If you are new to our clinic and have an appointment, we ask that you review the following:
Why are you a teaching clinic?
As a university we are highly committed to educating the doctors of tomorrow and actively incorporate their training into patient care. We believe this can provide a unique opportunity for our patients to be involved in expert care as our attending physicians have specialized clinical expertise. Some children enjoy learning that they are teachers and when they come to our clinic they are making a unique contribution to training doctors.
Why do visits in the teaching clinic take longer?
Typically, you will be seen by a team of physicians starting with a resident or fellow. Residents and fellows are medical doctors, getting advanced training in psychiatry. After the initial history is taken, they will discuss your case with the attending physician or team leader. After that, all of you will meet together to determine the best care options for your child. This team structure often results in a longer visit. There may also be times where they are waiting for the team leader to finish seeing another patient. Your mental health teams are aware that this approach works for some families and diagnoses and not others. We always encourage you to bring your concerns about this model or anything else to your team.
Why do you do consultations rather than long-term care in some cases?
Due to the overwhelming shortage of child psychiatrists, we are pioneering innovative strategies to help increase the patients that pediatricians care for in the community. Part of this is providing consultations rather than long- term care for selected patients who can be competently managed by a pediatrician with assistance.
What is the psychotherapy teaching clinic?
This is a clinic where the focus of patient care is on providing psychotherapy. Similar to 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 video record some psychotherapy sessions?
We use the videos to enhance the psychotherapy training of our trainees. The videos allow the supervising clinical team to view the session material as it happens in order to provide more effective supervision and psychotherapy training as well as a rich educational experience. We only use the videos for teaching purposes. They are not posted on the web or used for any non-educational purposes. The 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?
As part of an academic or teaching clinic, we have several providers participating in your care who are also pursuing their education. Generally, they are called trainees, and they have all received advanced training as part of their careers and continue to receive direct supervision by attending physicians, psychologists, social workers and therapists.
Fellows are doctors who have completed college, medical school and an adult psychiatry three or four-year residency. They are advanced in their psychiatry training and receiving additional specialized training in seeing children. At this point, they have often completed over 10 years of education at a college or university.
Residents are doctors who are either completing a rotation in child psychiatry as part of their general psychiatry training or part of their pediatric residency. They have completed both college and medical school and engaged in advanced medical training.
Medical students are people who are gaining exposure to child psychiatry as part of determining what kind of doctor they would like to be. They have completed college and begun their clinical rotations. They typically are involved in observing or taking patient history under the close supervision of residents and fellows.
Practicum students are trainees specializing in counseling, psychology or social work working towards graduate degrees in these fields. They complete a specific amount of required practicum hours are part of their clinical training. In the clinic, they may serve in roles that include care coordination, case management, assessment or psychotherapy. They are typically under the supervision of a licensed clinician.
Why is it hard to schedule follow up visits within the amount of time my doctor asked?
There are times in the clinic when there is a high demand for follow-up appointments, for example at the time of school return, prior to vacations, etc. During these periods, it may require adding several weeks to your requested follow-up time. 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?
It depends on their level of training. Residents and fellows function as full members of your team and are generally the doctors you will communicate with most directly. They will work to obtain the additional history and medical information and generally return phone calls or complete required documentation. They have open access to attending physicians throughout the visit and beyond in order to discuss questions or concerns you might have.
Why do I see different doctors over the year?
Some trainees in the clinic change every month and, in other cases, only after 2 years. We make every effort to have you see the same doctor while she/he is in our clinic; through communication with the supervising attending physicians and your medical record, we strive to maintain coordination and consistency over time.
Why do we fill out rating scales and forms about our child?
The majority of these rating scales are used to aid in diagnosis, to follow the effectiveness of treatment and to aid in on-going treatment decisions.
Why do you see my child without me present?
We like to give children an opportunity to ask questions and provide history that they may have difficulty saying with a caregiver in the room. Often this is because they don’t want to worry or upset their caregiver. Our observations of your child without you in the room are also very informative (e.g., how anxious does she get? How long does it take her to adapt to your absence?). If we have concerns about a child’s safety, either that she/he will harm himself or herself or someone else, we will tell you immediately so we can work together to keep everyone safe.
What is the difference between a psychiatrist, a psychologist and a social worker?
These professionals take care of mental health issues and received advanced training to do so. 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. Psychiatrists are familiar with many treatment modalities, such as therapeutic interventions, and are also able to prescribe medication.
A psychologist is someone who has received training in the science of behavior and the mind. There are many different kinds of psychologists. In our clinic, the psychologists have received advanced training in psychotherapy and assessment services for children and families, including young children.
A social worker has received master’s level training in social justice, human behavior, and human rights. The social worker in a mental health setting will work to improve the quality of life of child and family and to the development of the potential of each individual, group and community of a society. Social workers perform interventions through research, policy, community organizing, direct practice of therapeutic interventions, case management, and teaching.
What kind of therapist does my child have?
Therapy at our clinic is done by social workers, psychologists and psychiatrists. All three types of professionals have different degree programs but have received advanced training to provide therapeutic services to children.
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 inside of 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 have sat for boards with the ANCC (American Nurses Credentialing Center) and have obtained the right under the Missouri State Board of Nursing to provide services to patients/families as a Psychiatric Mental and 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 have sat for boards with the PNCB (Pediatric Nursing Certification Board) and have obtained the right under the Missouri State Board of Nursing to provide services to patients/families as a Certified Pediatric Nurse Practitioner. To provide psychiatric services, they have also sat for additional certification as Pediatric Primary Care Mental Health Specialist (PMHS).
Each Nurse Practitioner functions as a full member of your team and is generally the person you will communicate with most directly. They will work to obtain the additional history and information and generally return phone calls or complete required documentation. They have open access to attending physicians throughout the visit and beyond in order to discuss questions or concerns you might have.
Until what age will you see my child?
This varies some, depending upon the clinic and provider. Many of our attending physicians make efforts to limit seeing patients over 18 or over 21 because of the nationwide shortage of psychiatric services available to children and adolescents. We have also observed that transitioning to adult care can be a positive milestone for your child and are available to assist in this process.
What is an intake and what is involved in this appointment?
An intake is the first visit with a mental health provider. Different practitioners use different approaches, but the general goal is to get a broad history of your child and find out how the current symptoms are affecting your family. Some of our providers will do this over the course of several visits and others will use a single extended visit. Feel free to ask the person who schedules your intake how many visits are involved in your provider’s intake. Many of our providers also ask for standardized rating scales to help get additional information about your child. These are generally sent to you ahead of time and completed before the first appointment.
What should I bring to my intake appointment?
Please bring all of the forms and information that you received in the mail already completed. You may also bring other documentation you think might be helpful, such as school records, past treatment records or other information from people who know your child.
Who should come to my child’s intake appointment?
Some clinics meet with caregivers alone first, and if this is the case, it will be explained to you before your first visit. If not, we recommend bringing two caregivers that are involved in the child’s life. This allows us to get different perspectives on what is happening as well as having the option for the child to step out of the room with family supervision, should we need to talk to the caregivers individually without the child present.
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 health care 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 are not exhaustive and does not cover all diseases, ailments, physical conditions or their treatments.