What to expect for psychiatric and psychological appointments

Families may call directly to schedule an outpatient appointment. 

When you arrive at Children's Health

The outpatient clinics are located at Specialty Center Mockingbird 1.

• It is recommended that children above the age of five receive a brief explanation for the reason of their visit from their parent before they arrive. Statements such as "We know school has been quite difficult lately, and we are going to see someone who can help", or "we have not been getting along too well lately, and we need the advice of someone who can help so we can all do better", or "I know it has been hard to concentrate – we are going to see someone who can help us make this easier for you", usually reassures the child. It is not advisable to use the word "testing" with children, as they will undoubtedly get the wrong idea, and be unnecessarily nervous about the day. A practitioner will usually spend a few minutes with you and your child before your child is separated from you, to give the child a chance to get comfortable with our staff in your presence.
• Parents or guardian should accompany the child.
• If a person other than the child's guardian accompanies the child, a notarized letter from the parent authorizing this person to bring the child in for treatment will be required.
• Parents and legal guardians will be asked to show identification.
• If the child's guardians are divorced, please show evidence of custody before services are provided to the child.
• Insurance will be billed and a co-payment will be collected at the time of services. Patients who choose to pay out-of-pocket will be expected to settle their bill as services are provided.

Diagnostic evaluation

Most children who come to the clinic for the first time receive a diagnostic evaluation by a psychiatrist, psychologist or a licensed professional counselor.

• The initial evaluation will take one to two hours.
• The purpose of this evaluation is to determine the child's diagnosis and make recommendations regarding appropriate services.

Follow-up medication appointments with a psychiatrist

• Appointments typically last 30 minutes and may sometimes last longer.

Psychological testing

• Before your appointment send any previous testing. This is important so that procedures are not unnecessarily repeated possibly leading to invalid results.
• On the day of the evaluation, please be prepared to answer questions about the child's birth, development and medical history.
• Testing usually takes six hours of direct time with the child.
• The parent can expect to spend 60 to 90 minutes answering questions about your child's history and completing forms which will allow you to provide your observations of your child.
• You and your child will have a break for lunch. Lunch can be purchased here or brought to the facility.
• The temperature in our offices varies. It is helpful to bring a sweater or jacket for you and your child.
• Time is needed to review and interpret the tests before the psychologist meets with you to report on the findings. A later appointment will be scheduled for this meeting.

Psychotherapy appointments

• Parents are an essential part of a child's treatment and are likely to meet regularly with the therapists.
• Sessions usually last about 45 minutes.

• Average length of stay is 10 to 15 treatment days, or two to three weeks.
• Patients will attend school two hours a day with a certified teacher and work on assignments provided by their schools.

Intake

• If you are considering admitting your child to our day treatment program, please contact our intake coordinator at 214-456-8899. You will be given detailed information regarding our program and the process for admission.
• The decision to admit a patient to our program is made by a physician based on information obtained by the intake coordinator. This information may be given by a parent, the patient's primary physician or the patient's current treatment team. This information will be used to help determine the appropriate level of care.
• An initial evaluation is performed by a multidisciplinary team consisting of a psychiatrist, family therapist, nurse and other team members as available. This process, including signing consents and orientation to the unit will take about two hours.
• At least one parent or other legal guardian must attend the intake appointment.
• If there are any court orders pertaining to the child, such as divorce/custody orders, these must be presented at the time of the intake appointment.
• Parents or the child's legal guardians will be asked to provide picture identification and proof of insurance at the time of the intake appointment.

Daily schedule

• Treatment begins at 8:30 a.m. and ends at 3:45 p.m. On Fridays, treatment ends at 3 p.m.
• Lunch and two snacks are provided at each session. Food from home is not allowed. 
• Patients are required to wear school-appropriate clothing. A light jacket or sweater is advised.

Family involvement

The Day Treatment Program is unique in its focus on parenting and family work., which includes:

• Goals Group Daily from 8:30 a.m. to 8:45 a.m.
• Wrap-Up Group Daily from 3:45 p.m. to 4 p.m.
• Family Therapy one to two times per week
• Weekly Multi-Family Group Tuesdays from 8:30 a.m. to 9:30 a.m.
• Daily Parent Education Group 3 p.m. to 3:45 p.m., while not required, is strongly advised
• Shadowing is an opportunity for families to spend time working directly with your child on the unit.
• The staff is happy to assist families with any family and medical leave or other documentation required by an employer allowing you to participate in your child's treatment.

Neuropsychology is a specialty of Psychology that focuses on brain-behavior relationships. Pediatric Neuropsychologists use standardized assessment tools, as well as clinical observations, to better understand a child's cognitive, behavioral, and emotional functioning.  A neuropsychological evaluation reveals a child's strengths and weaknesses in the context of the child's developmental, medical, and psychosocial histories to inform treatment planning.  Strategies for remediation, accommodation, learning, emotional coping, and educational planning are among recommendations that may be provided based on the results of an evaluation. 

Populations commonly evaluated by the Neuropsychology Service include: 

• Traumatic brain injury (TBI)
• Epilepsy
• Stroke
• Pediatric cancer (i.e., ALL, brain tumor)
• Demyelinating diseases (i.e., multiple sclerosis, ADEM)
• Neurofibromatosis (NF)
• Genetic disorders

The services of this team are restricted to patients from other medical services at Children's Medical Center – no external referrals are accepted.

Our goals are to minimize stressful experiences, promote healthy coping and help patients and their families return to their prior state of emotional wellbeing. The psychiatry consult team consists of psychiatrists, psychologists, psychiatric social workers, a consult liaison nurse as well as clinical therapists. Emergency evaluation is provided for patients who present with psychiatric needs to the emergency department. Clinicians will coordinate admissions to the outpatient specialty clinics, intensive outpatient program, and day treatment programs, including community referrals to outside sources.

• Your medical doctor may recommend that your child be seen by someone from the psychiatry consultation liaison service. If so, we recommend that children and adolescents receive a brief explanation from their parents and members of the referring medical team prior to the consultation. A non-threatening statement such as, "Your doctors and I have noticed that things have been a lot harder than usual for you during this hospital stay. We are going to have someone meet with us to talk about different things that might be making it more difficult to be here and see what we can figure out to help you."
• A member of the psychiatry consult team completing the consultation will provide guidance regarding how the consult will proceed. It is typically helpful for the clinician to meet with the patient and family together, and then meet individually with the child and the family. Parents may wish to let their children know that coping with hospitalization can difficult by saying something like, "Being in the hospital can be tough and sometimes it helps to have someone you can talk to who can help."

For children who see a psychiatry clinician during their hospital stay, insurance will be billed.

Diagnostic evaluation

Most children who receive a psychiatry consult receive an evaluation by a psychiatrist, psychologist, licensed professional counselor or consult liaison nurse.

• The initial evaluation usually takes about two hours.
• The purpose of this evaluation is to determine the child's diagnosis and make recommendations regarding appropriate services during the hospital stay as well as in the community.
• Many different disciplines are part of the consultation liaison service, and some children benefit from working with more than one member of our service during their hospital stay.

Follow-up appointments

• After completing an interview with a child, the clinician may make recommendations for follow-up treatment during the hospitalization or following discharge in the community.
• Clinicians work closely with the family to ensure that all recommendations meet the child and family's needs and are manageable for the family to carry out.
• It is important that families contact the consult service if referrals or recommendations do not work out. Follow up and follow through after a patient is released from the hospital are critical components to the success and continued health and well being of children and adolescents.