Child and Adolescent Psychiatry

Using the conversational style and clinical vignettes found in all Practical Guides in Psychiatry titles, Dr. Stubbe takes clinicians through each step of the psychiatric care process, delivering essential fast facts and effective patient care strategies. Sections cover psychiatric evaluation; disorders seen in infants, children, and adolescents; treatment modalities and treatment planning; and special circumstances including psychiatric emergencies, child neglect and abuse, and family issues. Easy-to-use appendices include rating scales and resource information.

Neuro-developmental problems arising in childhood: attention deficit hyperactivity disorder (ADHD) autism and learning disability tic disorders Emotional and behavioural problems: disruptive behaviour feeding and toileting difficulties depression anxiety and OCD (obsessive compulsive disorder) response to trauma or life adjustment (such as domestic violence and divorce) attachment disorders Other significant mental health problems: eating disorders psychosis self-harm and attempted suicide Sometimes work is carried out with other professionals or carers of young people, rather than directly with the young person themselves.? For example, child and adolescent psychiatrists may work with teachers, foster carers, paediatricians, siblings or others involved with a young person in difficulty.
Consultant psychiatrists often provide specialist advice, leadership and support to the wider mental health team.
A good understanding of legal frameworks is also important, since child and adolescent psychiatrists may need to intervene by suggesting a particular care arrangement, educational provision or ensuring the safety of young people through legal means.
?Early intervention can make all the difference, even to potentially serious illnesses such as psychosis?. ?Rory Conn, Child and Adolescent Psychiatist, Whittington Health NHS Trust.

Common procedures/interventions
Most interventions involve talking to children and young people and their families to gain an understanding of difficulties and to find a way forward, within a child development perspective.
An example of a ?talking therapy? used with children and young people is cognitive behaviour therapy (CBT). CBT enables the patient to look at how they think and feel about a particular situation and to see how this might influence their behaviour. It can be used to help change unhelpful thinking patterns and behaviours.
Alongside many other non-drug treatments, child and adolescent psychiatrists may prescribe medication where necessary, such as anti-depressants and drugs for ADHD.
Child and adolescent psychiatrists often liaise with professionals from many other agencies to improve care for young people.

Associated sub-specialties
There are no formal General Medical Council recognised sub-specialties within child and adolescent psychiatry.?However there are a number of growing special interest areas including the following: Here are some examples of education and training opportunities: director of medical education -the NHS consultant appointed to the hospital board who is responsible for the postgraduate medical training in a hospital. They work with the postgraduate dean to make sure training meets GMC standards training programme director -the NHS consultant overseeing the education of the local cohort of trainee doctors eg foundation training [11] programme director. This role will be working within the LETB/deanery associate dean -the NHS consultant responsible for management of the entirety of a training programme. This role will be also be working within the LETB/deanery

SAS doctor roles
SAS doctors (Staff, Associate Specialists and Specialty Doctors) work as career grade specialty doctors who are not in training or in consultant posts. You will need at least four postgraduate years training (two of those being in a relevant specialty) before you can apply for SAS roles.

Other non-training grade roles
These roles include: trust grade clinical fellows

Other opportunities
Child and adolescent psychiatrists undertake research, which includes collaborating with colleagues in the UK and overseas, writing papers and presenting work at conferences.
There are good opportunities for research, for example in genomics [13] (how understanding individual genetics [14] can affect prescribing) and identifying the most effective components of different psychotherapies with children and young people It is also possible to work as a clinical academic, where a large percentage of the working week is assigned to research.
Research within this specialty, as is often the case, is subject to financial constraints. There is not always sufficient money to carry out all the necessary work.
There may also be opportunities to work in the private sector and overseas.

Academic pathways
If you have trained on an academic psychiatry pathway or are interested in research there are opportunities in academic medicine.
For those with a particular interest in research, you may wish to consider an academic career in psychiatry. Whilst not essential, some doctors start their career with an Academic Foundation post. Entry is highly competitive. This enables them to develop skills in research and teaching alongside the basic competences in the foundation curriculum. [15] Entry into an academic career would usually start with an Academic Clinical Fellowship (ACF) at ST1-2 and may progress to a Clinical Lectureship (CL) at ST3 and beyond. Alternatively some trainees that begin with an ACF post then continue as an ST trainee on the clinical programme post-ST4.
After completion of the academic foundation trainees can then apply for academic core training posts (instead of normal core training). ?A PhD is often taken, either during core or specialty training.
Applications for entry into Academic Clinical Fellow posts are coordinated by the National Institute for Health Research Trainees Coordinating Centre (NIHRTCC). [16] There are also numerous opportunities for trainees to undertake research outside of the ACF/CL route, as part of planned time out of their training programme. Find out more about academic medicine. [17] The Clinical Research Network [18](CRN) actively encourages all doctors to take part in clinical research.
There are opportunities to undertake research within the field of child and adolescent psychiatry.

Other opportunities
There may also be opportunities to work in the private sector and overseas.

Expand / collapse
This?section provides useful information about the availability of jobs, how to find vacancies and sources of further information.