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Assessment of child and adolescent psychiatric disorders

Assessment of child and adolescent psychiatric disorders

It is essential to undertake a full and comprehensive assessment before embarking on treatment of the problems. It may take more than one meeting before an assessment is completed. Assessments should be carefully planned and time allowed to explore with the child and family their attitude to the referral. Most clinicians recommend a semi-structured approach as long as the relevant details of the history are completed. The assessment process is complex and can be bewildering to patients with no previous experience of the process.

At the onset, the nature, purpose and the length of the interview need to be clarified. Children and families need to be informed about their rights to confidentiality and any conditions under which you would have to disclose information obtained during the interview. There is no set format for interviewing families and assessment may involve interviewing the whole family, individual members or the parents and child separately. The nature of the interview with the child will depend on the child’s developmental age and maturity. With young children, this may involve free play, observation and drawing. Older adolescents often express a wish to be seen on their own. There are statutory obligations to report disclosure of abuse in line with national and local child protection procedures. It is important to keep the child’s needs foremost in the mind. The initial assessment may indicate a need for the collection of further information from other agencies who have contact with the family or child, and consent needs to be sought before such contact can be made. Decisions about psychometric testing, physical examination and laboratory tests need to be considered.

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