Child and adolescent psychiatrists should be broadly trained clinicians able to address a variety of somatic, psychologic, and social needs of the patient and family. Their approach should combine the caution and competence required of a physician treating an individual patient with a broad concern for that patients development in the context of family, school, and society. This textbook provides an overview of child and adolescent psychiatric practice while focusing on the more common areas of clinical practice.
As such, it should serve the established practitioner as a rapid and accessible introduction to unfamiliar areas by taking into account the ever-expanding breadth of clinical practice. For general readers or students in professions other than medicine, this book will serve as an introduction both to the assessment and management of some commonly encountered clinical entities and to the range and standards of practice expected of a contemporary child and adolescent psychiatrist. There are currently about 6000 child psychiatrists in some sort of clinical practice in the United States, whereas there are between 7 and 12 million children with psychiatric illnesses, as identified by DSM-IVTR criteria [1,2].
Most of these children will not see a child and adolescent psychiatrist and, in many instances, the parents, teachers, and other professionals attempting to serve them may be unaware of the contribution that child and adolescent psychiatry can make to the child’s care.
The traditional roles of child and adolescent psychiatrists are those of diagnostician, therapist, and consultant. First, child and adolescent psychiatrists should offer a child and family a comprehensive diagnostic assessment that addresses the medical condition of the child; delineates the child’s emotional, cognitive, social, and linguistic development; and identifies the nature of the child’s relationship with his or her family, school, and social milieu.
Second, child and adolescent psychiatrists, like all physicians, treat illnesses, bringing to bear an armamentarium of somatic treatments and the more traditional skills of individual, family, and group psychotherapists. Because of the breadth of training they receive, child and adolescent psychiatrists should have special skill in appreciating the interaction among these therapies and their effects on one another and on the child and family.
Finally, in many cases, child and adolescent psychiatrists will serve as consultants.
This role is more developed in our specialty than in most other areas of medicine because of the constant disproportion between the number of patients and the number of clinicians. Inevitably, we consult and collaborate with parents, educators, and other professionals who may see the child and family more frequently and intensively than we do; because of the breadth of our training, we should offer a special competence in coordinating these efforts.
Concurrent with this role, we often must serve as advocates for children and their families in today’s environment of great clinical needs and comparatively limited resources.
List of Contributors
- Section I The Fundamentals of Child and Adolescent Psychiatric Practice
- Section II Common Child and Adolescent Psychiatric Disorders
- Section III Developmental Disorders
- Section IV Special Problems in Child and Adolescent Psychiatry
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Free download book Clinical Child Psychiatry, Editors William M. Klykylo and Jerald L. Kay – Second Edition