| What
is Family Trauma Services?
Family Trauma Services
is a private, for- profit mental health agency serving the
Washington Metropolitan Area. Family Trauma Services is licensed
by the Virginia Department of Mental Health, Mental Retardation
and Substance Abuse Services to provide outpatient mental health,
intensive home-based counseling, and partial-day treatment
services. Family Trauma Services is also licensed to place
children in treatment foster care homes in Virginia. In addition,
Family Trauma Services is licensed by the Maryland Department of
Health and Mental Hygiene to provide outpatient mental health
clinical services. Family Trauma Services has offices located in
the City of Alexandria, Virginia, Prince George's County,
Maryland, and Montgomery County, Maryland.
Satellite programs are located in
Woodbridge and Manassas, Virginia.
It is the mission of Family Trauma
Services to provide community-based comprehensive mental health
treatment services to children, adolescents, seniors, and
families. FTS services are based on the philosophy that traumatic
childhood experiences are often manifested in inappropriate
"acting out" behaviors. FTS provides a coordinated,
multi-therapeutic approach which simultaneously manages and
modifies the problematic behavior while addressing the core trauma
issues. FTS believes that youth are best supported within. a
family context, and that the family is best supported within the
community. FTS focuses on empowering families to become less
dependent on "the system" and preserving family
togetherness.
FTS recognizes that families needs
are continually changing and, as an agency, we strive to adapt our
services to meet the family's evolving needs.
FTS provides community-based,
home-based, and center-based mental health services, including
psychiatric assessments, medication evaluations, psychological
testing, in-home family counseling, in-home mentoring, partial day
treatment, individual psychotherapy, group psychotherapy, parent
support groups, parenting skills groups, academic tutoring, and
treatment foster care placement services.
FTS conducts specialized treatment
programs focusing on behavioral disorders, anxiety disorders,
sexual offending behaviors, social skills, parenting skills,
parent support, as well as programs designed to meet the needs of
children and adolescents returning to the community from
residential placements and/or placement in a correctional
facility. All of FTS's clinical interventions are needs-driven,
family-centered, and strengths-based.
FTS has extensive experience
working closely with youth in a variety of settings, including
group homes, foster homes, shelters, independent living settings,
and in their homes. FTS's treatment philosophy employs an
ecological perspective, believing that the best way to work with a
family is to involve all the systems that interact with it.
Whenever possible, FTS involves all
family members, extended family, professionals (e.g., mental
health professionals, therapists, probation officers, courts,
school staff), and community resources (e.g., coaches, church,
neighbors, employers, family friends) in developing a treatment
plan which is tailored to meet the individual needs of the entire
family.
FTS Counselors work extensively
with families and communities with the aim of encouraging families
to access available resources in their community with the overall
goal of reducing dependency on clinical services by transitioning
the family to more natural, less-intensive resources. FTS is
accustomed to working closely with schools, recreation centers,
social service agencies, Community mental Health Centers, job
training facilities and other programs in the community to assist
in establishing these relationships.
FTS continually strives to empower
families to learn the skills to advocate for their needs, to
assert their rights as clients in the system of care, and to
obtain the support they need in their neighborhood and community.
Transportation of client to
facilitate treatment is provided by FTS Counselors. Family Trauma
Services also provides 24-hour/7 day a week on-call crisis
intervention support.
Appointments are
available during evening and weekend hours. such as blood tests,
x-rays, or special assessments.
To register for groups, or to find
out more information about FTS's clinical programs, please call,
Wayne Parks, Director at (301)
Tel: (301) 567-6195
What
is a Comprehensive Psychiatric Evaluation?
Evaluation by a child and
adolescent psychiatrist is appropriate for any child or adolescent
with emotional or behavioral problems. Most children and
adolescents with serious emotional and behavioral problems need a
comprehensive psychiatric evaluation.
Comprehensive psychiatric
evaluations usually require several hours over one or more office
visits for the child, parents and family. With the parents'
permission, other significant people (such as the family
physician, school personnel or other relatives) may be contacted
for additional information.
The comprehensive evaluation
frequently includes the following:
- Description of present problems
and symptoms;
- Information about health,
illness and treatment (both physical and psychiatric);
- Parent and family histories;
- Information about the child's
development;
- Information about school and
friends;
- Information about family
relationships;
- Psychiatric interview of the
child or adolescent;
- If needed, laboratory studies
The child and adolescent
psychiatrist then develops a formulation. The formulation
describes the child's problems and explains them in terms that the
parents and child can understand. Biological, psychological and
social parts of the problem are combined in the formulation with
the developmental needs, history and strengths of the child or
adolescent. Time is made available to answer the parents'
and child's questions. Parents often come to such evaluations with
many concerns, including:
- Is my child normal? Am I normal?
Am I to blame?
- Am I silly to worry?
- Can you help us? Can you help my
child?
- Does my child need treatment? Do
I need treatment?
- What is wrong? What is the
diagnosis?
- What are your recommendations?
How can the family help?
- What will treatment cost, and
how long will it take?
Parents are often worried about
they will be viewed during the evaluation. The child and
adolescent psychiatrist is there to support the family and to be a
partner, not to judge or blame. They listen to concerns, and help
the child or adolescent and his/her family define the short and
long-term goals of the evaluation. Parents should always ask for
explanations of words or terms they do not understand.
When a treatable problem is
identified, recommendations are provided and a specific treatment
plan is developed. Child and adolescent psychiatrists are
specifically trained and skilled in conducting comprehensive
psychiatric evaluations with children, adolescents and families.
Dr. Wagdi Attia, FTS's Medical
Director, has been providing psychiatric assessments and clinical
services for Family Trauma Services since 1996. Dr. Attia is also
an Attending Physician at Howard University Hospital in Washington
D.C. and has active memberships with the American Medical
Association, American Psychiatric Association, Washington D.C.
Psychiatric Association, and the Egyptian Medical Association. Dr.
Attia received his medical degree from the Ain Shams School of
Medicine in Cairo, Egypt and his post-doctorate training from
Howard University.
This article and others like it can
be found on the American Academy of Child and Adolescent
Psychiatry website at:
http://www.aacap.org/publiccations/factsfam/index.htm.
Children
of Parents with Mental Illness
Mental illnesses in parents
represent a risk for children in the family. These children have a
higher risk for developing mental illnesses than other
children.
The risk is particularly strong
when the parent's illness is manic- depressive illness,
schizophrenia, alcoholism or other drug abuse, or major
depression. When both parents are mentally ill, the chance is even
greater that the child might become mentally ill.
Risk can be inherited from parents,
through the genes. Some of the risk also comes from parents'
behavior or moods. Mental disorders can keep parents from
providing the love and guidance necessary for a child's healthy
development. An inconsistent, unpredictable family environment
contributes to psychiatric illness in children. Mental illness can
hurt the marriage and the parenting abilities of the couple, which
in turn hurts the child. Some protective or positive things can
decrease the risk to children, including:
- Children knowing their parents
are ill and that the children are not to blame.
- A stable home environment.
- A sense of being loved by the
ill parent.
- A naturally stable and happy
personality in the child.
- Inner strength and good coping
skills in the child.
- A strong relationship with a
healthy adult.
- Friends.
- Interest in and success at
school.
- Other outside interests for the
child.
- Help from outside the family to
improve the family environment (for example marital
psychotherapy, or a class in parenting).
Medical, mental health or social
service professionals working with mentally ill adults need to
inquire about the children and adolescents, especially about their
mental health and emotional development. It is often useful for
such youngsters to be referred to a child and adolescent
psychiatrist for an evaluation.
Individual or family psychiatric
treatment can help a child toward healthy development despite the
problem of the parental psychiatric illness. The child and
adolescent psychiatrist can help the family work with the positive
elements in the home and the natural strengths of the child. With
treatment, the family can learn ways to lessen the effects of the
parent's mental illness on the child.
Unfortunately, families,
professionals and society often pay most attention to the mentally
ill parent, and ignore the children in the family. Providing more
attention and support to the children of a psychiatrically ill
parent is an important way to help prevent mental illnesses from
passing from one generation to the next.
This article and others like it can
be found on the American Academy of Child and Adolescent Psychiatry
website at:
http://www.aacap.org/publications/factsfam/index.htm.
Children's
Major Psychiatric Disorders
A child with a "major
psychiatric disorder" has a very serious illness affecting
several areas of the child's life. These areas include emotions,
social or intellectual I or the use of language. Children with
major psychiatric disorders may also have physical problems or may
also be mentally retarded.
When a child and adolescent
psychiatrist examines a child to learn if he or she has a major
psychiatric disorder, these are some of the signs they look for or
ask parents about:
- failure to look or smile at
parents or other care givers;
- very strange actions or
appearance;
- lack of movement or facial
expression;
- lack of interest in or awareness
of other people;
- odd way of speaking, or private
language that no one else can understand;
- strange conversations with
him-or herself.
- odd or repetitive movements,
such as spinning, hand-flapping, or headbanging; and
- panic in response to a change in
surroundings.
There are many different kinds of
major psychiatric disorders. The specific name given to a child's
illness will depend upon the combination of symptoms listed above,
and on how severe the illness is.
Major psychiatric disorders often
last a long time, and may be lifelong. However, when children with
these disorders begin treatment early, their health and ability to
perform everyday tasks will usually improve.
When parents are concerned that
their child may have a major psychiatric disorder, they should
seek a comprehensive evaluation as soon as possible. Observant
parents, pediatricians, teachers and others who see the child
regularly can compare the child with others in his or her age
group. Their observations are very helpful in the formation of an
initial assessment of the child's problem.
A comprehensive evaluation and
treatment plan will then involve a child and adolescent
psychiatrist, who coordinates his or her own findings with those
of parents, special educators, pediatricians, neurologists and
developmental and psychological tests.
Comprehensive treatment will
involve coordinating several of the following:
- psychotherapy;
- specific learning programs;
specific social skill and behavior
programs;
psychiatric medication;
special schools or hospitals; and
active involvement by the family
Perhaps because children change so
much as they grow, diagnosis of major psychiatric disorders in
youngsters is one of the most difficult areas of medicine. Thus,
it is extremely important that physicians with adequate training
and experience be involved in helping the child, and that parents
seek help as soon as they begin to be worried about their
child.
This article and others like it can
be found on the American Academy of Child and Adolescent
Psychiatry website at:
http://www.aacap.org/publications/factsfam/index.htm.
11
Questions to Ask Before Psychiatric Treatment of Children and
Adolescents
Treatment in a psychiatric hospital is
one of a range of available options when a
child or adolescent is mentally ill. Parents
are naturally concerned and may be
frightened and confused when inpatient
treatment is recommended for their child. By asking the following questions, parents
will
gain a better understanding of the proposed
stay in an inpatient facility
- Why is psychiatric inpatient treatment
being recommended for our child, and how
will it help our child?
- What are the other treatment alternatives
to hospital treatment, and how do they
compare?
- Is a child and adolescent psychiatric
admitting
our child to the hospital?
- What does the treatment program for
inpatient treatment include, and how will
our child be able to keep up with school
work?
- What are the responsibilities of
the
child and adolescent psychiatrist and
other people on the treatment team?
- How long will our child be in the
hospital,
and how do we pay for these services?
- What will happen if we can no longer
afford
to keep our children in this hospital and
inpatient treatment is still necessary?
- How will we as parents be involved in our
child's
hospitalization, including the decision or
discharge and after-care treatment?
- Is this hospital approved by the Joint
Commission
for the Accreditation of Healthcare
Organizations (JCAHO) as a treatment
facility for youngsters of our child's
age, or will our child be on a specialized
unit or in a program accredited for
treatment for children and adolescents.
- How will the decision be made to
discharge
our child from the hospital?
- Once our child is discharged, what are
the
plans for continuing or follow-up treatment?
Hospital treatment is a serious matter for
parents,
children and adolescents. Parents should
raise these questions before their child or
adolescent is admitted to the .hospital.
Parents who are informed about the hospital's
treatment plan and procedures can fully
contribute to the effectiveness of their child's
treatment.
If after asking the above questions,
parents
still have serious questions or doubts, they
should feel free to ask for a second opinion.
Parents seeking a referral to a local child
and adolescent psychiatrist may contact the AACAP, 3615 Wisconsin Avenue, N.W.,
Washington,
D.C. 20016, (202) 966-7300.
Medication may be an important part of
treatment
for some psychiatric disorders in children
and adolescents. Psychiatric medication
should only be used as one part of a
comprehensive treatment plan. Ongoing evaluation
and monitoring by a physician is essential.
Parents should be provided with complete
information when medication is recommended as part of their child's treatment plan. Children and
adolescents
should be included in the discussion about
medications, using words understand. By
asking the following questions, children,
adolescents, and their parents will gain a
better understanding of psychiatric medications:
- What is the name of the medication? is it
known
by other names?
- What is known about its helpfulness with
other
children who have a similar condition to
my child?
- How will the medication help my child?
How
long before I see improvement? When will
it work?
- What are the side effects which commonly
occur with this medication?
- What are the rare or serious side effects,
if
any, which can occur?
- Is this medication addictive? Can it be
abused?
- What is the recommended dosage? How
often
will the medication be taken?
- Are there any laboratory tests (e.g. heart
tests,
blood test, etc.) which need to be done
before my child begins taking the
medication? Will any tests need to be done
while my child is taking the medication?
- Will a child and adolescent psychiatrist
be
monitoring my child's response to medication
and make dosage changes if necessary? How
often will progress be checked and by whom?
- Are there any other medications or foods
which
my child should avoid while taking the
medication?
- Are there any activities that my
child
should avoid while taking the medication?
Are any precautions recommended
for other activities?
- How long will my child need to take
this medication? How will the decision be
made to stop this medication?
- What do I do if a problem develops
(e.g. if my child becomes ill, doses are missed, or side effects
develop)?
- What is the cost of the medication
(generic vs. brand name)?
- Does my child's school nurse need to
be informed about this medication?
Treatment with psychiatric medications is
a serious matter for parents, children and
adolescents. Parents should ask these
questions before their child or adolescent
starts taking psychiatric medications.
Parents and children/adolescents need to be fully informed about medications. If,
after
asking these questions, parents still have
serious questions or doubts about medication
treatment, they should feel free to ask for
a second opinion by a child and adolescent psychiatrist.
This article and others like it can be
found
on the American Academy of Child and Adolescent Psychiatry website at:
http://www.aacap.org/publications/factsfam/index.htm.
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