Dr. Henry Paul, MD

Psychiatrist, Author and Educator


January 28th, 2014

In the United States, doctors without special psychiatric training write the great majority of prescriptions for psychotropic medications. Although it is difficult to quantify, it appears that psychiatrists write only about 20 to 25 percent. It would be preferable to have all of these prescriptions written by a psychiatrist and particularly with children and teenagers it be done by a child and adolescent psychiatrist. Why? Because the practice of prescribing these specialized medications requires specific knowledge of children and teenagers that is only gained by those who have completed special training in child and adolescent psychiatry in approved residency programs.

A general (adult) psychiatrist goes to medical school and then completes postgraduate specialty training of four years of general psychiatry. A child and adolescent psychiatrist goes on for an additional two years receiving additional training in child and adolescent psychiatry.

In a child and adolescent residency, one learns about the details of child/teenage/family development in all areas: biological, neurological, educational, psychological, emotional, and physical realms. One learns about the field of pediatrics and is able to integrate physical illness and its effects into diagnostic and treatment expertise. There is detailed exposure to the diagnosis of all the mental disorders that occur in the formative years, both in outpatient and hospital settings. One studies feelings, behaviors, and thinking patterns. In addition, there is exposure to all the various modes of therapeutic intervention including individual, family, and group talk therapy.

In a child and adolescent psychiatry residency, one scrutinizes the use of psychotropic drugs for the many disorders of childhood and teenagers; not only the helping effects of medications but the side effects, the use of multiple medications, the emotional repercussions of taking medication on the child and family, and the introduction of medication to school personnel when necessary. Most importantly, one learns about the unique metabolism of medication by young people.

Only about eight thousand doctors are trained in child and adolescent psychiatry in the United States. This is a small amount, and the field is considered very understaffed. Because of this, it will not always be possible to see a trained child and adolescent psychiatrist, especially if you live in a rural area. Pediatricians, clinic nurse practitioners, and general psychiatrists are the other major prescribing groups for the child and adolescent psychotropics and, although the great majority has the skill in this area, it is best to find out how much experience in prescribing to young people in particular they have. You can simply ask your doctor directly about their education, continuing education, and of course, direct patient care experience. Additionally you can search the Internet, consult with local mental health associations, and with the referring person (pediatrician) to learn more about the doctor in question.

Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

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