In the past few years, there has been a major shift in the mental health care of child and adolescents from inpatient care to non-hospital community ambulatory settings. Economic pressures have primarily driven this change in service delivery. Insurance companies and managed care organizations have not only restricted access to hospitalization and limited length of stays but additionally have sharply reduced reimbursements for treatments. State and federal policies for inpatient treatment and reimbursement have followed similar trends. As a result, mental health planners have attempted to develop programs to deal with this trend of restricted inpatient care shifting treatment of children and adolescents to home and community settings. Some of these new programs are well planned and others are hastily planned and implemented. The pitfall to this community approach is that there is a population of chronically disturbed children and adolescents, and highly stressed parents often lacking adequate personal and family resource who may not respond to these new less restrictive, less costly community approaches which potentially may lead to an unsafe and dangerous situation for the child, adolescent, family and the community.
With this in mind, the purpose of this book is to provide comprehensive and up-to-date information regarding child and adolescent outpatient, day treatment and community psychiatry. The emphasis of this book is to provide practical knowledge through clinical case illustrations and to explain various strategies in a detailed fashion.
Table of Contents
Preface. Section 1. Ambulatory Services: Clinical, Administrative, and Training Issues. Administration of Ambulatory Services for Children and Adolescents: Historical View, Present Issues, Challenges, and Solutions. The Specialty Clinic: A Bridge Between Research and Clinical Practice. Child and Adolescent Services in a Community Mental Health Center: Transition, Organization, and Staffing Issues. Training in Ambulatory Setting. Section 2. Assessment. Psychiatric Assessment of Infants and Parent-Child Interaction. Psychiatric Evaluation of School Age Children. Psychiatric Assessment of Adolescents and their Families. The Process of Psychological Assessment. Speech and Language Evaluation. Forensic Community Child and Adolescent Psychiatry. Section 3. Common Disorders of Childhood and Adolescence. Affective Disorders in Children and Adolescents. Obsessive Compulsive Disorder, Tics and Tourettes Syndrome and Separation Anxiety Disorder. Attention Deficit/Hyperactivity Disorder. Conduct and Oppositinal Defiant Disorder. Alcohol and Substance Abuse in Children and Adolescents. Pervasive Developmental Disorders and Learning Disorders. Section 4. Therapeutic Interventions. Pharmacotherapy in Children and Adolescents. Cognitive-Behavioral Therapy with Children and Adolescents. Individual Psychotherapy and Use of Play with Children. Individual Psychotherapy with Adolescents. Behavioral Interventions with Children and Adolescents. Group Psychotherapy with Children and Adolescents: Key Issues. Part 5. Day Treatment for Children and Adolescents. Day Hospital: Planning, Staffing and Administration. Therapeutic Milieu in a Day Hospital for Children and Adolescents. Day School for Emotionally and Behaviorally Disturbed, and Learning Disabled Children and Adolescents. Part 6. Other Community Based Programs. Mental health Services in Schools: Expanding Opportunities. Finding Our Way Home: Home and Community Based Care. Therapeutic Nursery. Foster Care.
Harinder S. Ghuman (Edited by) , Richard M. Sarles (Edited by)