therapist making referral to psychiatrist

[Andy]

The pediatrician talked to the therapist and they decided that therapist can make this referral. Why does it matter? I will ask therapist what this means when we go there next week.

So, therapist will sign the forms today. The forms will be given to the insurance people and someone will call me to set up the appointment if insurance is approved.

Why does this have to be so complicated?

Do I understand correctly that therapist would continue with his visits and psychiatrist will cover other areas - maybe explore possibility of some more diagnoses? difficult child is doing awesome but when his anxiety hits hard and strong like this last two weeks, I sometimes wonder if it is more than anxiety. I know some of you have mentioned possible Obsessive Compulsive Disorder (OCD).

 

[Janna]

The last agency we dealt with, their rules were to see psychiatrist for medications, you MUST have therapy with therapist as well. Their idea behind this rule is because if your child is on psychiatric medications, they need counseling or some type of therapy behind that.

Really, it's a good thought. medications, alone, never "cure" or really fix anything. Especially with kids when the medications constantly change, don't work, puberty hits, etc.

I never had a problem with it. Maybe therapist can help to figure out what's triggering some of the anxiety, help difficult child learn how to deal with that. psychiatrists don't typically take the time to do all that, yanno?

Glad you got the referral.

 

[Andy]

Thank you Janna - That is what I was thinking - needed it verified.

So, what exactly does psychiatrist do to determine which medications are needed? Does he give some evaluations to try to figure out what all is going on?

Funny, I feel so good to be able to do this but still do not understand it all.

When I called for the referral, the nurse asked if there was something the pediatrian could work with us and prescribe. He is tops in his field and can prescribe many of the medications that may work for difficult child. I told her that I just felt like we needed to see someone actually working in the child psychiatrict field for more options.

I have no idea if I am messing up here - just going with what feels right.

 

[Wiped Out]

Andy,
I think seeing the psychiatrist is a good idea. As to what medications, it probably depends on the psychiatrist. difficult child's psychiatrist meets with us, talks with us and decides what medications to try. easy child's psychiatrist listened to the symptoms, talke with easy child and me and decided what to prescribe. I also know that easy child's therapist conferred with the psychiatrist and thought maybe a mood stabilizer was needed. That will be our next step if the current doesn't work.

I hope you are able to get an appointment. soon! Hugs.

 

[Janna]

Every psychiatrist is different, Andy. So, I don't know what your psychiatrist will do to determine medications.

The *good* ones I've had - they have met with D for an initial evaluation (typically a 1 hr visit) to gather history, behaviors, maybe gather school information, etc. Whatever you have I'd bring with you, especially if you have something from the teacher(s), say, noting issues with anxiety.

Then, after that 1 hr evaluation, sometimes they may ask about medications, or wait until the 2nd visit (so they can watch D) to make a medication decision. Or, sometimes, they'll give me a couple of options for medications, and I'll go home, read up and then go back to make a final decision.

If you have medications in mind, I'd write them down and discuss them with psychiatrist. psychiatrist and therapist, if in the same agency, should probably discuss difficult child back and forth.

With J, he was so easy - he has ADHD, there's no question, I went in and asked for a stimulant and on he went LOL! I don't think he even had a full hour evaluation. But, that psychiatrist was already familiar with him from D - so it was easier.

You can take your time with this. I hope you get some answers, though.

 

[BusynMember]

Andy, I think your son probably has what I do---mood disorder spectrum. It includes depression, generalized anxiety disorder, panic disorder and Obsessive Compulsive Disorder (OCD) and they all need treatment. Your son is more like me as a child than any child I've read about here. I didn't even think there was another me .
Unfortunately, it doesn't go away on it's own. Mine just continued into adulthood when the paramedics knew me by name because I would call in the middle of the night thinking I had some horrible disease or because I thought I was losing my mind. They used to ask me about my kids...lol. It impacted my marriage too. I think he needs medication and cognitive behavioral therapy (read the book "Feeling Good" by Dr. David Burns). CBT helped me whereas other therapy did not. However, it didn't stop my need of medication, as much as I tried to deal without medications. The panic attacks could come on at any time and I'd be shopping with a half filled grocery cart and it would suddenly hit with no warning. I'd freak out, leave the store (and grocery cart), get into my car and my heart would be pounding while I sweat--and my brain was filled with fog. In THAT condition, I would speed home to my "safe place", blowing off red lights and almost getting myself and others killed. I had no control of my panic attacks without medications. At one point I couldn't leave the house at all (agoraphobia). Please be open minded about medications (not overmedicating him, but just some), and help him have a better life than I did. The degree of his anxiety and hypochondria reminds me of myself--and it is such a horrible way to live. You never know when it'll hit you, but when it does, it gets you good. (((Hugs))) to you and the little one that I feel such a kinship with. Bet he's a great kid too. I had the best heart myself.

 

[SearchingForRainbows]

Andy,

The group our difficult children go to works the same way as the last one Janna used. The psychiatrist prescribes the medications, the therapist provides the counseling. Also, like Sharon's (WO), experience, the therapist and psychiatrist are in contact with each other and with us.

I think things are handled like this where we live because their is a shortage of child psychiatrists. Plus, it is probably more cost effective for the therapist to do the counseling. In general, this arrangement has worked out well for us too.

Keeping my fingers crossed that your difficult child starts to do better soon... WFEN

 

[Andy]

Thank you all! Yes, difficult child is a very cool kid.

The psychiatrist and therapist work in the same hallway. therapist stated that psychiatrist was a friend of his so I know they will work very well together. I am sure that therapist and pediatrician doctor also work well together but for some reason, I am feeling that this is a stronger connection. Always good to have people working close to each other when there is a need to communicate. I think therapist and pediatrician doctor mainly communicated via therapist's reports where therapist and psychiatrist will actually have more times available to "discuss"?

Great news! I think I mentioned that the receptionist had stated April 17th as the earliest date for new patients. I got the call today and difficult child will be seen Thursday, March 26th! (also an indication that they work well together - I think therapist has already started the conversation and got difficult child in earlier). That is the end of next week! Wow!!! It does mean however that we do not see therapist before then. I was hoping to see him again before this all started to ask some more questions but onward and upward we go!!! We do get to see therapist on Friday so maybe I will have different questions.

difficult child went on the class trip today. husband met the group for the State Capital tour and said all the kids looked tired. difficult child told husband that he was scared. We will see if that means a melt down tonight and tommorrow!

I keep Midwest Mom's words close by to remind me that this goes deeper than is seen. Just because he seems to be doing well doesn't mean he is. Keep reminding me MM! Your input has given me strength.

Thank you all again! I will let you know how today went and what happens on Thursday.

 

[BusynMember]

Andy, your son is a great kid. He is NOT crazy. He is nervous. Nervous means he worries about his health, has panic attacks, probably ruminates over dumb things (I do that) and freaks out sometimes due to anxiety. He is a normal kid who is on "fight and flight" all the time. I have a really good book for you to read. Maybe you can help your boy learn to calm himself. The book really helped me. I hope I have the right authors. It's an older book, but I think it is still the best panic book I ever read. It's called "Don't Panic" by Wilson and Reid. I don't know their first names anymore. I would see if Amazon has it. It has really cool explanations of panic attacks--dissects them--and tells you how you can stop a panic attack in it's tracks. As a nervous ninny, it really did a lot of good for me. Your child is going to have a good life. They knew NOTHING about what I was going through way back in the dinosaur days , but they do understand now. And it sounds like your precious boy will be getting the best of help. So smile. He's going to be ok and one day he'll look back on this, as I do, and say, "Boy, was I nervous! I hope I can help somebody not go through what I did!" (((Hugs)))