Child and Adolescent Mental Illnesses FAQ - How to Choose A Mental Health Professional For An Adolescent

Written by HealthyPlace.com Staff Writer

School-based services
Schools must provide appropriate special education and related services for children who are identified as seriously emotionally disturbed and in need of special educational help. For qualifying children, school staff and parents write an Individualized Education Program (IEP), which specifies the amount and type of special education the child requires, the related services the child may need, and the type of placement which is suitable for teaching the child.

Special education services are specifically educational in nature. While these educational services may be helpful to the emotionally disturbed child, a more complete treatment program may also be needed, such as psychotherapy services.

Special education services must be provided at no cost to parents. The IEP must be revised at least every year, with parents participating in the revision.

How can my child get help through their school?

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If your child has emotional or behavioral problems that upset their school attendance or performance, talk to the teacher, counselor, and/or principal of your child's school (public or private) and ask for an evaluation of your child.

If you think your child would benefit from special education and mental health services, ask your local public school for a "Request for Evaluation" Form and related information leaflets and brochures. Private school students can be evaluated by the public school they would have attended.

If mental health and other support services are needed for your child, a case manager should be assigned to help you and your child find and use all the services that may be needed (e.g., education, mental health, vocational). A school counselor can assist. For information assistance, look in the Finding HELP Phone List under Children & Teen Services. Special Parent Information Network (SPIN) on all the islands, the Learning Disabilities Association or, in Waianae, Legal Services for Children may be helpful.

Community-based outpatient treatment
Outpatient treatment usually means that the child lives at home and receives psychotherapy at a local mental health clinic or from a private therapist. Sometimes psychotherapy is combined with a home intervention and/or a school-based special education program. Outpatient therapy may involve individual, family, or group therapy, or a combination of them.

For families who do not have private insurance coverage, but may have QUEST or Medicaid or no insurance, there are state funded Family Guidance Centers within each Community Mental Health Center to assist families in receiving the appropriate outpatient treatment or other referral for children and adolesants. Community-based day treatment (also called Community-based instruction) Day treatment is the most intensive nonresidential type of treatment. It has the advantages of keeping the child in the home, while bringing together a broad range of services designed to strengthen the child and improve family functioning. The specific features of day treatment programs vary from one program to another, but may include some or all of the following components:

1. Special education, generally in small classes with a strong emphasis on individualized instruction.
2. Psychotherapy, which may include both individual and group sessions.
3. Family services, which may include family psychotherapy, parent training, brief individual therapy with parents, help with specific tangible needs such as transportation, housing, or medical attention.
4. Vocational training.
5. Crisis intervention.
6. Skill building with an emphasis on interpersonal and problem-solving skills and practical skills of everyday living.
7. Behavior modification.
8. Recreation therapy, art therapy, and music therapy to aid social and emotional development.
9. Drug and/or alcohol counseling.
10. Children participate in a day treatment program for 6 hours a day. Lengths of stay are usually one school year, but can be shorter or longer.

Some day treatment programs are physically located on a school site where they may have a wing of their own that includes classrooms and office space. Other day programs are run in mental health centers, other community agencies, or on the grounds of a private clinic or hospital.

Community-based residential programs
Community-based residential programs involve the use of either group homes or therapeutic foster homes. This type of treatment assumes that there is a need to bring about a total change in the child's environment.

Foster-home placement
Foster home placement is, in many ways, a "natural" approach to treatment because it provides a family unit, which is the normal developmental situation for a child. A foster home will provide additional components beyond the nurturing characteristics of a wellorganized family. These additional components may include special training for the foster parents in behavior modification and crisis intervention.

"Therapeutic" foster homes offer additional support, including psychotherapy and case management. Therapeutic foster homes usually foster only one child at a time, whereas regular foster homes may have multiple children placed with them.