Svetlana Libus, MD. Diplomate of the American Board of Psychiatry and Neurology. Childs, Adolescent and Adult Psychiatry
About Treatment
Benefits and  Risks of Medications
Benefits and Risks of Therapy
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What to Expect
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  Because you will be putting a good deal of time, money, and energy into treatment, you should choose a physician carefully. I strongly believe you should feel comfortable with the doctor you choose, and hopeful about the treatment. When you feel this way, treatment is more likely to be very helpful to you.

 
  By the end of our second or third session, I will tell you how I see your case at this point and how I think we should proceed. I view treatment as a partnership between us. You define the problem areas to be worked on. I use some special knowledge to help you make the changes you want to make. If I decide, that you/your child need medication, I will discuss it with you. I will explain the rational behind my decision, medication options, risks, and benefits. I also will provide some reading material, so you can learn more about biology of mental disorders and mechanism of action of psychotropic medications. The baseline assessment of a child or adolescent to initiating psychopharmacological treatment is a complex process requiring careful evaluation of multiple psychological, physiological, and social parameters. It can be a time-consuming process. I encourage you to be patient. Once decision is made, I will not postpone the initiation of the treatment.

 
  Psychiatric illnesses are broad-based disorders involving disturbances in mood, cognition, and behavior that significantly affect many aspects of child’s functioning. Psychopharmacologic treatment is directed toward improving one or more of these disturbances. I will be seeing you child every month for therapeutic drug monitoring. Beginning of new medication, dose adjusting, presence of adverse effect from medication will require more close monitoring. Before I prescribe medication to your child, I will refer you to your pediatrician to obtain baseline laboratory studies. There are some medications that require regular blood work, and it will be your responsibility to obtain it.

 
  I also will be able to provide psychotherapy for you/your child. Psychotherapy is not like visiting a medical doctor. It requires your very active involvement. It requires your best efforts to change thoughts, feelings, and behaviors. For example, if I don't ask, I want you to tell me about important experiences, what they mean to you, and what strong feelings are involved. This is one of the ways you are an active partner in therapy.

 
  I expect us to plan our work together. In our treatment plan we will list the areas to work on, our goals, the methods we will use, the time and money commitments we will make, and some other things. I expect us to agree on a plan that we will both work hard to follow. From time to time, we will look together at our progress and goals. If we think we need to, we can then change our treatment plan, its goals, and its methods. Minor, major, and multiple problems take different amounts of therapy time (both frequency of sessions and duration).

 
  An important part of your therapy will be practicing new skills that you will learn in our sessions. I will ask you to practice outside our meetings, and we will work together to set up homework assignments for you. I might ask you to do exercises, to keep records, and perhaps to do other tasks to deepen your learning. You will probably have to work on relationships in your life and make long-term efforts to get the best results. These are important parts of personal change. Change will sometimes be easy and quick, but more often it will be slow and frustrating, and you will need to keep trying. There are no instant, painless cures and no "magic pills." However, you can learn new ways of looking at your problems that will be very helpful for changing your feelings and reactions.

 
  Most of my therapy clients see me once a week for 6 to 12 months. After that, we meet less often for several more months. Therapy then usually comes to an end. The process of ending therapy, called "termination," can be a very valuable part of our work. Stopping therapy should not be done casually, although either of us may decide to end it if we believe it is in your best interest. If you wish to stop therapy at any time, I ask that you agree now to meet then for at least one session to review our work together. We will review our goals, the work we have done, any future work that needs to be done, and our choices. If you would like to take a "vacation" from therapy to try it on your own, we should discuss this. We can often make such a "vacation" be more helpful.

 
  I will send you a brief set of questions about 6 months after our last session. These questions will ask you to look at our work together, and sending them to you is part of my duty as a therapist. I ask that you agree, as part of entering therapy with me, to return this follow-up form and to be very honest about what you tell me then.

 
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