If you are new to our clinic and have an appointment, we ask that you review the following:
Why is it a teaching clinic?
As a university, we are dedicated to training the next generation of physicians, integrating their education into our patient care practices. This approach allows patients to engage directly with their healthcare team, overseen by attending physicians who have expertise in specialized clinical care. Additionally, children who visit our clinic have a valuable experience of contributing to medical education, playing a key role in the development of future doctors.
Why do visits to the teaching clinic take longer?
Usually, a resident or fellow will see you first as part of the physician team. Residents and fellows are medical doctors, getting advanced training in psychiatry. After the history is taken, they will discuss your case with the attending physician or team leader. After that, everyone meets together to decide the best care options for your child. This team structure often results in a longer visit. There may also be times when they are waiting for the team leader to finish seeing another patient. Mental health teams know this approach suits certain families and diagnoses, but not all. We always encourage you to bring your concerns about this model or anything else to your team.
What are the reasons for choosing consultations over long-term care in certain situations?
Due to the overwhelming shortage of child psychiatrists, we are pioneering innovative strategies to help increase the number of patients that pediatricians care for in the community. This approach involves offering consultations instead of extended care for certain patients who can be managed by a pediatrician with support.
What is the psychotherapy teaching clinic?
This is a clinic where the focus of patient care is on providing psychotherapy. Like other clinics, patients are seen initially by the fellows, who are supervised by attending psychiatrists and psychologists experienced in providing psychotherapy services, and who may also join the session.
Why do you record psychotherapy sessions?
We use the recorded videos to enhance the psychotherapy training of our trainees. The videos allow the supervising clinical team to view the session material as it happens to provide more effective supervision and psychotherapy training, as well as a rich educational experience. The videos are only used for teaching purposes. They are never posted on the web or used for any non-educational purposes. These videos are bound by the same confidentiality requirements as your medical records. Video recording will only occur following your explicit consent and will be discussed with you further at your appointment.
What is a trainee, fellow, resident, or student?
In an academic or teaching clinic, multiple providers involved in your care may also be engaged in furthering their education. These individuals are referred to as trainees. They have received advanced training as part of their professional development and continue to work under the supervision of attending physicians, psychologists, social workers, and therapists.
Fellows are doctors who have completed college, medical school, and an adult psychiatry residency program. They are advancing their psychiatry training to specialize in seeing children. At this point, they have often completed over 10 years of education at a college or university.
Residents are doctors who have completed college, medical school, and are currently training in an adult psychiatry or pediatric residency program. These residents are advancing their training to specialize in seeing children.
Medical students are students who have completed college and are currently training in medical school to become clinical physicians. These students are gaining exposure to child psychiatry and typically observe patient care or may also take patient history under the close supervision of residents and fellows.
Practicum students are students who have completed college and are currently training for a graduate degree in counseling, psychology, or social work. These students are gaining clinical training while applying their classroom knowledge and are typically part of the care coordination, case management, assessment, or psychotherapy team under the close supervision of a licensed clinician.
Why is it hard to schedule follow-up visits within the amount of time my doctor asked?
At certain times, such as the start of the school year or before holidays, the clinic experiences increased demand for follow-up appointments. During these peak periods, it may be necessary to extend the wait time for your requested follow-up. You are encouraged to send a MyChart message (or call) between visits should you have any immediate concerns.
What role do trainees play in my care?
The responsibilities of residents and fellows vary according to their training level. These practitioners serve as integral members of the medical team and typically function as the primary point of contact for patients. They collect added history and relevant medical information, respond to telephone inquiries, and complete necessary documentation. Throughout patient visits and beyond, residents and fellows have direct access to attending physicians to address any questions or concerns that may arise.
Why do I see different doctors throughout the year?
The length of time a trainee rotates in the clinic is based on their training program. We make every effort to schedule you with the same doctor to provide continuous care. Should the need to schedule with a different doctor occur, the physician team reviews your medical record together to support coordination and consistency over time.
Why do we fill out rating scales and forms about our child?
These rating scales are used to aid in diagnosis, to follow the effectiveness of treatment, and to aid in ongoing treatment decisions.
What is the reason for meeting with my child when I am not present?
We like to give children an opportunity to ask questions and provide history that they may have difficulty talking about when a caregiver is in the room. Children often worry about upsetting their caregiver, and our observations of your child’s anxiety and the length of time to adapt without your present are informative. If we have concerns about a child’s safety, we will tell you at once so we can work together to keep everyone safe.
What is the difference between a psychiatrist, a psychologist, and a social worker?
In an academic or teaching clinic, you may have multiple providers involved in your care. These individuals may be psychiatrists, psychologists, and/or social workers. They have received advanced training degrees in their specialty as part of their professional development to take care of mental health issues. These professionals often work together to create a comprehensive treatment plan for your child.
Child Psychiatrists are doctors who have completed college, medical school, an adult psychiatry residency program, and a child and adolescent fellowship program. A child psychiatrist is a medical doctor who specializes in the diagnosis, treatment, and prevention of mental, emotional, behavioral, and developmental disorders in children and adolescents. They address complex conditions and severe mental health symptoms by considering biological factors, and are familiar with psychiatric treatment modalities, such as therapeutic interventions and medication management.
Like pediatricians and other medical doctors, psychiatrists went to medical school and view psychiatric disorders as medical illnesses, which need to be evaluated by taking a complete history of current and past symptoms as well as assessing other factors that are relevant to the development of illnesses.
Child psychologists have completed college and a doctoral degree (Ph.D.) in psychology, which is the science of behavior and mind. They have received advanced training in psychotherapy (talk therapy) and behavioral assessments for children and families. These professionals specialize in behavioral, emotional, and social problems and often address school-related issues, learning disabilities, anxiety, and coping skills.
Social workers have received a master’s level training in social justice, human behavior, and human rights. Social workers in mental health assess, diagnose, and treat mental health conditions. They create treatment plans and help access community resources. They provide counseling to improve the quality of life of children and families by supporting those dealing with mental, emotional, or substance use challenges.
What kind of therapist does my child have?
Usually, your child will see a psychiatrist (or resident or fellow) first. After the history is taken, you will meet to decide the best care options for your child. Mental health teams know this approach suits certain families and diagnoses, but not all. We always encourage you to bring your concerns about this model or anything else to your team.
What is a nurse practitioner, and what role do they play in my care?
A Nurse Practitioner (NP) is an advanced practice registered nurse who has completed graduate-level education. Nurse practitioners hold national board certification in an area of specialty. The two board certifications the nurse practitioners may hold within our clinic include:
- Psychiatric and Mental Health Nurse Practitioner – Board Certified (PMHNP-BC):
- This is a Nurse Practitioner who has completed graduate-level training concentrated in psychiatry and mental health care. They passed the board certification exam with the ANCC (American Nurses Credentialing Center) and have obtained the right under the Missouri State Board of Nursing to provide services to patients and families as a Psychiatric Mental Health Care Nurse Practitioner, Board-Certified (PMHNP-BC).
- Certified Pediatric Nurse Practitioner (CPNP):
- This is a Nurse Practitioner who has completed graduate-level training concentrated in providing pediatric care. They passed the board certification exam with the PNCB (Pediatric Nursing Certification Board) and have obtained the right under the Missouri State Board of Nursing to provide services to patients and families as a Certified Pediatric Nurse Practitioner. To provide psychiatric services, they have also obtained certification as a Pediatric Primary Care Mental Health Specialist (PMHS).
The nurse practitioners function as full members of your team and are generally the person you will communicate with most directly. They obtain history, return phone calls, and complete documentation. Nurse practitioners have access to the attending physicians throughout the visit to discuss questions or concerns you might have.
What is the age limit for seeing my child?
Due to the nationwide shortage of psychiatric services for children and adolescents, our attending physicians prioritize patients under 18 years of age. We recognize that transitioning to adult care is an important milestone and are committed to supporting you throughout this process.
What happens during an intake appointment?
An intake refers to the first appointment with a mental health provider. While approaches may vary among practitioners, the primary goal is to gather comprehensive background information about your child and assess how current symptoms affect your family. This process can take place during a single, extended session or more than one session. Your scheduler can answer questions about the intake process and the expected number of appointments. Your provider may ask that standardized rating scales be completed to supplement information about your child; these are often provided in advance for completion before the first appointment.
What should I bring to my intake appointment?
Please bring the completed forms and information you received in the mail. You may also bring helpful documents, such as school or treatment records, or other relevant information about your child.
Who needs to attend my child’s intake appointment?
Providers may prefer first to meet with caregivers alone; if so, you’ll be notified before your visit. If not, we suggest bringing in two involved caregivers to provide different perspectives and allow for supervised discussions with caregivers if needed.
The information contained on this webpage is solely intended to provide an overview of clinical services performed by physicians of Washington University School of Medicine.
Information about diseases and medical conditions on this site and on its linked resources is for educational and informational purposes only and should in no way be taken to be the practice of medicine or the provision of medical, nursing, or professional healthcare advice or services. The information should not be considered complete and should not be used in place of a visit, call, consultation, or advice of your physician or other health care provider. The information obtained from this site and any linked resources is not exhaustive and does not cover all diseases, ailments, physical conditions or their treatments.