Assessment begins with getting to know a little about you. Understanding your anxieties.
Who is most worried? Whose idea was it to come? What are you hoping for? Being curious about your situation together. Assessment often refers to the first meeting, but in reality it continues throughout our meetings as I understand you and the situation more.
The first meeting will involve information gathering but I will not ask lots of questions in a set pattern. I will listen to what you bring and how you describe the issues, wanting to find out more and engage you so that you feel comfortable and understood. I am interested in your/your child's goals, rather than assuming what they might be.
Assessment can be therapeutic when it is done this way and I hope you will experience it as helpful, even if there is a long way to go.
In an initial assessment meeting, I ask general questions to get a broad look at the situation and background, wondering "why this issue, and why now?" Common presenting symptoms are anxiety and panic, unhappiness, irritability, obsessions, anger and withdrawal. Together we will be making sense of the situation, which may be complex, working out where to intervene to make things better.
A diagnosis can sign-post to the right treatment and interventions. It can help obtain funding from medical insurance companies or from education services. However, a label is not always necessary or helpful; we are all different and the current classification system is often inadequate to explain and communicate about a young persons' distress and difficulties. When receiving a diagnosis, some young people may feel ashamed or that they are inadequate or flawed, whilst others may experience great relief at understanding why they are different or struggle.
Most importantly I aim to understand your distress, how it arose, what is maintaining it and find ways of making changes that you want.
Coming to see a psychiatrist can be daunting and you or your child may feel nervous. I won't ask you to lie on a couch, won't be in a white coat and aim to put you at ease.
Diagnostic and Neuro-Developmental assessments
Sometimes the question you come with may be around a specific disorder. For example, does she/he/I have ADHD or an Autistic Spectrum Disorder? These assessments will include gathering information and observations from school and other settings, completing standardized questionnaires and asking specific questions - starting with a possible diagnosis and seeing if the presentation fits it.
Usually these assessments take around 3 meetings but this does depend on individual situation; if there has already been previous assessment (e.g. a speech and language or educational psychology report is available) and the information gathered shows consistent difficulties, a diagnosis may be given more quickly. Likewise, it may be clear after one meeting that the diagnostic criteria are not met. Making a diagnosis is only the first step but can guide us to the most effective treatment.