Child psychiatric follow-up care is a key part of managing mental health conditions in children and adolescents. It is not a one-time event, but an ongoing process aimed at monitoring the child’s development, adjusting treatment when necessary, and providing continuous support to both the child and their family.

This is an overview of what a typical child psychiatric follow-up appointment looks like at Murmo:

Frequency and setting:

Frequency: This varies depending on the child’s condition, the severity of symptoms, their level of stability, and the type of treatment involved. Follow-up appointments may take place weekly, biweekly, monthly, or less frequently (for example, quarterly) if the child’s condition is stable.

Setting: Follow-up appointments typically take place at a child psychiatry clinic, private practice, or sometimes via telemedicine (video consultations). We prefer in-person appointments, but online sessions can occasionally be arranged as well.

Participants:

The child/adolescent: The primary focus of the follow-up appointment.

Parents/Guardians: They play an essential role in providing additional information, discussing concerns, and understanding the treatment plan. Younger children often attend together with their parents, while older adolescents may have more individual time with the psychiatrist, with parental involvement either before or after the session.

Other family members (sometimes): If family dynamics are a significant factor, other family members may also be involved in the process.

Other professionals (less commonly at every follow-up, but in coordination): The psychiatrist often collaborates with therapists, school counsellors, paediatricians, or other specialists involved in the child’s care. Sharing information between professionals is vital.

Key elements of a follow-up session:

Introduction and building rapport

  • The psychiatrist welcomes the child and the family, with the aim of creating a comfortable and safe environment.

  • In the case of children, this may include engaging in play or having conversations that help ease tension and build trust.

Review of progress since the last appointment

  • Symptom assessment:

The psychiatrist asks about any changes in symptoms (such as mood, anxiety, attention, behaviour, sleep, or appetite) using specific questions. Rating scales may also be used for objective monitoring, completed by the parents and/or the child.

  • Functioning:
    Discussion focuses on how the child is functioning at home, at school (including academic performance and social interactions), and during extracurricular activities. Are there any new challenges or improvements?

  • Medication review (if applicable)

    • Effectiveness: Is the medication helping with the target symptoms?

    • Side effects: Are there any new or ongoing side effects? This is a critical part of medication management in children, as they may not always be able to clearly express side effects themselves.

    • Adherence: Is the child taking the medication as prescribed?

    • Dose adjustment: Based on the above, the psychiatrist may decide to adjust the dosage, switch medications, or discontinue medication if necessary.

    • Therapy progress (if applicable): If the child is also participating in therapy (for example, CBT or play therapy), the psychiatrist will ask about progress in therapy and any challenges that may have arisen

  • Discussion of current concerns and challenges

    • Parents and the child have the opportunity to raise any new concerns, questions, or difficulties they may be experiencing.

    • This is also a chance for open communication about stressors, family changes, or school-related issues that may be affecting the child’s mental health.

  • Safety assessment

    • This is a fundamental part of every child psychiatric follow-up appointment. The psychiatrist assesses for thoughts related to self-harm, suicide, or harm to others.

    • This may also include questions about bullying, substance use, or any risky behaviors.

  • Updating the treatment plan

    • Based on the assessment, the psychiatrist reviews and updates the overall treatment plan. This may include:

      • changes to medication management,

      • recommendations for new or modified therapeutic interventions,

      • suggestions for school accommodations or support,

      • referrals to other professionals (for example, a clinical psychologist, family therapist, special education specialist, or art therapist),

      • guidance for parents on behavioral management strategies and ways to support their child at home.

  • Psychoeducation and support

    • The psychiatrist continues to provide psychoeducation about the child’s condition and the reasoning behind the treatment plan.

    • They also offer support and guidance to parents on how to best support their child and manage any challenges that may arise.

    • This may include discussing parenting strategies, parental stress management, or connecting families with community resources and support services.

  • Scheduling the next appointment

    • Before concluding the session, the next follow-up appointment is scheduled, taking into account the child’s needs and the urgency of their condition.

Goals of follow-up care:

Symptom management: To ensure that symptoms are controlled and minimized as much as possible.

Improved functioning: To help the child thrive across all areas of life, including school, home, and social relationships.

Relapse prevention: To identify and address potential triggers that may lead to a worsening of symptoms.

Medication safety and effectiveness: To monitor and optimize medication treatment when applicable.

Empowerment: To equip the child and family with coping strategies, knowledge, and practical tools.

Continuity of care: To provide ongoing support and adapt care to the child’s changing needs over time.

Child psychiatric follow-up care is a collaborative process in which the psychiatrist, the child, and the family work together to achieve the best possible outcomes for the child’s mental health and overall well-being.