Initiating Treatment, Selecting An Outpatient Treatment Provider

A good starting point for obtaining counseling services for your child is to consult with your child’s pediatrician/primary care physician. Have the doctor do a physical examination to determine if a medical condition is causing or contributing to your child’s emotional/behavioral difficulties. Make sure that the physical exam is thorough and includes blood work and, if your child is middle school age or older, a urine drug screen. If your child’s symptoms are not related to a medical condition, then mental health or substance abuse treatment may be recommended. If you have an HMO insurance plan, ask your doctor to give you feedback on your list of “in-network” providers. If you have a traditional indemnity or PPO plan, ask your doctor to provide you with the names and phone numbers of at least two treatment providers that he/she thinks would be a good match for you and your child.

In addition to your doctor, I strongly recommend that you consult with your child’s guidance counselor or other member of the school counseling staff (guidance counselor, social worker, psychologist or student assistance coordinator). School counselors are accustomed to working with children experiencing difficulties and can be a great source of support and expertise in connecting you to a treatment provider in your area.

Selecting A Treatment Provider:

To help determine the probability of a good match between you and a potential treatment provider, it is crucial to conduct a telephone consultation and to ask a lot of questions. Consider your first telephone contact and first therapy session as a two-way interview. While the treatment provider assesses you and your child’s difficulties and treatment needs, you are assessing the treatment provider’s personality, treatment philosophy and skill level. 

Ask the treatment provider the following questions:

• Do you accept my insurance ____________________?
• What are your fees?
• What are your credentials? What is your professional license?
• Do you have experience working with patients my child’s age? How many do you have in your total caseload?
• Do you have experience working with my child’s presenting difficulty? How many patients with my child’s difficulty have you treated?
• What is your treatment philosophy?
• Do you have any specialized training?
• What is the average length of treatment for my child’s type of difficulty?
• If my child does not want to come to therapy or is uncooperative with you, how will you handle that?
• Do you communicate and work with school staff if necessary? 

If you are still not sure, then ask:

• What are your strengths as a treatment provider?
• Is there anything else you think I need to know as a parent/guardian of a potential patient?

Since most of us do not have ample experience in directly questioning a professional about his/her expertise, it may feel uncomfortable asking these kinds of questions. I urge you to put aside your discomfort. Not asking questions and adequately assessing the compatibility between you and a potential treatment provider increases your risk of wasting your time, money and hope.

The type of responses you get to these questions may vary greatly. What often matters as much as the answers is the openness and sincerity with which they are given. From a credentials standpoint, you want a licensed treatment provider (or someone under the direct supervision of a licensed treatment provider) with both experience and specialized post-masters training. 

In making a final decision about a treatment provider, ask yourself the following questions:

• Did the treatment provider sound professional, knowledgeable, warm and considerate?
• Was I comfortable speaking to this treatment provider?
• Did the treatment provider welcome my questions? Did he/she answer the questions fully or did I have to probe for more thorough responses?
• Was the treatment provider patient with me or did I feel rushed?
• If you left a message on the treatment provider’s voice mail or answering service – Did the treatment provider return my call within a reasonable amount of time?