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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.
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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.
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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.
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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.
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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).
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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.
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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.
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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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