Approved by Council October 2004
To be reviewed October 2009
Child and adolescent psychiatry is almost universally practiced in collaboration with others. In most clinical situations, the core collaboration is with the child and family. Additional collaborative interaction with other mental health professionals, school personnel, health professionals (primary care and specialty pediatric care), child welfare personnel, juvenile justice personnel, child and family advocates, and a variety of paraprofessionals is often required. The AACAP recognizes these collaborations as elements of the treatment process. The number and the intensity of these collaborative interactions will vary based on the clinical, developmental and overall psychosocial needs of the child. Whether formal or informal, one-time or ongoing, compensated or pro-bono, collaborative engagements are an integral part of child and adolescent psychiatric practice.
Collaborations are required in all treatment settings, at all levels of care, both acute crisis and long-term encounters. This is especially true in special populations such as those with complex co-morbid conditions, including developmental disabilities, substance abuse problems, juvenile justice and/or child welfare involvement. In all consultative work, it is important to define and periodically refine the goals of the collaborative activity for all participants. The focus of these collaborations may include issues related to biopsychosocial evaluation, risk assessment, treatment planning, psychopharmacologic interventions and/or second opinion consultations.
Child and adolescent psychiatrists collaborate in the following ways at systems levels:
- Consultation about integration of psychiatric care in specific child systems of care,
- Administrative consultation for policy development and planning,
- Second opinion consultation to a child serving agency or payor,
- Consultation to a system-of-care team,
- Consultation to a family team, and
- Working as a member of a system-of-care team in the delivery of services, such as psychotherapies and pharmacotherapy.
When a child and adolescent psychiatrist collaborates in the above referenced situations, it is critical to clarify, at the outset, the roles, functions, responsibilities and boundaries encompassed in the request and to assure that any assumption of responsibilities is commensurate with and the resources (time, information, access to others, reimbursement, etc.) are adequate for the performance of the tasks requested, within the normally accepted standards of care.
In collaboration efforts where the child and adolescent psychiatrist is responsible for any therapeutic intervention(s), ---access to pertinent information must be available on an ongoing basis. All communication about patient care must follow HIPPA guidelines with clear and appropriate documentation.