Teenagers tend to be resistant to acknowledging problems or accepting help because so much of their self-esteem and identity are tied up in feeling "normal" like their peers. Dr. Rivers-Bulkeley enjoys working with teenagers and he is usually able to develop a therapeutic alliance after a few sessions. In those situations in which he is unsuccessful at building a relationship, he informs the parents so that the services of another clinician can be sought.
The evaluation of an adolescent involves meeting with the teenager, interviewing the parents and sometimes talking to teachers (with written permission), and typically requires 1 to 3 sessions to complete. It is often helpful to consult with the pediatrician and sometimes laboratory tests are indicated. Referrals for psychological testing may occasionally be requested to clarify or quantify certain types of problems.
At the conclusion of the evaluation, the adolescent and parents are invited to participate in a discussion with the doctor about his findings and recommendations, and they are given the opportunity to ask questions. Dr. Rivers-Bulkeley is conservative about the use of medication and believes that it should only be prescribed when the potential benefits outweigh the risks. If medication is part of the recommended treatment plan the doctor will explain his reasoning, list any other options and review possible side effects.
Dr. Rivers-Bulkeley feels strongly that adolescents who are having problems should participate in psychotherapy or counseling whether or not the individual is taking medication. This can be provided by Dr. Rivers-Bulkeley or by another licensed professional.