While you probably know more about depression now than you did before reading this book, it is time to learn about what treatments are out there and available to meet the specific needs of your child. The medical jargon associated with treatment is enough to send your head spinning! The best place to start is to understand the difference between practitioners, treatment regimens, and how insurance works.
Mental Health Practitioners
Mental health professionals that you might want to seek out or that you might be referred to include pediatricians, family practitioners, psychiatrists, psychologists, social workers, and counselors. The first three professionals just listed have been to medical school and completed extensive residencies in order to earn their degrees. Many of these have also obtained further training in order to become specialists in a particular area of medicine, such as a pediatrician who is specifically trained to treat children and adolescents.
Psychiatrists (John Doe, M.D.) specialize in diagnosing and treating mental illness. They prescribe medications if necessary, and some provide therapy. However, most psychiatrists focus their practices on diagnostic and medication issues.
If you are considering going to a psychiatrist, it is best to find one who specializes in child and adolescent psychiatry. He is more likely to understand the unique differences in children versus adults, and he will know how to handle medications at an age-appropriate level.
Who is best equipped to make a diagnosis?
The best choice is either a psychiatrist or psychologist. The biggest difference is that psychiatrists can prescribe medication if necessary. But a psychologist can just as easily make a diagnosis and refer to a psychiatrist to determine if medication is an appropriate option for optimal treatment.
Pediatricians and Family Practitioners
Pediatricians and family practitioners cannot be overlooked as good alternatives for medication issues. Often they have had plenty of experience with depressive patients and prescribing medications with good results. Some will be more comfortable than others in doing this and will only treat those patients with symptoms that are very specific and mild. Others will immediately refer you to a psychiatrist. If you are considering using these physicians for the treatment of your child, you can be fairly sure they will tell you if this is something they routinely do or if they would prefer to give you a referral.
Psychologists (John Doe, Ph.D.) have a doctoral degree, which typically means they have a master's degree in addition to the doctoral education that includes more schooling and internship training. In terms of education for mental health, psychologists have more extensive education than medical doctors. They are capable of making a diagnosis for your child but cannot prescribe medication, although there is a movement to change this. They are capable of performing evaluations and treatment (therapy). Like medical doctors, they often have a specialty, such as child psychology.
If you can't find a specialist in your area, don't give up on the hope of getting good treatment. Ask around, and chances are you will find a doctor or other mental health professional that may not be specifically trained in the area of children but has experience anyway and can handle the issues you present.
Social workers (John Doe, LCSW) typically have master's degrees and are able to make diagnoses and provide therapy. In some areas, social workers are just as capable of providing the same quality of treatment as a psychologist. But psychologists will almost always have more in-depth training across a broad range of treatment methods. If you would rather employ a social worker, the best thing to do is to research his education, experience, and reputation.
You've heard that no question is stupid. In the case of making a decision as to where to take your child for treatment, research is key. Ask questions, and then ask more! Don't stop until you are satisfied that you know everything you can about a particular provider or treatment process.
Some psychiatrists and psychologists employ social workers to do screenings with new patients. They will often perform what is called an “intake evaluation” to better determine what services might be needed. Less serious cases may be referred to social workers, and more complex issues get passed on to psychologists and psychiatrists.
Last, you may encounter what is called a licensed professional counselor (John Doe, LPC). Their training can be obtained in several different arenas, but most have a master's degree. Depending on the severity of your child's problems and the amount of training a counselor has, this may be the perfect treatment provider.
Types of Treatment
Treatment for your child will primarily be either medication, therapy, or a combination of the two. These treatments are discussed more in depth later. For now, in making the decision to get treatment, you will need to suspend your beliefs and or your suspicions about both.
The reason you are seeking help for your child is because you are not the expert here when it comes to treatment. While you may be an expert on who your child is and what his problems are, a mental health professional will provide a much more objective, unbiased opinion about your child.
Medication issues will include your child's specific complaints, his age, weight, and other factors. A doctor will work to get the medication best suited for your child. A good doctor will address with you any concerns you may have about your child taking medication. He will explain the benefits of medication as well as any possible side effects. His goal should be to make an accurate diagnosis and determine whether medication is necessary. In addition, he should provide education not only to you but also to your child at an age-appropriate level.
A physician who gets offended or defensive about your wanting a second opinion is not likely to be sympathetic to your questions and concerns. He should be more than willing to do whatever you feel is necessary to feel comfortable about your child's treatment. As a general rule, if he balks at getting a second opinion, move on.
Therapy may be on an individual basis with your child, or it may include other members of the family. The type of therapy will depend on your child's specific problems and needs. It will also take into account other factors that might need to be addressed, such as family problems, parenting issues, or school issues. For it to be most effective, a therapist should try to address all the issues that may be contributing to your child's depression.
When considering therapy for your child, if he is also on medication, make sure you have a therapist and physician who are willing to collaborate with one another and with you. The best treatment will be one in which everyone is playing on the same team and where no critical information slips through the cracks.
Your participation in the process is important as well, but try not to bombard them with phone calls. Unless it's an emergency, you will have better luck if you make a list of your questions and concerns as they arise. One phone call with several questions is better than four different contacts.
Every moment counts when trying to get your child help. This is because children change constantly and quickly. A failure to stay one step ahead of your child's problems will result in missed symptoms. Often, the later the treatment comes in the course of the depression, the harder it is to treat successfully.
It's also okay to ask for a few minutes before or after your child's appointment with the therapist or doctor if you need it. Doctors and therapists may have certain rules about this process, but they do understand that you are a worried parent and that you will need some attention, too. Consider changing doctors or therapists if they are uncooperative with this process.
Insurance and Payment
A quick word needs to be said about insurance and payment for treatment. Take the time to review your health-care plan carefully or call your provider. You need to know which type of treating professional is covered by your insurance and what your payment will be after insurance pays its portion. If you have a particular professional that you wish for your child to see, make sure she is included in your plan. You've come this far in deciding to get help for your child. Skipping the insurance step is apt to result in unnecessary frustration and misinformation.