Parenting for Prevention: Getting Professional Help
PART 1: Parenting Styles
PART 2: Communication
PART 3: Lessons from School
PART 4: Discipline
PART 5: Normal Development
PART 6: Substance Use and Abuse
PART 7: Identifying the Problem
PART 8: Getting Professional Help
PROFESSIONALS, THERAPY, AND HOSPITALIZATION
HOW TO KNOW WHEN YOUR ADOLESCENT NEEDS HELP
INSURANCE (For counseling or hospitalization)
SUGGESTIONS FOR COPING WITH THE SYSTEM
SUGGESTIONS FOR COPING WITH THE CHILD
SUGGESTIONS FOR COPING WITHIN THE FAMILY
PROFESSIONALS, THERAPY, AND HOSPITALIZATION
There are many professionals available to evaluate and provide treatment for those in need. Each one has different qualifications and skills, so it is important that you are aware of what different professionals do in order to get the best care possible for your teen.
This section has a list of different professionals, their qualifications, and options that you have when choosing a therapist. It is also possible that your decision in choosing a therapist or hospital may depend on whether or not your insurance will cover the therapy and/or hospitalization, so there is a list of questions you can ask your insurance representative to find out which professionals and services qualify for coverage. There is also a list of the rights you have while working with a therapist. Being and staying informed is the first step toward treatment, no matter what the ailment.
HOW TO KNOW WHEN YOUR ADOLESCENT NEEDS HELP
Deciding if your child is in need of psychiatric or other help can be a very difficult thing to do. It is important to find out what other people who know your child think; get input from your child’s teachers, your friends, and other family members.
Children develop at a rapid rate, but in different ways (see Normal Development), and it is possible that your child’s actions are within that gray area of normal development that makes a decision difficult. If you are not sure that your teen needs professional help, use the following list to help you decide if you need to have your child professionally evaluated. Signs that it is time to get help:
- Teachers, child care providers, or other parents are reporting problems, and/or inappropriate behavior.
- Your child is not getting along with other children, or is socializing with others who are in trouble.
- Your family is experiencing constant conflict.
- Your child is excessively withdrawn or aggressive.
- Your child’s personal habits have changed significantly or are not appropriate to the child’s age (sleeping, eating, hygiene, clothing, etc.).
- You are aware of repeated high risk behavior which is harmful to them, such as cutting self and/or pulling hair.
- Your child’s behavior or personality has changed dramatically.
- Your child is saying things like: “I wish I were dead,” “I wish I’d never been born,” “You’d be better off without me.”
- Your child is unable or unwilling to discuss these problems with you.
No matter what, if you are still seriously concerned about your child’s behavior, seek help.
Child Psychiatrists have specialized training in working with children and adolescents who have psychiatric disorders.
Counselors have a Master’s Degree (M.A.) in counseling with one or two years in an accredited graduate school counseling program. There are two levels of licensing.
LCPC (Licensed Clinical Professional Counselor) is a person licensed to practice independently.
LPC (Licensed Professional Counselor) is someone who is licensed to practice, but requires supervision within their agency.
Neurologists are physicians who specialize in the nervous system and the treatment of related disorders.
Neuropsychiatrists specialize in the study and treatment of nervous and mental diseases to minimize the effects of brain injury. They often work with schools, employers, and the families of injured people.
Pastoral Counselors have a degree from a seminary or rabbinical school. Although counseling is not usually their main occupation, many have some limited training in counseling, and some have degrees in pastoral counseling.
Psychiatric Nurses have a degree in nursing (B.S.N. or M.S.), specializing in psychotherapy and psychiatric hospitalization.
Psychiatrists are physicians who assess, diagnose, and prescribe medications and treatment.
Psychologists usually have a doctoral degree in psychology. They do testing, make evaluations, and provide therapy. They do not, and cannot, prescribe medications.
Psychotherapist is a general term that can be used by anyone. Request specific background and credentials when interviewing a psychotherapist.
Social Workers are people educated to work with individuals and families to identify problems through the study of family/social histories, they identify needs and make referrals. Master’s level social workers may also provide therapy.
Physicians, psychiatrists, psychologists, social workers, and psychiatric nurses are licensed by the state, which means they must meet certain educational and training requirements. These professionals and others also belong to professional associations requiring education and training credentials for membership.
State Regulation: The Illinois Department of Professional Regulation provides lists and rosters of state-licensed medical doctors, psychologists, and social workers.
320 W. Washington
Springfield, IL 62768
Phone: (217) 785-0800
Illinois Psychological Association (IPA): The Association has a Psychologist Finder Service and a list of members. Members of the Illinois Psychological Association are licensed by the state and have met the educational and recommended requirements required by the Association.
203 N. Wabash, Suite 2106
Chicago, IL 60601
Phone: (312) 372-7610
Illinois Association for Marriage and Family Therapy (IAMFT): Clinical members of IAMFT have met its education, experience, and supervision requirements. For a free copy of IAMFT’s statewide directory, or for referrals, you can contact them.
2021 Midwest Road
Oak Brook, IL 60521
Phone: (630) 260-9010
You can contact other professional associations as well for referrals and questions about the credentials of a specific professional. These associations are: American Psychiatric Association, Illinois School Psychology Association, National Association of School Psychologists, or National Association Social Workers (NASW). Check your local listings for their phone numbers and/or addresses.
Selecting a therapist for your child is a highly personal matter. A professional who works very well with one individual may not be a good choice for another person. There are several ways to get referrals of qualified therapists, including the following:
- Check with your insurance company for limitations (see the section on Insurance).
- Talk to close family members and friends for their recommendations, especially if they have had a good experience with therapy.
- Many state psychological associations operate referral services which put individuals in touch with licensed and competent mental health providers. Call the American Psychological Association’s Practice Directorate at 202-336-5800 for the name and phone number of the appropriate state organization.
- Ask your child’s primary care physician for a referral. Tell the doctor what is important to you in choosing a therapist so he or she can make appropriate recommendations.
- Inquire at your church, synagogue, or place of worship.
- Look in the phone book for the listing of a local mental health association or community mental health center and check these sources for possible referrals.
- Look in the resource sections of this directory.
Ideally, you will end up with more than one therapist to interview. Call each one and request to ask the therapist some questions, either by phone or in person. You may want to inquire about his or her licensing, level of training, their approach to therapy, and participation in insurance plans and fees. Such a discussion should help you sort through your options and choose someone with whom you believe you and your teen might interact well.
Family Therapy - Family therapy focuses on treating the family as a unit. The family members usually meet with a therapist to learn how to better understand each other’s viewpoint and focus on learning/strengthening healthy family dynamics. Family therapy can provide a way for the therapist to offer the family needed support and understanding in a time of crisis.
Group Therapy - Group therapy focuses on learning from the experiences of others. Your child can check out his perceptions by comparing them against the perceptions of his/her peers, but in order for this type of therapy to be successful, your child has to be able to experience some pressure without undue distress.
Individual Therapy - This form of treatment involves regularly scheduled sessions between your child and a therapist. The aim is for your child to learn more about himself/herself by sharing thoughts and feelings with a trained, understanding, and experienced therapist.
Medication Therapy - Medications are often used as part of the treatment for identified disorders. If your child is prescribed any medication, be sure he/she is monitored by a physician who is an expert, such as a general psychiatrist or a child and adolescent psychiatrist. Only a physician or psychiatrist can prescribe medication.
Self-Help Groups - Self-help groups are usually not led by a professional therapist, but the groups can be very helpful because the members provide mutual support and comfort to one another as the members face common problems.
After choosing or being referred to a therapist/counselor, you will set up a schedule or treatment plan for your teen, and possibly the family as well. In working with the therapist, you and your child have the right:
- To ask questions at any point.
- To refuse any intervention or treatment strategy.
- To be fully informed regarding fees for therapy and methods of payment, including insurance reimbursement.
- To be fully informed regarding the therapist’s estimation of approximate length of therapy to meet your agreed-upon goals.
- To discuss any aspect of your therapy with others outside of the therapy situation, including consulting with another therapist.
- To refuse to answer any questions.
- To review the progress of the therapy.
- To terminate therapy at any time.
- To be fully informed of the therapist’s qualifications to practice, including training and credentials, years of experience, and so forth.
- To be fully informed of any diagnosis (if the therapist uses one).
- To be fully informed of the limits of confidentiality in the therapy setting and under what circumstances the therapist may discuss the case.
It may be necessary to hospitalize your child for crisis stabilization when circumstances are such that he/she is a danger to himself or others. To determine if this is necessary, you will need to consult a psychiatrist. Upon admission, you will be asked for information about your child’s development, present problems, and about your family. This will be the beginning of a formal and thorough assessment that will be completed by the treatment team.
A mental health treatment team is made up of a combination of professionals who are collaborating on your child’s treatment, making evaluations, and should include the client and family members.
On the basis of an evaluation, recommendations will be made for the treatment of your child while he/she is in the hospital and after he/she leaves. You have the right to review and agree to or reject any of these recommendations.
During admission, find out who your primary contact person will be, when the doctor will see your child, and when you can meet with your contact person to discuss treatment recommendations.
Remember that no medication can be administered to your child until you have been fully informed of its purpose, side effects, other options, and have given permission.
Upon discharge from the hospital, your child may go directly home with you. You and the hospital treatment team will have worked out a follow-up plan such as:
- Partial hospitalization - an extensive full day therapeutic program with the child returning home in the evening.
- Intensive Outpatient Program (I.O.P.) - usually three hours a day after school.
- Therapy - weekly individual, group, and/or family therapy.
- Regular visits to the psychiatrist to monitor medication
- Special school program
Recommendations may also include specialized services to support your child and family. Many of these services are available in the community, such as SASS, Wraparound, Respite, Case Management, or ICG.
It may be possible that your child will not be ready to return to your home at the time of discharge from the hospital. The treatment team may recommend residential placement, which is a setting where structure, supervision, education, and treatment are provided in a live-in treatment center. Like hospitals, these facilities vary in scope and quality. Each state has regulations concerning the licensing of the professionals that work in the facilities. It is important for the center to be close enough to your home so you can visit easily, and the people in charge should also know about your child’s physical and psychiatric condition, recognize and use his/her strengths, know his/her treatment plan, and monitor the effects of his/her medication.
If residential treatment is recommended, be sure to ask about funding. It is possible that the responsibility for funding may lie with a state agency or your local school district. In any case, you will be asked to help out to the extent that you are able.
When your child is taking medications, you should know:
- What time your child should take his/her medication.
- How your child should take it (before eating, with meals, or after).
- What food, drinks, or activities to avoid.
- Whether or not your child can take over the counter or prescribed medications for any other ailments (colds, fever, ear infections, sore throat, etc.).
Also, ALWAYS REMEMBER the following:
Ask your physician what kind of behavior to expect from your child when he/she is on the medication, what kind of side effects to watch for, and whom to call if there are any problems related to the medication. Some rules to follow when your child requires medication are:
- Medications should only be given to the child for whom it was prescribed, and never to any other member of the family.
- Always lock up you child’s medication, and make sure other children do not have access.
- Adults should always supervise the administration of children’s medication.
- Inform your doctor of any other medication your child is receiving from other doctors, and also inform the doctor of any allergic reactions your child might have to medications.
- If your child needs to take medication during school hours, inform the school nurse and ask your doctor to sign a permission slip to allow them to administer the medication at school.
- Your child needs to be monitored regularly by their doctor while on medication regarding its use, adjustment in medication dosage, need for blood tests, and other tests if needed.
- Adolescents should be educated about medication by experts.
- Children should have professional and family support while on medication.
- If medication is going to be given by others (babysitters, relatives, friends, etc) while you are out of town, make sure they have written instructions as to when to give the medication, side effects to look for, and your doctor’s phone number in case of an emergency.
INSURANCE(For counseling or hospitalization)
It is important to be aware of your insurance coverage and the process to initiate services. In a crisis situation in which hospitalization is required, the crisis workers or facility will assist you in the area of insurance coverage. In the case of outpatient mental health and substance abuse services, it is necessary to follow a structured, thorough process. Some suggestions on what to do when you call your insurance company are:
- Ask and write down the name of the person with whom you are speaking.
- Explain that you are requesting information regarding hospitalization or outpatient mental health benefits. The insurance representative will ask you the reason for seeking counseling. Use common outpatient symptoms, e.g., depression, anxiety, stress, family counseling, substance abuse. Some services (marital, DUI, etc) may not be covered, so it is important to focus on your symptoms.
- Ask if your company requires pre-certification/authorization, and if so, what is the process.
- The insurance company may have the names of specific therapists or they will give you certain degrees or licensing accepted on your insurance plan (MA, LSW, LCSW, LCPC, Med, Psy. D, Ph.D, MD, DO, etc).
- Ask what happens if you want your child to see someone not on their list.
- Ask how many sessions will be authorized and if there is an authorization number.
- Ask if there is a deductible and whether or not you have already met it. Also, ask if there is a co-pay, whether the co-pay applies before or after the deductible has been met, and what the co-pay is.
- Ask if there is anything you can do if you are unhappy with the provider of care.
REMEMBER: Bring your insurance card and/or insurance/managed care information with you to the appointment.
SUGGESTIONS FOR COPING WITH THE SYSTEM
Families need to know how to be effective in getting help. You need to know what questions to ask, which people to see, and especially where to go for help when you feel overwhelmed and discouraged. Here are some suggestions:
- Try to keep a record of everything. Names, addresses, phone numbers, dates or crisis events, admission to hospitals, dates of discharge, etc Make notes of conversations and conferences, make copies of everything you mail, and keep all notices and letters that you receive.
- Be polite and keep conversations to the point. Do not allow yourself to be intimidated, and do not try to intimidate the service providers. Sometimes it helps to have a friend or someone with you.
- Write letters of appreciation when warranted, and write letters of criticism when necessary. Give suggestions and ideas for improvement if you can.
- Do not accept a vague answer or a statement which seems confusing.
- If you are not getting the responses you need, contact the administrator of the agency. If you have private insurance, call your insurance company. You may also make a formal complaint to the licensing agency for that profession.
- Do not be afraid to acknowledge that you need help in dealing with the situation. This is the first step in removing the stigma often attached to these common problems.
- Network with other families facing the same or comparable challenges, and ask your social service providers for area support networks for families.
- Finally, be assertive! You are paying, either directly or through taxes, and are entitled to information, respect and courtesy.
SUGGESTIONS FOR COPING WITH THE CHILD
- Try to work out a plan with the therapist or psychiatrist for the family/school to follow when the child is acting out or displaying problem behaviors.
- Learn to recognize signs, such as changes in sleeping or eating habits, withdrawal, etc. The child may be able to identify early signals of distress and may also be able to tell you what method he or she has used successfully in the past to gain control of symptoms and to relieve stress. A visit to a psychiatrist may help prevent a full-blown crisis, particularly when the child needs an adjustment of medication.
- Anticipate troublesome situations. If your child cannot handle large family gatherings, find someone to stay with the child while the rest of the family attends.
- Do not agree to stop medications because you believe the condition is “cured” or because your child says the medication makes them sick. Confer with the doctor who prescribed the medication.
- Avoid pampering. Set reasonable rules and limits and stick to them. If you find this difficult to do, ask the child’s doctor or a counselor to help you do this.
- Do not suggest that the child “pull himself/herself together.” If he/she could, they would, but not being able to do so is part of the illness. Focus on what is accomplished, rather than what is not accomplished.
- The child may be over stimulated by emotion laden communications, so keep levels of expressed emotion to a reasonable minimum.
- At times the child may suffer from memory loss or inability to concentrate. Though this is frustrating, do not insist that the child try harder to concentrate. Just repeat the information in a non-judgmental way.
- Reassurance and expression of your support can also help the child to feel hopeful and positive about the future.
SUGGESTIONS FOR COPING WITHIN THE FAMILY
It is natural to feel resentment regarding some of the behaviors of the child. Realizing that he/she is ill does not always overcome the hurt, anger, frustration, or dismay felt by the family. Guilt is also a natural and common feeling even though the family did not cause the illness. Remember, mental illness is a no-fault disease. Those who care about the mentally ill person need to focus on the future and on what can be done to improve the situation. Keep the following in mind:
- Avoid placing blame and guilt.
- Seek the support, understanding, and relief you need. Remember, you must keep yourself healthy and able to cope because you, the family member, are the one most able to pursue the needed services for your loved one.
- Continue your own outside interests.
- Schedule time for yourself.
- Remember, other family members are also affected, and they probably are experiencing denial, guilt, and depression just as you may be. Keep communication open by talking with them about these feelings.
- Learn all you can about the illness and make such information available to all of the family, including the ill member.
- You may be concerned about your child being labeled. While some psychiatric disorders are not curable, they are treatable. You may feel good telling your friends and relatives, “Yes, my child did have a significant problem, but we got the needed medical treatment. Our child and family are now stronger because of it.”
- Find out about benefits and support systems when things are going well; don’t wait for a crisis.
Video
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