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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Diane J. on April 7, 2001, at 21:52:24
My 10-year-old daughter takes Paxil, and it has helped her a great deal. She has a psychiatrist whom she sees every two months for "medication management." This doctor was not the one who originally prescribed the Paxil, but when my daughter's first psychiatrist relocated to another area of the state we began seeing this doctor.
What I was wondering is how often should my daughter see the psychiatrist? I have an uneasy feeling that Dr. R isn't really paying that much attention to her even when we do go in to see him. I realize Dr. R can only go on what we tell him. but still, he doesn't offer much support.
Dr. R sees children, adolescents, and adults in his practice. Is it different when you go to a pediatric psychiatrist? My daughter recently had her well check-up at her pediatrician's office and I asked if he could prescribe the Paxil, but he said no, because the pediatric group does not prescribe that drug.
I know that Paxil has not been approved by the FDA for children, even though it is often prescribed. It has helped my child immensely. But knowing this, I would like her psychiatrist to be giving her attention. Can someone tell me what is the appropriate amount of involvement between a psychiatrist and a young patient? Should my daughter have more than a 15-minute appointment every two months? Thank you in advance.
Posted by Moors on April 8, 2001, at 13:59:37
In reply to How often should my child see her p-doc?, posted by Diane J. on April 7, 2001, at 21:52:24
> My 10-year-old daughter takes Paxil, and it has helped her a great deal. She has a psychiatrist whom she sees every two months for "medication management." This doctor was not the one who originally prescribed the Paxil, but when my daughter's first psychiatrist relocated to another area of the state we began seeing this doctor.
>
> What I was wondering is how often should my daughter see the psychiatrist? I have an uneasy feeling that Dr. R isn't really paying that much attention to her even when we do go in to see him. I realize Dr. R can only go on what we tell him. but still, he doesn't offer much support.
>
> Dr. R sees children, adolescents, and adults in his practice. Is it different when you go to a pediatric psychiatrist? My daughter recently had her well check-up at her pediatrician's office and I asked if he could prescribe the Paxil, but he said no, because the pediatric group does not prescribe that drug.
>
> I know that Paxil has not been approved by the FDA for children, even though it is often prescribed. It has helped my child immensely. But knowing this, I would like her psychiatrist to be giving her attention. Can someone tell me what is the appropriate amount of involvement between a psychiatrist and a young patient? Should my daughter have more than a 15-minute appointment every two months? Thank you in advance.Hi,
My son is on medication prescribed by a psychiatrist. We see him every 6-7 weeks and I have the same questions you do. My son plays with the toys in the office (He is almost 11) and I explain to the doctor how things are going, how he is doing at home and school. Sometimes I leave wondering why we have to go so often as long as things are on an even keel. Psychiatrists seem to be mostly about medication and don't seem to deal a lot with methods to help your child, etc., which I find frustrating. But how much insight can a doctor have about a child in 15 minutes? In speaking to other friends whose children see psychiatrists, I found several answers - from 2-3 times a year, to once a month. One family works with their pediatrician who consults with the psychiatrist. So, this really explains nothing to you, except that there seems to be no hard and fast rule.
Posted by Sulpicia on April 8, 2001, at 14:13:45
In reply to Re: How often should my child see her p-doc?, posted by Moors on April 8, 2001, at 13:59:37
> > Hi--
Yes, I've been there too. My 15 y/o has bipolar disorder so we needed the best pdoc for meds.
Most of her interactions in the beginning were medication management and at one point I asked
him if he just didn't do therapy -- something I thought was crucial. His answer surprised me.
He said that right now he felt she was too unstable for it. As she stabilized, I raised the issue
again, and he told me that he didn't think she would benefit from a theraputic relationship at that
point. In the last several months however, she has expressed an interest in seeing the pdoc for
therapy, and he is delighted. So for us, knowing how the pdoc was thinking about this, this worked.For medication management with informed parents -- meaning that you know what to watch for with the
med and your child's problem, these sporadic visits seem fine. I would certainly ask, on the phone or
in person, whether your child would benefit from therapy. If yes, from whom?Not all kids need therapy or will participate but I would certainly pin the pdoc down.
The other factor here is insurance. We pay full price to our pdoc. None of the good ones accept our insurance
and even if we stayed with our insurance [which would have led to my child's death I might add] a psychiatrist
would not be doing her therapy. A social worker would.So ask the pdoc about therapy, figure out how your insurance works, and take it from there.
And of course educate yourself about Paxil and your child's diagnosis -- i.e., what is the most
efficacious treatment.
Good luck,
S.
Posted by stjames on June 3, 2001, at 13:21:23
In reply to How often should my child see her p-doc?, posted by Diane J. on April 7, 2001, at 21:52:24
On thearpy and pdoc's-
It is important to remember that a pdoc is a medical doc and unless they have taken special
training they are not qualified to do thearpy.
It takes ~7 years to become a MD, ~2 more to specalize in psyc (this is medical psyc, not behavior) There is not time to study human behavior. The course of study in human behavior
is a MSW or psychology degree, taking 6 to 8 years (if a PhD).A child Pdoc is specilized, and I suspect some are qualified to do thearpy. To do this properly
we are asking one person to have almost 20 years
of schooling. My experiances with Pdoc's and thearpy is that they do make this distinction, they are medical doc's and can refer to a therapist. If one wants parenting tips, a child psychologist or MSW who specilizes in kids is the person to ask. There is nothing wrong with a MSW or "social worker" doing therapy, that is what they are trained to do. They are better at it than Pdocs as this is what they do all day.Yes, i know that everyone wants to get it all from one doc. However, it is unresonable to ask someone to be an expert in 2 fields. I have never
had a pdoc do real psychotherapy, they do not have time to regulate meds and deal with underlying issues.james
Posted by Diane J. on June 3, 2001, at 18:20:56
In reply to Re: How often should my child see her p-doc?, posted by stjames on June 3, 2001, at 13:21:23
Hello--
My daughter saw a child psychologist for a year before the decision was made to try Paxil. The decision was made with input from the psychologist, my daughter's teacher, the pediatrician, the psychiatrist, and of course, Kendra's dad and me.Last summer Kendra saw a new therapist, another child psychologist, for a few months. After a time, Dr. C thought Kendra didn't need to come in anymore because she had made a good deal of progress.
The question I asked, how often should my child see her p-doc, refers to her psychiatrist. He prescribes the meds. He would like Kendra to come in every 2 months. Kendra has been happy and healthy during the entire school year, and I wondered if she could see Dr. R even less than that schedule. He is not providing therapy, just medication management.
Anyhow, that's the story.
> On thearpy and pdoc's-
>
> It is important to remember that a pdoc is a medical doc and unless they have taken special
> training they are not qualified to do thearpy.
> It takes ~7 years to become a MD, ~2 more to specalize in psyc (this is medical psyc, not behavior) There is not time to study human behavior. The course of study in human behavior
> is a MSW or psychology degree, taking 6 to 8 years (if a PhD).
>
> A child Pdoc is specilized, and I suspect some are qualified to do thearpy. To do this properly
> we are asking one person to have almost 20 years
> of schooling. My experiances with Pdoc's and thearpy is that they do make this distinction, they are medical doc's and can refer to a therapist. If one wants parenting tips, a child psychologist or MSW who specilizes in kids is the person to ask. There is nothing wrong with a MSW or "social worker" doing therapy, that is what they are trained to do. They are better at it than Pdocs as this is what they do all day.
>
> Yes, i know that everyone wants to get it all from one doc. However, it is unresonable to ask someone to be an expert in 2 fields. I have never
> had a pdoc do real psychotherapy, they do not have time to regulate meds and deal with underlying issues.
>
> james
Posted by stjames on June 4, 2001, at 0:08:47
In reply to Re: How often should my child see her p-doc? » stjames, posted by Diane J. on June 3, 2001, at 18:20:56
>
> Hello--
> My daughter saw a child psychologist for a year before the decision was made to try Paxil. The decision was made with input from the psychologist, my daughter's teacher, the pediatrician, the psychiatrist, and of course, Kendra's dad and me.
>
> Last summer Kendra saw a new therapist, another child psychologist, for a few months. After a time, Dr. C thought Kendra didn't need to come in anymore because she had made a good deal of progress.
>
> The question I asked, how often should my child see her p-doc, refers to her psychiatrist. He prescribes the meds. He would like Kendra to come in every 2 months. Kendra has been happy and healthy during the entire school year, and I wondered if she could see Dr. R even less than that schedule. He is not providing therapy, just medication management.
>
> Anyhow, that's the story.
>
>
>
> > On thearpy and pdoc's-
> >
> > It is important to remember that a pdoc is a medical doc and unless they have taken special
> > training they are not qualified to do thearpy.
> > It takes ~7 years to become a MD, ~2 more to specalize in psyc (this is medical psyc, not behavior) There is not time to study human behavior. The course of study in human behavior
> > is a MSW or psychology degree, taking 6 to 8 years (if a PhD).
> >
> > A child Pdoc is specilized, and I suspect some are qualified to do thearpy. To do this properly
> > we are asking one person to have almost 20 years
> > of schooling. My experiances with Pdoc's and thearpy is that they do make this distinction, they are medical doc's and can refer to a therapist. If one wants parenting tips, a child psychologist or MSW who specilizes in kids is the person to ask. There is nothing wrong with a MSW or "social worker" doing therapy, that is what they are trained to do. They are better at it than Pdocs as this is what they do all day.
> >
> > Yes, i know that everyone wants to get it all from one doc. However, it is unresonable to ask someone to be an expert in 2 fields. I have never
> > had a pdoc do real psychotherapy, they do not have time to regulate meds and deal with underlying issues.
> >
> > jamesJames here....
I was responding generally to this whole thread, hince my warning "On thearpy and pdoc's". Given that she is doing well, all that is required of a pdoc is to keep tabs on the meds, if you want more talk find someone who does this.
Keep in mind that while you are free to ask questions, we are free to go on tangents, esp. if we have ADD !
James
Posted by Willow on June 4, 2001, at 7:20:29
In reply to Re: How often should my child see her p-doc?, posted by stjames on June 4, 2001, at 0:08:47
"He would like Kendra to come in every 2 months. Kendra has been happy and healthy during the entire school year, and I wondered if she could see Dr. R even less than that schedule."
Just come out and ask the doctor if you could not come in less frequently for the reasons you have stated. If he says no ask for his reasoning.
BEST WISHES
Willow
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