Finding Your Treatment Team

Before your first appointment with either a pediatrician, mental health professional, and/or psychiatrist, consider the following questions to be prepared for discussing any changes you have observed with your child:

• What are some behaviors you are noticing in your child that differ from their previous norm?
• Has there been a stressful event recently—a big family move, divorce, conflict in the home, or death of a loved one— that may have your child feeling off-kilter?
• What has your child been saying to you about their mood that would give you an indication something has changed?
• Has your child expressed that they have been experiencing physical pain such as stomach aches or headaches that cannot be explained by a pediatrician?
• What do the changes look like in your child? Irritable mood? Crying? Hyper behavior?  Try to document the ranges of mood your child is expressing and if possible, at what time of day.

Finding a Clinician

Finding a clinician can be a challenging process. If you have never worked with a mental health professional before, you may not know where to start. Often, pediatricians can recommend and refer you to a mental health professional that would be appropriate. Here are some questions you may want to consider as you begin to research different mental health workers:

• Do they take my insurance or offer a sliding scale or affordable options?
• What is their certification and licensing?
• How much experience do they have with pediatric mood disorders?
• Do they have references from other parents?
• Do they have good communication skills with young people and families?

Making the most of your appointment

When you or your child begin to work with a mental health professional, there can be a lot of questions and information you want to explore during your first appointment. Here are some steps that will help you make the most of your appointment:

• Bring relevant medical records for your child.
• If your child is currently taking any medication, write down the name, dosage, and when you administer/or they take it.
• Bring information on any allergies or any previous adverse reactions to medications.
• If you have been tracking or taking notes about your child’s mood, have those notes handy.
• Prepare a list of questions to bring with you. Having a written list of questions will help to ensure you do not forget to ask anything.
• At the end of the session, ask if there is anything else you should know that has not been discussed.
• Find out how you might follow up most effectively if you have additional questions.

The process of finding your child’s diagnosis

Diagnosis can be a challenging process, especially when diagnosing children. The way children experience and explain symptoms are different from the way adults do. There are certain diagnoses that are more commonly diagnosed in children, such as Attention Deficit Hyperactivity Disorder (ADHD) or Oppositional Defiant Disorder (ODD). Sometimes the behavioral responses seen in children that live with a mood disorder can be misinterpreted as symptoms of other conditions such as ADHD or ODD. This is why you’ll need to engage in a discussion about the rationale for the diagnosis and see if there are any other conditions that also may have similar symptoms. Here are some other questions you can ask a clinician for more information about the diagnosis:

• What is the diagnosis?
• How is the diagnosis treated?
• How is this diagnosis similar or different from other diagnoses that may be relevant?
• Is there any chance of comorbidity (meaning two or more conditions occurring at once)?
• What steps are recommended for treatment for your child specifically?
• How should follow-up occur?

From the initial conversation and diagnosis, it is likely several options will be made available to you. The treatment options for children can be individual therapy, family therapy, group therapy, seeing a psychiatrist, and taking medication. While these options are not all-encompassing, the ones listed are most commonplace in the treatment of mood disorders.

A mental health diagnosis can be best addressed when the whole health of the child or teen is considered. Ensuring that a child has access to treatment providers that can both assess their physical and mental health will ensure better accuracy in diagnosis and treatment.

What to know and ask about individual therapy

An individual therapist should be a licensed professional, preferably one who is experienced in working with children and families. The questions listed below will help you as you identify and engage with a therapist:

• Does the mental health professional take the insurance you have? If not, is there a sliding scale that can be offered to best accommodate your financial needs?
• How often would your child have appointments?  What does the therapist recommend as a schedule?
• What methodology do they use in their practice? Ask them to explain that methodology, and their training.
• Ask about the duration of the therapy they think will be recommended for your child.
• If you have concerns about your child’s willingness to attend appointments, discuss those concerns.
• Discuss with the therapist what indicators will be used to measure how well your child is responding to the therapeutic process.
• Ask if the therapist can work collaboratively with other professionals in your child’s life, such as a school social worker, pediatrician, and/or psychiatrist. **

**A note on the benefits of collaborative care: Asking a therapist to collaborate with other mental health professionals such as a school social worker, pediatrician, psychiatrist that is also working with your child will help the professionals understand the needs of the child more holistically. For example, the school social worker may observe something that a therapist working outside of that setting may not observe. When care teams can work together, better treatment outcomes are more likely. 

What to know and ask about family therapy

Family therapy sessions are when multiple family members work with a therapist to solve issues related to the family unit. If a young person in your family is living with a mood disorder, it may put a strain on the family unit. Engaging in family therapy can help to solve communication issues and address both the individual and collective needs of the family unit. The questions listed below will help you as you identify and engage with a family therapist:

• Does the mental health professional take the insurance you have? If not, is there a sliding scale that can be offered to best accommodate your financial needs?
• How often would your family have appointments? What does the therapist recommend as a schedule?
• What methodology do they use in their practice? Ask them to explain that methodology and their training.
• Discuss with the therapist their approach to family therapy.
• Will the family always be together for sessions?
• Which family members should be involved?
• How does the therapist plan to safeguard the individual feelings of each family member while working collaboratively?
• Discuss the course of the family therapy process. How long will sessions last? What indicators will be apparent if progress is being made?

What to know and ask about group therapy

Different agencies and treatment centers offer group therapy as a way for like individuals to meet with a mental health professional to work through stressors and symptoms. If you are interested in group therapy for yourself or for your loved one, here are some things that you might consider:

• Will your insurance be able to cover the group sessions? If not, is there a sliding scale that can be offered to best accommodate your financial needs?
• How many members will be in the group, and what is the expectation for participation?
• Will you or your child learn better in a group setting?
• What approach is the clinician taking to facilitate the group? Is the group meant to be educational in nature or more about discussing individual feelings?
• What are the outcomes someone might expect if they participate in the group?

Medication

Deciding whether your child should take medication can be a difficult decision. It is a decision to be made with careful consideration, as medication can affect a younger developing brain differently than it would an adult brain. If the recommendation of the mental health professional is that trying medication might help, here are some questions you may want to consider:

• What is the purpose of the medication? What does it treat?
• How much should the dosage be?
• When should the medication be given to my child?
• What are the possible side effects?
• Are there any interactions with this drug I should be aware of?
• Typically, how long does it take for this medication to be effective?
• How would we know if there was a need to try another medication or a different dosage if this medication does not work well?
• What are any negative reactions possible when taking this drug?
• Is the drug addictive? How would we phase off the drug if that becomes necessary?