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Facing the Comprehensive Psychiatric Evaluation


The first step to helping your troubled child create a better life

“Comprehensive psychiatric evaluation.”  Maybe those words sound scary to you, but they shouldn’t.  If your child or teen is struggling in school, with friends, and with family, it breaks your heart to watch.   Beneath any anger, resentment and frustration, you can see that your child/teen is hurting.  If your child’s emotional and behavioral reactions to stress causes him or her to spin out of control; if he or she struggles with self-regulation; if he or she appears depressed or withdrawn; or if he or she swings from highs to lows, frequently lashes out in anger, or just seems to be having a tough time with school, at home or socially, there is something you can do.  You can get help.  And the first step is the evaluation.

Here’s what you can expect.

The purpose of a comprehensive psychiatric evaluation is to assess the problem, take a look at the home and school environment, review family member’s health histories and your child/teen’s developmental history, and of course, talk with you and your child/teen.  You will be seen both together and separately, and you may both be asked to complete one or more questionnaires.  You should expect the process to last several hours, and it may involve more than one office visit.  Further assessments such as speech and language evaluation or lab tests may be part of the process.

Following the visit, the psychiatrist will arrive at a formulation, which is a diagnosis or a description of the child’s problem, explained in clear and simple terms.  The formulation includes all aspects of the situation – the biological, the psychological and the social, and takes into account the child and family’s history, strengths and unique character.

Let’s be frank.  Admitting that your child has a problem, and that you have not been able to make it better, is difficult.  It may feel like a big step to begin the process of getting help.  Or things may have gotten to the point where you just can’t ignore it any more, or pretend that it’s “just a phase.”  You know it’s time to do something.

One of the things that parents are often secretly worried about is that they will face scrutiny and be judged when their child is evaluated.  You should know this:  You will never be judged or blamed in any way.  There is no blame and there are not “sides.”  You, your child/teen and your child/adolescent psychiatrist are a team, working together to help your child achieve a more fulfilling life.  The psychiatrist is there to provide support and help to both you and your child.

Most parents coming to an evaluation have a lot of questions and worries about the issues they are facing.  You may wonder why your child is so unhappy, or so angry, or so out of control.  You may wonder if the behaviors that concern you are “typical teenage” matters or something else.  You may feel guilty, confused, and worried.  And then there are concerns about costs of treatment, insurance coverage, length of treatment, and other practical matters.

Remember, the child/adolescent psychiatrist is your partner.  He or she will listen to you both, and guide your whole family along the process, beginning with defining the goals of the evaluation.  You should always speak up if you don’t understand something, and he or she will be glad to explain.

At the conclusion of the evaluation, the psychiatrist will go over the diagnostic formulation with you and your child/teen, and outline the next steps.  If the evaluation has uncovered a treatable problem, you will receive recommendations and a specific treatment plan.

You don’t have to feel helpless, and hopeless, when it comes to your struggling child or teen.  Whether the issues are mild or severe, you can get help for your child.  The first step is the comprehensive psychiatric evaluation.  It could be the first step to a better life for you and your child.