Child & Adolescent Psychiatry; a Specialized Field

The decision to refer a child or teen to a psychiatrist can be difficult and for some scary. This is understandable. Their brains are still developing, medications can affect children and teens differently than they do adults, side effects may seem risky to some. At Campbell Teen & Family Therapy, Inc. we recommend that children and teens always see a Child & Adolescent Psychiatrist that has completed the extra 2-year fellowship working with children and teens. They are best suited to understand the complexities of treating minors and helping parents and families to understand the treatment recommendations.

We are excited to have Dr. Joseph Gulino join our staff as our in-house Child & Adolescent Psychiatrist who is a specialist in pediatric psychiatry. We want to offer the best care for your child or teen. We value a collaborative model and having a psychiatrist in house means that communication is easy and all of the providers are on the same page.

We often get questions about psychiatric treatment and would like to address some of our frequently asked questions below.

What is the difference between a pediatric Psychiatrist and an adult Psychiatrist?

Child and adolescent psychiatrists are specialists in pediatric psychiatry. They are physicians that after four years of medical school chose to complete a four-year residency in psychiatry to treat adults but then also chose to pursue further specialized training to treat children by completing a two-year fellowship working with children and teens. Their focus is diagnosing and treating disorders that affect how children think, feel, and behave. They look at the whole child/teen including the genetic, physical, developmental, cognitive, emotional, family, and peer influences on the mental health.

When should a pediatrician, therapist, school counselor, etc. refer their patient or student to a child & adolescent psychiatrist?

There are numerous reasons why a child/teen should be referred to a specialist in pediatric psychiatry including the following:

– If the child/teen is displaying behaviors or expressing emotions that could be potentially dangerous to themselves or others (suicidal, homicidal, physical aggression, self-harming behaviors, eating disorders, substance abuse, or other self-destructive behaviors)
– If the child/teen was hospitalized on a psychiatric unit
– If there is suspicion for psychosis
– If there is a history of abuse, neglect, or other trauma
– If the child/teen has received six to eight weeks of therapy, or another intervention, without significant improvement
– If there has only been a partial response to a psychotropic medication or when any child/teen has been prescribed two or more psychotropic medications
– If the child/teen has a chronic physical condition and begins to display behaviors that interfere with the treatment of that condition
– If there is a significant change in mood, behavior, or functioning without an obvious eliciting event
– If there are emotional or behavioral problems and the caretaker has their own emotional, behavioral, or substance abuse problems

What are reasons for why a parent should make an appointment for their child with a pediatric psychiatrist?

Just as a child/teen with a cardiac concern should be seen by a pediatric cardiologist or how a child/teen with a neurologic concern should be seen by a pediatric neurologist a child/teen with a mental health concern should be seen by a specialist in pediatric psychiatry. Parents should take their child to a pediatric psychiatrist for any of the reasons noted above or if they are observing changes in their child to include: significant changes in mood, excessive anxiety/worry, school avoidance, isolation, seemingly “addicted” to social media or electronics, significant drop in grades, disturbed sleep, difficulty concentrating, changes in appetite, significant/persistent irritability, bizarre behaviors, significant or persistent misbehavior, vocal or motor tics, known or suspected restricting/binging/purging of food, difficulties transitioning (i.e., to SARS-CoV-2 restrictions), stress from events (i.e., excessive/persistent negative reactions to media or social media coverage of school shootings), or any other significant changes in behavior.

Is telemedicine as effective as in-person psychiatry?

Telemedicine, appointments conducted via video, as a medical modality have been studied for decades and the studies show it to be as effective as in-person appointments for the field of psychiatry. Moreover, the vast majority of patients/parents report preferring it due to its convenience to include the time saved from not having to drive to and from the doctor’s office, not having to leave work during the day, etc. Patients also find being seen in their home to be comforting especially when addressing emotional problems. At CTFT we have noticed that is has become increasingly hard to find a psychiatrist with openings. Telemedicine makes it possible for our clients to access a specialist living in Southern California, thus eliminating the wait time to get in with someone local.

Does seeing a psychiatrist mean that my child or teen will be prescribed medication?

A psychiatric evaluation is a comprehensive exam which is in part to determine if medication can be helpful. Medication is not always needed for treatment it can often be helpful for certain conditions but for other conditions is often unnecessary or even not recommended for all children or teens. Having a very thorough assessment means that you can be assured that your child or teen is receiving an accurate diagnosis and the most relevant treatment for their individual needs. Many children and teens are not prescribed medication, while others will need it. The best way to know if medication should be added is to consult with the experts!

If you or someone you know is wondering if a psychiatric exam is right for their child or teen, do not hesitate to call. Dr. Gulino still has openings as the newest member of our team and new to our community as he resides in Southern California. Don’t miss this rear opportunity to get an appointment with a psychiatrist who specializes in pediatrics. Call or text now 408-628-0532 Email or schedule an assessment on line at