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Monthly NewsNote
May 2005
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Preparing For The Psychiatric Consultation
When a child or teenager is struggling with an emotional problem or ADD, someone
close to them such as a family physician, social worker or teacher will suggest
a psychiatric consultation for diagnosis and treatment. I've found that the consultation
is generally much more effective if the patient is properly prepared, so this
NewsNote provides information on how parents can prepare their children to see
the doctor.
First I’ll describe two unprepared cases that I saw quite recently. John
is a very bright 16 year old boy with very clear signs of ADD, Inattentive Type.
He had always been distractible, but had managed to work hard and do well. But
now in the 10th grade he was slipping because of the difficulty of the work
and amount of required reading. I made the diagnosis and recommended the use
of medication. His parents agreed, but as we talked John began to squirm in
his seat and finally leaned over to his mother and said he did not want to take
any medication. I was surprised, and the session ended.
A few days later his mother called to say John had talked to them. He had been
upset because he thought the medication would make him crazy. He knew someone
who took medication and said he was very strange.
No one had prepared John for our meeting or discussed the possible use of medication.
Had that been done the program would have gone much more smoothly and John would
have been spared unnecessary anxiety.
The next boy is Tim. Tim is a bright 10 year old boy in the 4th grade. He bounced
in, sat down, and looked at me. It was clear he had no idea why he was there.
I then asked him if he knew why we were meeting and I mentioned that I was going
to try to help him. He stared and said he didn’t know why he was there.
Here are several strategies to prepare your child for a productive and positive
consultation:
1. Take the time to explain about the meeting. I think that a good method
is to start with a problem the child knows he has. For example, if a student
knows he is having trouble getting homework done, the reason for the visit is
“to see if the doctor can help you with your homework problem”.
If you take the known problem and suggest help might be available, a positive
atmosphere has been established.
2. For a young child, it may be important to tell him that he is going to talk
to the doctor. Often an unprepared child comes in expecting “shots”
which they don’t want.
3. As you can see from John's example, it is also important to talk to teenagers.
The subject of medication may come up and the teen will say with great force
“I’m not going to put that stuff in my body.” Don’t
argue. Just ask him to visit the doctor and get his opinion. Make sure he knows
no one will force him to do something he doesn’t want to do.
As you can see, preparation for the appointment is very important. If you are
not quite sure how to do that, call the doctor for guidance before the appointment.
It is not always easy to know what to say, so don’t hesitate to call.
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