When should we question if our child is getting the right treatment?

ContemplatingWelcome to Part Nine of our Summer 2013 blog series…Ten Questions Parents and Caregivers Ask About Kids and MedicationToday, we’ll explore the topic: When should we question if our child is getting the right treatment?

Today’s question applies to any mental health treatment provided to kids and teens- not simply pharmacologic treatment.

I’m astounded by how many kids come into our practice with a history of  being on a specific medication regimen for an extended period of time, or extended involvement with a psychologist or counselor with little or no benefit. It’s not at all unusual for me to see kids who have been taking medication for months or years and neither the parent or the child can tell me why the medication was originally prescribed, or how they would be able to know if the medication is working.

Here are six “red flags” that should signal to a parent, either at the onset of treatment, or at any point during a course of treatment, that they may want to question the treatment prescribed for their child…

  • Your professional can’t explain WHY your child is experiencing the difficulties that led you to treatment. “Why” needs to come before “what”. If they can’t give you a reasonably coherent explanation of why your child is experiencing the difficulties that led you to seek help, there’s a good possibility they won’t be able to identify the appropriate remedies.
  • Your professional is unwilling or unable to discuss the range of evidence-based treatments for your child’s condition. While there are many conditions for which medication may be considered a “first-line” treatment, for most mental health conditions seen in children and teens, alternative evidence-based treatments exist. If they’re not familiar with the alternatives, or not comfortable in recommending alternatives that they themselves don’t offer, parents need to question whether they’re pursuing the right course.
  • Your professional is unable to share the intended goals of their treatment. I see this frequently in kids receiving longer term therapy that appears ineffective. If your doctor/therapist can’t specifically describe to you how their ongoing treatment will address your child’s presenting problems, you may be in the wrong place.
  • Your professional can’t offer a reasonable estimate of the time required to see significant progress from treatment, and next steps if your child doesn’t respond. The conditions we treat with medication or psychotherapy significantly impact multiple areas of child development. There’s an opportunity cost to ineffective treatment. If treatment is not helping, it’s probably hurting…if it’s preventing your child from having access to a more effective treatment.
  • Your professional is unwilling to meet with you to discuss your child’s progress. In fairness to your child’s physician, you may need to schedule a formal appointment for such a discussion and pay them for their time, since recent mandated changes in insurance billing make it difficult or impossible for prescribers to get insurance reimbursement for services when your child is not present. In counseling or therapy, confidentiality doesn’t keep a clinician from meeting with parents or sharing their overall impressions of your child’s response to treatment.
  • Your professional is reluctant to seek another opinion when your child’s condition is getting worse. Nobody (but Jesus) has all the answers and not every physician or clinician is a good fit with every child/family. At times, I’ll recommend a second opinion to families when what I’m recommending doesn’t seem to be working or I’m out of ideas. The right professional will check their ego at the door when your child is struggling.

As a parent of a child with an emotional, behavioral or developmental disorder, you don’t have to settle. When your child isn’t getting better within the anticipated time frame, ask questions. When you don’t get reasonable answers, you owe it to your child to seek out more effective help.

Photos courtesy of http://www.freedigitalphotos.net

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Question MarkEnjoying the content in this series…Ten Questions Parents and Caregivers Ask About Kids and Medication? Miss any of the posts earlier in the series? Here are links to the first eight questions we addressed…

  1. Why does it seem so many kids are on medication?
  2. How would I know if my child would benefit from medication?
  3. What type of evaluation should a child receive before starting medication?
  4. Who’s qualified to prescribe medication for my child?
  5. When should parents consider non-medical treatment first?
  6. How well should medication work for my child’s condition?
  7. Are the medications prescribed to kids and teens with mental illness safe?
  8. How long will my child need medication?

About Dr. G

Dr. Stephen Grcevich serves as President and Founder of Key Ministry, a non-profit organization providing free training, consultation, resources and support to help churches serve families of children with disabilities. Dr. Grcevich is a graduate of Northeastern Ohio Medical University (NEOMED), trained in General Psychiatry at the Cleveland Clinic Foundation and in Child and Adolescent Psychiatry at University Hospitals of Cleveland/Case Western Reserve University. He is a faculty member in Child and Adolescent Psychiatry at two medical schools, leads a group practice in suburban Cleveland (Family Center by the Falls), and continues to be involved in research evaluating the safety and effectiveness of medications prescribed to children for ADHD, anxiety and depression. He is a past recipient of the Exemplary Psychiatrist Award from the National Alliance on Mental Illness (NAMI). Dr. Grcevich was recently recognized by Sharecare as one of the top ten online influencers in children’s mental health. His blog for Key Ministry, www.church4everychild.org was ranked fourth among the top 100 children's ministry blogs in 2015 by Ministry to Children.
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