Question about Psychiatrists

Discussion in 'General Parenting' started by Sunshine1966, Sep 7, 2009.

  1. Sunshine1966

    Sunshine1966 New Member

    My son, 6 years old, is diagnosed with ADHD and ODD. He takes Focalin XR 15 mg in the morning and 7.5 mg around 4 pm. The Focalin actually makes a big difference especially with school. He's able to work with a paraeducator and learn things, at least he's had some social success in handling the workings of being in school, standing in lines, etc.

    He's been seeing a psychiatrist for about 3 1/2 years now - he's been on several other medications that weren't right for one reason or another.

    I just feel like with our psychiatrist that he wants to give a medication and that's it. He usually measures his weight and periodically his height since he has a very poor appetite on Focalin. I cannot recall him ever taking his pulse or blood pressure. I know that these drugs can affect that and I'm wondering if I should be concerned that its not checked at the office or am I overreacting?

    When I read the explanation of ODD and the criteria that has to be met I was overwhelmed with how much of that my son exhibits! All the time, every day is a constant battle. It wasn't until recently that I began to realize that the ODD wasn't just not wanting to do what you wanted. At this point, my son will ask me a question and I'll answer with the correct answer. His reply is always, "no Mom, what about this or that?" He can't possibly ever, ever agree with the reply he's gotten. The opposition comes out of him no matter what, no matter who, etc.

    Its so difficult to see him in such emotional frustration all the time. If I could give him anything it would be peace. I feel like he doesn't have alot of that in his spirit. He does have good times, loves to be tickled, is very compassionate with people and caring. But, when the bad times roll they roll big and its difficult to get past that.

    Thanks for any input you can give me!
  2. Fran

    Fran Former desparate mom

    Psychiatrists don't usually deal with the therapy end of our kids. Our experience with pediatric psychiatrists really was from the diagnosing end of the treatment plan and making suggestions for other therapies. They monitored our son but it wasn't until the hospital that I saw the doctor really be the head of the team that is required for kids with behavior problems of many or any etiology.
    My son spends 15 min every 3 months with his psychiatrist at present. Of course he is an adult and more feedback regarding what difficult child needs is easier to get.

    I guess I would want more intervention and input in how to redirect my son to grow away from the negative behaviors and how to teach him to develop better life skills. Maybe your doctor can help you find how to do that or where to go to help your son with those issues.
  3. smallworld

    smallworld Moderator

    We happen to be lucky to live near a large city where child psychiatrists practice integrated care -- medication managements AND weekly psychotherapy. So each of my three children sees a child psychiatrist for 50 minutes of weekly therapy, where they are learning to cope with their strong emotions. That psychiatrist also prescribes their medications. But I am told this is the exception, not the rule.

    I agree with Fran that if your son's psychiatrist is not performing this function, then it is time to bring someone on to the team to help your son learn coping skills. I strongly believe that medications alone do not solve the problems. If a child is on medications, he should also be in therapy. The two should go hand-in-hand.

    Good luck.
  4. compassion

    compassion Member

    Currenlty, my daughter is seeing psychiatrist every 2 months for medications. We also have a familytherapist, pyschcologist(see twice a week) and behavior analyst on our team. My daughter is not participating but we are. We do insist that she see the psychiatrist. Comapssion
  5. timer lady

    timer lady Queen of Hearts

    My tweedles see psychiatrist 30 - 45 minutes every 2 months; psychiatrist checks weight & if they complain of any other issues, will do a quick neuro exam, BiPolar (BP) & pulse. The rest of the time is some therapy & discussing how they can work on controlling their conditions. (It wasn't that way until they hit 14 or so)

    kt & wm also see a therapist on a weekly basis with a lot of in home services.

    Having said that, this isn't the norm either. Before we started with this psychiatrist (6 yrs ago) it was all medication management, no involvement in treatment team or plan.

    Having adopted your difficult child out of foster care have you looked for add'l services for him. Integrated Listening Systems (ILS) workers to help with daily social skills & behavioral intervention. PCAs to help with ADLs so it isn't such a fight? Might want to check into it.
  6. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    I've been seeing psychiatrists since 1977. They really haven't changed all that much. A good one will do intensive evaluating and medication management and use a colleague for therapy. At this point in time, having been correctly diagnosed, my GP just gives me the medications and I see a therapist of my choosing. Psychiatrists are mainly doctors who try hard to figure out the elusive puzzles of brain disorders. I actually think NeuroPsychs do much better diagnosing--I've been to them (and so has my son and daughter) as well. At this point, I feel most psychiatrists are the "drug givers." I lived near Chicago by sensational therapeutic universities and got great help and I still feel this way. You really need more than just a psychiatrist for all around treatment and a stellar diagnosis. JMO :tongue:
  7. Christy

    Christy New Member

    These days a psychiatrist who does therapy is rare. It all comes down to money and is driven by insurance companies. Paying a therapist is cheaper that paying a psychiatrist so many psychiatrists do not have the opportunity to do more than answer a few quick questions and write prescriptions. Ask your psychiatrist to recommend a therapist preferably someone who works in the same practice.
  8. Sunshine1966

    Sunshine1966 New Member

    Thanks so much to all of you for your input! I haven't been on here in a long time and I feel like I've come home when I read all of the posts! Its great to be in a place where I know that others feel my same pain and frustration.

    I will definitely look into therapy for him. I know that when we first adopted him they allowed him 6 counseling visits a year but that was back when there wasn't much trouble at all. I need to apply for more help because I know its available.

    Thanks so much!
  9. TerryJ2

    TerryJ2 Well-Known Member

    I agree with-the others. Smallworld's experience is unusual. Most psychiatrists figure out the diagnosis (or in our case, are told the diagnosis by another dr) and simply prescribe medications. They very seldom practice medicine in the conventional sense, and unless they advertise as being Jungian or something, they don't do any therapy at all.
    We also use a regular pediatrician and a child psychologist. I make sure they all have access to the others' records for my son.
    You are learning the hard way. :)
    You have to be your own advocate.
    Right now, Obsessive Compulsive Disorder (OCD) and ODD are only symptoms, in my humble opinion. I think you will end up with-a better diagnosis along the way, but you may have to change doctors.
    Which medications did NOT work? And what were the effects? Those can give you huge clues as to what the underlying diagnosis is.
  10. Nomad

    Nomad Guest

    Some psychiatrists are better for therapy than others. Obviously, if your child is on psychiatric medication, he or she will need to see a psychiatrist at regular intervals during the year.

    Many feel an ideal approach is to see a psychiatrist for medication needs and a psychologist or other licensed mental health professional for traditional therapy.

    Additionally, depending on the circumstances, sometimes family therapy is appropriate or might be helpful as an add-on to traditional therapy (usually weekly).

    I agree, if your child is adopted, check into adoption aftercare services...and see if you might be entitled to additional funding for mental health services.

    Wishing you well.
  11. Christy

    Christy New Member

    My son is also adopted from fostercare. One of the best things we did was keep his medical assistance along with our private insurance. It has been a godsend when it comes to covering prescriptions and hospitalizations. If you son qualifies as a special needs adoption then you should be entitled to medical assistance which should cover the therapy appointments.
  12. totoro

    totoro Mom? What's a GFG?

    I agree with the others.
    Our psychiatrist asks us how long we would like to make the apt for after each visit.
    We usually go for 1 hour.
    15 minutes for K
    15 minutes for family
    30 minutes just husband and I
    She checks K's height and weight each time.

    We go over everything each time. If things were ever fine (LOL) we would slow down and shorten the Apt's. We see her once a month, but will be seeing her every 2 weeks now.

    We also see a therapist who has her Doctorate once a week, for an hour.

    If the insurance company tries to say you maxed out on your visits a lot of time you can claim a chronic condition to receive extended or unlimited visits.

    Good luck, I would at least want to see a therapist. A lot of times they will make suggestions and let you know if they agree with your psychiatrist.
  13. TerryJ2

    TerryJ2 Well-Known Member

    If the insurance company tries to say you maxed out on your visits a lot of time you can claim a chronic condition to receive extended or unlimited visits.

    True, and sometimes the dr's ofc can get the ins reinstated every 6 wks or so. They just re-file it. I don't know if it's given the same code or not, but the staff has always been good about making sure our coverage isn't dropped. You have to learn to jump through hoops.
  14. totoro

    totoro Mom? What's a GFG?

    Hoops and hurdles and mountains!