The type of problems I see
I treat the range of disorders encountered in child mental health. These will usually include:
Attention and hyperactivity problems including ADHD and related neurodevelopment conditions,
Anxiety disorders including obsessive-compulsive disorder and phobias
Tic disorders and Tourette’s syndrome
Depression
Difficulties with social interaction, in particular when autism spectrum disorder is suspected.
PANS/PANDAS Paediatric autoimmune neuropsychiatric syndromes
I have extensive experience in adolescent mental health: I can help with adolescent emotional crises, preferably adolescents who are willing to be helped, although with a bit of patience and strategy, I have been able to successfully engage some rather difficult adolescents with the help of their parents.
If you are concerned about your teenager and cannot bring him or her to accept psychological help, please make a brief appointment of 30 or 60 minutes with me to discuss the best strategy. This has been a very successful approach. .
I also treat most adolescent mental health problems:
Mood disorders including Depression and Bipolar illness
Anxiety and obsessive-compulsive disorder
I am very experienced in dealing with teenagers who have suicidal urges
I can be helpful with drug misuse problems but usually if this is part of a wider problem
Trauma related conditions. I will administer EMDR (eye movement desensitisation and reprocessing) when indicated.
Eating disorders: anorexia and bulimia.
I will refer to my adolescent outreach treatment project named the Bear Project YPT when indicated, where a multidisciplinary team can offer a broader treatment package.
I am trained in a range of psychological interventions but I will usually integrate the following therapies as appropriate in my practice: EMDR: Eye movement desensitization and reprocessing, Mentalisation based therapy, Mentalisation based family therapy. If formal CBT is required, I will usually refer to an appropriate clinical psychologist when a more structured and extended course of therapy is required.
What happens on the first appointment
In order to assess the situation I have to ask many questions to both parents and the young person. I ask these questions in a conversational way. Some questions can only be answered by the parent others by the child or teenager. It is important that I meet both parents. I usually start by seeing the child with his parents because this allows me to gain an understanding of all the concerns, as well as to obtain everybody’s perspective and assess the young person’s disposition in the presence of their parents. There is usually more than one problem and more than one view to each problem. It is also easier and less embarrassing for the child, if I see him with his parents initially.
If I am seeing a teenager I will give the teenager the choice, as he or she might want to speak to me alone initially. Parents should of course not be put off by this as it is mostly an attempt to engage the teenager in the process.
There is no immediate need to see brothers and sisters unless of course they are part of the problem in question.
Parents are often uneasy about giving a full account of their child’ s problems in front of them. I sometimes meet with parents without the child during the course of the assessment. I also like to see the child on their own if they are old enough and accept. This can usually be done within the first appointment.
It is sometimes very useful to have a report from school. I will however not contact them without your permission.
I may need to carry out a physical examination on a child but can usually manage this without taking all their clothes off. I don’t often need to take bloods for tests. I rarely need to request a brain scan, which will need a separate arrangement. After the first appointment, I will write a report about my assessment to you and to the referring doctor. If there is a need for psychological treatment I will sometimes refer on to a clinical child psychologist or psychotherapist. If medicines need to be involved then I will manage these myself, jointly with the referring GP or paediatrician.
It might be helpful to explain to your child what sort of person you are taking them to see. I suggest that you say the following: That you are taking them to meet a doctor to see if there is a medical reason for their problems, They will return home afterwards, The doctor will ask them some questions but that it is not a test or an exam. There will be no injection or operation.
A first appointment lasts about an hour and a half. If I need to see your child again it will be for a shorter period. I can meet with parents rather than the child for follow-up. This is not because I think parents are causing the problems –they are usually not- but because they have the power to make a change for their child. It is often the case that changing the way a teacher or parent handles a child helps to resolve the problem.
Indeed, I can do very little in any case without your support and cooperation. I am looking forward to meeting with you.