The Psychiatric Evaluation Process for Adults and Children
Children up to age 13
(or for older children whose development is more like that of a preadolescent)
The first consultation is 60 minutes, focused on obtaining a comprehensive picture of your concerns about your child, and the world in which the child lives. I look to you for information about:
I will ask about the family structure; who is in the home, and how the members of the family relate to one another. In the case of divorced, separated or re-blended families, I always prefer to meet with all of the parents whenever possible. If that is not workable, please be sure to discuss this with me before the first appointment.
It is very important for me to understand the process of your child’s development from birth onwards, to review the developmental milestones, and the ways through the years, you have both succeeded and felt challenged by your child. I also obtain information about the family history. As many psychiatric disorders can run in families; knowing of any blood relatives who have emotional or neurological problems is very helpful.
A review of the child’s medical history and of any previous efforts at therapy,psychological evaluations, school assessments
or previous medication treatments is also done at the first appointment.
Please send copies of any and all previous evaluations ahead of time if possible, or bring them to the first appointment.
The second appointment,usually 45 minutes in length, is spent with the child doing a clinical interview. I will often do several different kinds of things with your child during the evaluation. Verbal questioning, picture drawing, playing of games for therapeutic purposes, as well as puppet play, playdoh or other artistic media may be used to provide sources of information about your child’s mental state. I look both for areas of strength as well as for problem areas in order to find ways to use your child’s best abilities in the service of their growth and development.
The third appointment, usually 45 minutes in length, is for me to meet with parents again to discuss:
and to help you to begin implementing a treatment plan.
This appointment can be 60 minutes in length, at your request. The fee is based on time spent in session.
In between these appointments I may ask to get information from your child’s teachers either verbally or using various behavioral assessment questionnaires. Medical tests such as:
There is no automatic testing that I do for every child. Psychological or Neuropsychological testing may sometimes be recommended for clarification of diagnoses, for assessment of treatment interventions and school IEP’s.
Adolescents (13 to 17 years of age)
For adolescents, the same information needs to be obtained as in the above description, however I usually go about the evaluation in a different way. At the first appointment, both the teen and the parents come in together initially. I do not see parents of teens without their child present to prevent any perception on the teen’s part that the evaluation is biased towards either the parents’ or the child’s point of view. I usually begin with parents and the teen in the room to gather concerns and to obtain medical, family and past treatment history. I then will ask the parents to wait in the waiting room while I talk with the teen alone for the remainder of the hour.
The second consultation, usually 45 minutes in length, is spent initially with the teen completing the mental status evaluation, and then with the parents alone to talk about their concerns and treatment plan. We then bring the teen back in at the end to talk about implementing a treatment strategy.
My evaluation for adults usually consists of a single hour spent both gathering information about the problems and concerns that lead to the consultation, as well as all history gathering and treatment decision planning. On occasion longer periods of time are needed for more complex situations, but the majority of adult consultations are completed in one hour.
I do not automatically prepare a written summary or evaluation report for diagnostic assessments; however I am happy to do so for any patient or family that requests one. There will be an additional fee based on the time it will take to prepare the letter or report.
If medical testing of any kind is indicated, I will give you a request slip that can be taken to a medical laboratory, your primary care physician or other type of testing facility for the indicated test. We do not do any direct blood drawing or urine testing here on the premises.
If psychological or neuropsychological testing is recommended, I can provide the names of doctors in this office, or outside of this practice who can do this for you. My preference is to have the testing done by a psychologist whose work I know and trust from past experience. If a Ph.D. in this office does the testing, it can almost always be done faster as I can get to them more quickly for scheduling, give more specific information for questioning, and get the results sooner from in house testers than those outside the practice. Verbal reports can sometimes be obtained within 12 to 24 hours of the test completion, allowing rapid use of the information in the testing even before the written report has been prepared.
written by Peter H.Robbins, M.D.