Dr. David Palmiter's Blog for Hectic Parents

I find that many parents have little idea what to expect when taking their child or teen for mental health services. In my last blog, I described elements of a good mental health evaluation for a child or teen. In this entry I will describe elements of quality outpatient mental health treatment. (Please keep in mind that some of these elements may not be present in your child’s or teen’s care but s/he may still be receiving good treatment.)

√ A diagnostic impression is shared. The insurance company is usually getting this information, so you should too. More importantly, having these words allows you the opportunity to educate yourself about the condition(s).

√ The clinician has discussed how he or she arrived at the diagnostic formulation and the the primary scientific findings pertaining to such (e.g., causes, prevalence, outcomes).

√  The clinician shares specific information regarding which treatment(s) is/are   recommended. This should include giving you the name of what each treatment is called; again, this allows you to educate yourself about the science behind the intervention. The clinician also does well to include, in instances when more than one intervention is recommended, which intervention is treating which problem or diagnosis; a discussion of the prognosis is also usually advisable.

√ The clinician endeavors to answer all of your questions, either at the time that you ask or later, including telling you when the available science does not allow a question to be answered well or thoroughly.

√ The clinician develops measurable treatment goals in collaboration with you and/or your child or teen. These goals need not be (and usually are not) a comprehensive listing of what will be worked on. But, they include signposts that help you to know (1) if the treatment is working and (2) when you are done.

√ The clinician is comfortable with, and even encourages, you and your child or teen to express differences of opinion regarding what s/he is stating or recommending.

√ The clinician follows the agreed upon treatment plan and doesn’t make changes without getting your informed consent.

√ The clinician tracks progress, keeps scheduled appointments, doesn’t take phone calls or check his or her phone during the appointment (unless you’ve agreed to an exception), meets the entire time, remains both pleasant and alert and gives you sufficient notice of any extended vacations or breaks from treatment.

√ You get the sense that the clinician cares about your child or teen and his or her success.

√ You are kept informed about progress. While the clinician may not share information that your child or teen wishes to keep confidential, s/he should keep you informed in general terms. If the treatment is behavioral in focus, it is also commonly recommended to teach you how to coach and reinforce the skills your child or teen is learning.

√ If there are problems at school, the clinician should be available to collaborate with school personnel; sometimes this may warrant attending an in-person meeting at the school.

√ The clinician may recommend things you can do to augment the work (e.g., read a book, attend a support group meeting).

√ The clinician is not shy about bringing up sensitive topics, including if s/he believes that your getting mental health care for yourself could be helpful.

√ Appointments are scheduled at a pace that is consistent with how the treatment is usually prescribed (something you can easily learn yourself with a little leg work).

√ While your insurance company may dictate what is covered and what isn’t, you should never get the sense that the insurance company is dictating what is diagnosed or what treatment(s) is/are being recommended.

Good luck! To find a clinician near you, click here.