescent Development >
      • Surviving Adolescence audiobook
    • Adult Development >
      • The Aging Father audiobook
      • Finding Happiness in Parenthood audiobook
      • Playtime for Grown Ups audiobook
      • Sex After Forty audiobook
      • Understanding Masturbation audiobook
      • With a Little Help from My Friends audiobook
      • Why Cougars Seduce audiobook
  • Interviews
    • Interview: Dr. Colarusso's books
    • Interview: Toddlers
    • Interview: Adolescence
    • Interview: Intimacy and Sex after Forty
    • Interview: Spring Break for Kids
    • Interview: Healthy and Unhealthy Childhood Relationships
    • Interview: The Aging Father
    • Interview: Choosing a Therapist for Your Child
  • Videos
    • Choosing a Therapist
    • Guiding Your Toddler's Development
    • Sex After Forty
    • Surviving Adolescence
    • Toddler's Mind
    • Finding Happiness in Parenthood
    • Understanding Masturbation
    • With a Little Help from My Friends
  • Your Challenges
  • Contact

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What Parents Need to Know About Choosing a Therapist for Their Child

By Calvin A. Colarusso, M.D.
Clinical Professor of Psychiatry, 
University of California at San Diego


Few things in life make parents more concerned then the idea that their child has significant emotional or behavior problems and needs professional help. Once the decision to seek professional help is made, difficult questions arise.  Who sees children for emotional problems?  What are their qualifications? How do I know if they are competent? What can I expect to hear when I call one of them?  How will they go about evaluating my child? What kind of therapy is right for my child? These and other questions understandably make parents anxious. In this book those questions are addressed and answered in plain English from the parents’ perspective.

     Child psychiatrist, Calvin Colarusso M.D., has been evaluating and treating children for fifty years. He writes in a simple direct style that makes it possible for parents to take the first step toward getting an evaluation of their child with less apprehension and greater understanding of the procedures involved.

     What Parents Need to Know About Choosing a Therapist for Your Child is a roadmap directing parents toward a solution for existing problems and a path to healthy development for your child.

     This book includes information on:

          The credentials of mental health professionals who evaluate and treat children.

          Basic components of a child psychiatric evaluation.

          Evaluation procedures with young children.

          Evaluation procedures with adolescents.

          Techniques used in the treatment of children and adolescents.

          The relationship between diagnosis and treatment recommendations.

About the author: Calvin Colarusso M.D.

     An eminent authority in the field of child and adult development, Dr. Colarusso is a board-certified Clinical Professor of Psychiatry at the University of California at San Diego where he served for two decades as Director of the Child Psychiatry Residency Training Program.
      
    He is also a Training and Supervising Analyst in child and adult psychoanalysis at the San Diego Psychoanalytic Institute and an internationally known lecturer to students, professionals, teachers and the general public on many aspects of normal and pathologic development.

     His ebooks, audio books, and books in print have been published in English, Korean, and Spanish. See www.calbooks.info . In addition, Dr. Colarusso has published over 50 articles and book chapters in peer-reviewed journals.


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BOOK EXCERPT

What Parents Need to Know About Choosing a Therapist for their Child

Copyright © 2011 by Calvin A. Colarusso, M.D. All rights reserved

True Nature Productions

www.truenatureproductions.com

ISBN: 978-0-9839802-9-2

Introduction
When a child is having emotional or behavioral problems, parents become not only concerned, but also may need to seek professional help. When lesser measures fail, the next step may be finding a child psychotherapist.

Many parents have no idea who to turn to or how to assess the qualifications of such a professional. What can be expected during an evaluation? If therapy is needed, what is the therapeutic process?

In this eBook I will address those questions and provide information and guidelines to help you though a difficult time which, with the proper intervention, could turn into a great benefit for your child.  As you’ll see at www.calbooks.info, I’m an adult and child psychiatrist who has been evaluating and treating children for five decades. I understand how difficult it is to face the reality that your child is in need of help and to find the right person to intervene. Let’s begin with an understanding of the various mental health professionals who evaluate and treat children and how their credentials differ.

 A child psychiatrist is a medical doctor who has chosen to specialize in mental and emotional problems. In order to become a psychiatrist, a man or a woman must have graduated from medical school, likely spent a year as an intern, and then spent at least four years, full time, in adult and child residency training programs. Two or three of those years would be spent in an approved program working exclusively with children. Not every psychiatrist is a child psychiatrist. So when considering a physician for your child, ask specifically if the person has completed a residency in child psychiatry, in addition to the years of training in adult psychiatry. Physicians are the only professionals, in nearly all states, who are licensed to prescribe medication.

Psychologists also treat children. They go through a lengthy graduate school program that can take five or more years to complete. After graduating with a PhD, psychologists spend a year or more in a clinical setting working with patients under supervision. After passing a licensing examination in their chosen state, they are ready to begin a practice and see patients. If you are considering a psychologist for your child, you should inquire about that person’s specific training and experience with children.

Social workers also treat children. They undergo two or more full time years of training in social work before becoming licensed to practice. As with child psychiatrists and psychologists, it is important to ask about the social worker’s training and experience in treating children.

Marriage and family counselors may work with children. As with all of the professionals mentioned above, experience in treating children and their families is critical.

If you live in a community where all of these professionals are available, knowledge of the individual’s reputation gained from friends or local professional organizations can be extremely helpful in making an appropriate choice.

Techniques

Psychotherapy—Play therapy: In plain English, psychotherapy is talking therapy. When dealing with children, particularly young children, play is often utilized as a way of understanding the child’s inner world. Children naturally express themselves through play. Child therapists have toys, board games, puppets, blocks, etc. available for the child to use. The child reveals his or her inner world by the games they choose to play and the fantasies they express while playing. The child therapist will watch the play and participate when asked, form a comfortable working relationship with the child, often communicating information to the child by commenting on the content of the play. Unlike younger children, adolescents usually prefer to sit and use words as the major form of communication between therapist and patient.

Work with Parents: Parents play an essential role in the treatment of their child. Particularly with younger children, they provide information about the child’s difficulties and developmental information from birth onward to the chronological present. In addition, they bring the child to the therapy setting and are financially responsible for the treatment. With adolescents, their role is less prominent but just as important to the success of the treatment. In addition to assisting in the evaluation, they provide emotional support and structure to the therapy by working with the therapist to maintain the treatment alliance during periods of resistance on the part of the adolescent. We will delve more deeply into all of these subjects later in this book.

Any experienced therapist who is worth his or her salt understands that he or she treats a child at the pleasure of the parents. Failure to maintain a respectful and cooperative relationship with the parents inevitably results in the end of the therapy.

 Medication; Medication is useful, indeed, necessary in the treatment of many conditions in childhood. However, medication should be part of a comprehensive program which, following a thorough evaluation, may also include psychotherapy and work with the parents.

The Diagnostic Evaluation

Not every competent child therapist proceeds in exactly the same manner.  But every experienced therapist recognizes these basic concepts and utilizes the following elements in a thorough evaluation.

Basic Concepts:

The immaturity of the child’s mind does not allow him or her to understand the need for an evaluation or to participate in it with the same degree of comprehension or cooperation as an adult. Hence the need to involve parents in the evaluation procedure.

In reference to the question of why parents need to participate in the diagnostic process, it is important to recognize that children are not independent. They live with parents or other adults who control many aspects of their lives. Parents not only make the decision to bring their child for help, but also provide information about the present and past that the child cannot give because of a lack of knowledge and intellectual immaturity.

Since children’s capacity to think, express feelings, and manage their behavior changes with age, , techniques and procedures will vary depending upon the developmental level of the child. For example, the evaluation of a five year old will differ significantly from the evaluation process with an adolescent.

Basic Components of a Child Psychiatric Evaluation:

1.    A history is obtained from the child’s parents or other caretakers and additional relevant sources, such as physicians and teachers.

2.    Diagnostic interviews, two or more, with the child or adolescent, alone.

3.    Additional procedures, if indicated, such as psychological, neurological, or educational testing.

4.    Diagnosis, treatment recommendations, and prognosis, which are formed after all necessary information has been obtained and carefully considered.

5.    A summary conference in which the clinician’s conclusions are conveyed to the parents and to the child.

I’ll now describe the child psychiatric evaluation from the parents view point and experience.

EVALUATION PROCEDURES WITH YOUNG CHILDREN

Although the component parts are the same in the evaluation of younger children and adolescents, they are not utilized in the same manner because of the developmental differences between the two.

For children from birth through approximately age 11 or 12 years of age, the sequence of the evaluation is as follows: The concerned parent or guardian, after a thorough search to insure competence and experience, calls the child therapist for an appointment. Then the history is obtained from the parents in a series of two or three 45-minute sessions. After that, the child is interviewed individually at least twice. If needed, additional procedures such as psychological testing are obtained at this point. After assessing all of the relevant information, the therapist schedules a summary conference with the parents but not with the young child.

Initial Contact

The initial contact, almost always in the form of a phone call, is very difficult for most parents –often the most difficult moment in the entire evaluation experience. That’s because the decision to seek professional help is almost always made with considerable apprehension, fear, and misgiving.

(END OF EXCERPT)  

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