“If you bungle raising your children, I don’t think whatever else you do well matters very much.”- Onassis
The psychiatric assessment of a child or adolescent starts with obtaining a psychiatric history by interviewing the young person and his/her parents or caregivers. The assessment includes a detailed exploration of the current concerns about the child’s emotional or behavioral problems, the child’s physical health and development, history of parental care (including possible abuse and neglect), family relationships and history of parental mental illness. It is regarded as desirable to obtain information from multiple sources (for example both parents, or a parent and a grandparent) as informants may give widely differing accounts of the child’s problems. Collateral information is usually obtained from the child’s school with regards to academic performance, peer relationships, and behavior in the school environment. Psychiatric assessment always includes a mental state examination of the child or adolescent which consists of a careful behavioral observation and a first-hand account of the young person’s subjective experiences. The assessment also includes an observation of the interactions within the family, especially the interactions between the child and his/her parents. Treatment will usually involve one or more of the following elements: behavior therapy, problem-solving therapies, parent training programs, family therapy, and the use of medication. The intervention can also include consultation with pediatricians, primary care physicians or professionals from schools, juvenile courts, social agencies or other community organizations.