Adolescent Psychiatry

Adolescent psychiatry deals with the diagnosis and treatment of mental health issues in adolescent children. In general, psychiatrists who treat adolescents also treat children and are said to be child and adolescent psychiatrists. In other cases, they are psychiatrists who treat adults but have a subspecialty of treating adolescents. The adolescent psychiatrist evaluates and treats disorders of behavior, feeling and thinking in adolescents.

Adolescent psychiatry is practiced by licensed physicians who have full psychiatric training. In addition to general psychiatric training, the adolescent psychiatrist receives two extra years of advanced training in the diagnosis and treatment of children, adolescents and their families. In the United States, after passing a national exam with the American Board of Psychiatry and Neurology, child and adolescent psychiatrists are board certified in the specialty of child and adolescent psychiatry. Adolescent psychiatrists are able to offer a complete medical psychiatric assessment as well as any necessary interventions or treatments for behavioral and emotional problems and psychiatric disorders. Because adolescent psychiatrists are physicians, they can prescribe medication and monitor its usage and effects.

In treating adolescents, the psychiatrist draws on knowledge of various psychological, social and biological aspects of adolescence to work with patients. The first meeting of psychiatrist and potential adolescent patient involves an evaluation to determine the nature of the complaint, paying attention to all components: social, cognitive, emotional, developmental, genetic, physical, educational, family and peer. A picture of the patient begins to develop, and the psychiatrist can offer a diagnosis and propose a treatment plan. The diagnosis is shared with the patient and the patient's family. The psychiatrist discusses the proposed treatment plan with the adolescent and his or her family.

The most effective approach to treatment is one that integrates numerous resources such as psychotherapy at the individual, group and family levels, consultation with other professionals and medication. The adolescent psychiatrist also serves as an advocate for the patient, making sure the best interests of the adolescent are served. A psychiatrist may be called in to consult with teachers, social agencies or juvenile courts, for instance.

The adolescent psychiatrist has received special training in the identification and treatment of disorders that affect adolescents. Such disorders include drug dependency and delinquency, mood disorders, depression and anxiety disorders and attention-deficit hyperactivity disorder (ADHD). The special training undertaken by the adolescent psychiatry trainee involves taking an active part in consulting with other professionals in the field.

Treating adolescents and their families in varied settings is also part of the training. By working in the field, adolescent psychiatrists hone their psychiatric skills and gain a measure of experience. However, the learning process is never really complete. Adolescent psychiatrists must keep up with advances by reading the newest psychiatric literature and attending periodic psychiatric conferences. As psychiatrists learn, they apply the new knowledge to their work.

Adolescent psychiatrists can help the families of adolescents determine whether the behavior of their children falls within the range of normalcy. Parental input is important here, since the parent can offer information regarding the earlier health and behavior of the teen patient. Part of the assessment includes evaluating the relationship between teen patients and their families. A teen is probably normal if he or she enjoys and participates in school or work, gets along with family members, sustains friendships and sets aside time for and takes pleasure in age-appropriate leisure activities.

When parents first become concerned about the behavior of a child, they may speak to a relative, friend, school counselor, pediatrician or clergyman. At this point, the family may be told to seek an evaluation of the teen by an adolescent psychiatrist. The psychiatrist listens to all that is said by parents and child and attempts to look at long- and short-term factors that may help or further exacerbate the problem. The psychiatrist also looks for any contributory factors that may cause the problem to persist. The medical history of the child is evaluated to see whether there is a medical condition that impacts the problem. School performance is examined as is the teen's social and emotional development within the context of the school environment.

When the evaluation is complete, the adolescent psychiatrist may reassure parents that the teen's behavior is normal while offering advice on effective parenting. Sometimes the psychiatrist will suggest some type of program or activity for parents or adolescents that can help to enhance normal development. At other times, an adolescent and/or the parents may need a brief period of counseling to assist with minor developmental issues, temporary stress or other difficulties that may stem from the individual temperament of the adolescent. If an adolescent psychiatric disorder is revealed during the course of the psychiatrist's evaluation, the psychiatrist will outline the recommended course of treatment.

Adolescent Psychiatry: Selected full-text books and articles

The Adolescent in Turmoil By Allan Z. Schwartzberg Praeger, 1998
Adolescent Breakdown and Beyond By Moses Laufer Karnac Books, 1997
The Interpersonal Theory of Psychiatry By Harry Stack Sullivan; Helen Swick Perry; Mary Ladd Gawel W. W. Norton, 1953
Librarian's tip: Chap. 15 "The Juvenile Era," Chap. 17 "Early Adolescence," and Chap. 18 "Late Adolescence"
Assessment of Mode of Anger Expression in Adolescent Psychiatric Inpatients By Cautin, Robin L.; Overholser, James C.; Goetz, Patricia Adolescence, Vol. 36, No. 141, Spring 2001
Is Electroconvulsive Therapy Unsuitable for Children and Adolescents? By Baldwin, Steve; Jones, Yvonne Adolescence, Vol. 33, No. 131, Fall 1998
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