Management in Child Psychiatry

Management of children with psychiatric disorder is based upon several principles:

Take the child’s developmental stage and overall level of functioning into account.

Most problems are treated initially with reassurance,support and behavioural interventions.

Whatever the treatment, involve the family.

Avoid removal from school or home wherever possible.

Medication has a limited role in most disorders.

General principles of behaviour therapy

Desired behaviours need to be reinforced and unwanted behaviour should be decreased

Positive reinforcement is used to promotedesired behaviours. It involves the use of rewards which include tangible rewards- food/toy etc and social rewards – praise.

Unwanted behaviours can be decreased by ignoring them or taking away existing
privileges . For example: withholding TV viewing or a regular excursion.

Punishment should not be used to bring about a behaviour change

One has to be consistent in providing reinforcements and they should be contingent to the behaviour Indicators for Referral to Specialized mental health centres

If the child is suicidal

If the child exhibits verbal, physical or sexual aggression

If the child is suspected of using drugs

If the child has made attempts in the past to harm oneself and continues to do so.

If the child exhibits behavior, which is difficult to control.