By Vera Joffe, Ph.D. (copyright, 2006)

1. Whenever you go to a doctor, make sure that you know the reason for your visit to a psychiatrist, and also to a psychologist. What are your concerns? What do you think is going on with your child (or with you)?
    
2. Once you choose a psychologist to work with, make sure that the person has knowledge and even specialty in the area of concern you have for your child.
    
3. Make sure to tell everything you want, and to ask all the questions you have for the new psychologist.
    
4. The psychologist should use information from many sources and situations to gather data to reach a diagnosis (if there is one) for your child. At first, the psychologist will spend time with you; ask you questions about development of your child, and about reason for referral. The doctor should also find out about your child’s strengths, his/her social life, academic, emotional, as well as leisure activities.
    
5. Then, at times it’s helpful to gather information from the teachers, and from other people working with your child, such as a coach, or a dance teacher, counselor, etc.
    
6. Once the psychologist completes enough information, including interviewing your child, she/he will seat with you and give you feedback about possible diagnosis, and a treatment plan for your child. It is important you do that so that you understand the process of working with the psychologist, and what interventions she/he will use. Please, make sure that you ask the psychologist how she/he arrived at the conclusions about the psychological assessment of your child, and how she made a decision about TX for your child.
    
7. "Evidence Based treatment": is treatment that is indicated for certain conditions based on results of empirical research. For instance, if your child has anxiety, or depression, research shows that the best treatment for such condition is Cognitive Behavior Treatment. You can learn more about this in the internet. So, you can ask the therapist: “Are you basing your decision about the intervention on research?”
    
8. Once treatment and interventions start, it is important to keep the parents as active agents of change also. Therapy works better if parents are involved in the interventions, not only that, but also if both parents are united in implementing changes during treatment. For instance, outcome of treatment is less successful if one parent does not participate in the process of change, and a parent openly does not agree with the therapy, especially if there is a divorce in the situation.
    
9. I usually work not only with the child, the parents, and the family. In certain cases it is very helpful to consult with the school, and to even develop some interventions at school. For instance, if I have a child diagnosed with selective Mutism, it does not help for me to only work with the child in my office. I work very closely with the school, and the parents. And only in that situation treatment can be successful. I once had a case with a child with Selective Mutism, but the school did not allow me to visit, and to talk to the teacher. As a consequence, we could not work with that school. IN addition, schools should allow parents to see their children’s classrooms any time. I would not send my child to a school that does not allow for a professional to observe the classroom at some time.
    
10. Once the therapist develops the goals, you may want to review that often. How are we meeting the initial goals? What behaviors need to change? We should always set up expectations a little lower than we want. For instance, I remember having a first session with a young couple where the parents were very anxious about a child who did not eat anything solid. The boy was already 3 years old, and he only ate Gerber’s food. The parents were so anxious that they wanted me to develop a plan right away, with the guarantee that I was going to change their child’s behavior overnight. And they said: “We tried everything already, you name it, and we tried it. With time, we found out that there were many other issues that were important in the child’s life, such as the child did not sleep in his bed, but only with the parents, the child only wore one outfit everyday, and the child had speech delay. Thus, out work was going to involve a lot more than working with a youngster who “only ate baby foods”. Once we found out about all the issues, we started working on the one that was most likely to be successful to change to help the parents have a sense of success, and of change for the better.

I hope that these guidelines were helpful for you. Please, send me an email for questions and comments,

Sincerely,
Vera Joffe, Ph.D.
Licensed Psychologist