If your child has been referred for a psychiatric evaluation, it is completely normal to have questions.
What are they going to ask? Will my child have to talk without me in the room? Does an evaluation automatically mean medication? What if my child shuts down and refuses to talk?
For many parents, the uncertainty surrounding the appointment can feel almost as stressful as the concerns that led them there.
A psychiatric evaluation is not a test your child can pass or fail. It is an opportunity for a mental health professional to understand the whole picture: what your child is experiencing, how they are functioning at home and school, what may be contributing to their symptoms, and what kind of support could help.
Here is what families can generally expect.
The First Step Is Understanding What Has Been Going On
A psychiatric evaluation usually begins with a conversation about why you are seeking help.
You may be asked when you first noticed a change, what symptoms concern you, how long they have been happening, and how they are affecting everyday life.
- Mood and anxiety
- Sleep and eating habits
- Behavior at home
- School performance
- Friendships and social relationships
- Attention and concentration
- Medical history
- Current and previous medications
- Developmental history
- Family mental health history
- Previous therapy or mental health treatment
This can feel like a lot of questions, but there is a reason for it. The American Academy of Child and Adolescent Psychiatry explains that evaluating a child requires looking at developmental, behavioral, emotional, cognitive, educational, medical, family, peer, and social factors rather than focusing on one symptom alone.[1]
Your child is more than the problem that brought you through the door. A good evaluation is designed to understand that.
Your Child or Teen May Speak With the Provider Separately
Depending on your child’s age and the reason for the psychiatric evaluation, the provider may spend time talking with you and your child together and may also speak with each of you separately.
For teenagers especially, having some private time with the provider can be an important part of the evaluation.
This is not about keeping parents out of the process. It gives young people an opportunity to talk openly about things they may find difficult to discuss in front of a parent, including friendships, relationships, substance use, anxiety, depression, or safety concerns.
Clinical guidance for adolescent mental health assessment supports gathering information directly from both the young person and their parent or caregiver, recognizing that each may have important information to contribute.[2]
They Will Probably Ask About Safety
Parents are sometimes surprised when a clinician asks their child directly about self harm or suicidal thoughts.
These questions are a routine and important part of many evaluations.
A provider may ask whether your child has ever thought about hurting themselves, wished they were not alive, attempted suicide, experienced significant aggression, or felt unsafe.
The purpose is not to scare your child or assume that something is wrong. It is to make sure the clinician has an accurate understanding of your child’s current level of risk and can recommend the appropriate level of care.
The American Academy of Pediatrics identifies recognition of suicide risk, severe impairment, and other serious symptoms as an important part of evaluating children and adolescents.[3]
A Diagnosis May Not Happen Immediately
One of the biggest misconceptions is that every family will leave the first appointment with a definitive diagnosis.
Sometimes the picture is clear. Sometimes it takes more time.
Symptoms can overlap between conditions. Anxiety can look like avoidance or irritability. Depression can affect concentration. Attention difficulties can be influenced by sleep, trauma, anxiety, learning challenges, or other factors.
A comprehensive evaluation may include information from parents, the child, medical providers, therapists, school personnel, previous records, or psychological and educational testing when appropriate.[1]
The goal is not to put a label on your child as quickly as possible. The goal is to understand what is happening well enough to make thoughtful recommendations.
Does it Mean My Child Will Be Put on Medication?
No.
An evaluation and a prescription are not the same thing.
Medication may be one recommendation, but depending on your child’s needs, the treatment plan could include therapy, medication management, additional testing, changes in support at home or school, or a combination of approaches.
If medication is recommended, this is also your opportunity to ask questions. What is the medication intended to help with? What side effects should you watch for? How will you know whether it is working? How often will your child need follow up appointments?
You should understand the plan and feel comfortable asking why a particular treatment is being recommended.
How Parents Can Prepare
You do not need to arrive with a perfectly organized history of everything your child has ever experienced.
But a little preparation can make the appointment easier.
Before the evaluation, consider writing down the behaviors or symptoms you have noticed, approximately when they began, medications your child currently takes, previous diagnoses or treatment, major recent changes or stressors, and any questions you want to make sure you ask.
If you have relevant school evaluations, psychological testing, medication records, or information from previous providers, ask whether those records would be helpful.
Most importantly, talk to your child about the appointment in a way that does not make it sound like a punishment.
“We are going to meet with someone whose job is to understand how you have been feeling and help us figure out what might make things easier.”
What Happens After the Evaluation?
Once enough information has been gathered, the provider will discuss what they are seeing and what they recommend next.
According to the American Academy of Child and Adolescent Psychiatry, the goal is to bring together the biological, psychological, social, developmental, and family pieces of the child’s experience into an understandable picture and treatment plan.[4]
That plan will look different for every child.
For some families, the next step may be outpatient therapy. For others, psychiatric medication support may be appropriate. Some children need additional assessment or more intensive behavioral health services.
The psychiatric evaluation is not the end of the process. It is the beginning of understanding what your child needs.
You Do Not Have to Have All the Answers Before Asking for Help
You do not need to know whether your child has anxiety, depression, attention deficit hyperactivity disorder, or another mental health condition before scheduling an psychiatric evaluation.
That is what the psychiatric evaluation is for.
If something has changed in your child or teenager and your instincts are telling you they need more support, it is worth paying attention.
Three Rivers Therapy provides psychiatric evaluation and medication management along with outpatient therapy and additional behavioral health services for youth and families throughout Washington. We accept most major insurance and Washington Medicaid.
If you are concerned about your child or teen, reach out to Three Rivers Therapy to learn more about scheduling an evaluation.
Sources
- American Academy of Child and Adolescent Psychiatry. Psychiatric Diagnostic Evaluations.
- American Academy of Pediatrics. Guidelines for Adolescent Depression in Primary Care: Identification, Assessment, and Initial Management.
- American Academy of Pediatrics. Mental Health Competencies for Pediatric Practice.
- American Academy of Child and Adolescent Psychiatry. Comprehensive Psychiatric Evaluation.
