Child psychiatrists typically see patients between 4 and 18 years of age.
Understandably, the way a child psychiatrist interacts with a child changes as the child grows and matures.
Every child's needs and abilities differ, but generally as a child approaches their teens they need an opportunity to speak to their psychiatrist in private. This may be for a few minutes every appointment, or perhaps an entire appointment every few sessions.
The spirit behind this is that there are often topics that a minor will want to discuss, but not in the presence of their guardians.
The psychiatrist will often have to explain the idea of mandated reporting. I.e., the idea that there are certain topics that a physician must report to the minor's guardians and/or local authorities. The minor is then given the opportunity to decide how they would like to proceed. Should a minor share something inadvertently, the psychiatrist must still complete any mandated report.
After explaining mandated reporting, a psychiatrist then will attempt to provide an opportunity to privately explore topics that concern their patient. This can be a delicate balance because the psychiatrist has to balance the need for the minor to speak privately with the need to engage with the child's legal guardian in treatment planning. The legal guardian needs to be made aware of any unsafe behaviors or trends that may indicate the minor needs closer supervision or changes in their treatment approach.
However, if any confidences are broken lightly, the minor may not want to share sensitive information in the future.
It is very typical for a psychiatrist to spend time with guardians discussing how privacy is navigated when their patient is also minor. This allows the guardians to know more about when they will be contacted and to share any concerns they have about appointments conducted without a guardian present.
If the family has separated a child's mental healthcare appointments into medication management appointments and psychotherapy appointments, a guardian may opt to sign a release of information so that the psychiatrist can speak to the minor's therapist directly.
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