For Families Receiving Psychiatric Care
At the Child and Adolescent Psychiatry Outpatient Clinic
The main catchment area for the clinic includes the entire state of Oregon. Cases accepted for ongoing treatment must be within reasonable commuting distance. Diagnostic evaluations, however, can be completed for youths from any part of Oregon. The clinic also accepts patients from Southwestern Washington with eligible insurance coverage. Referral sources vary widely, but most commonly come from OHSU and Doernbecher Hospitals, families, pediatricians, family physicians, schools and the State of Oregon Services to Children and Families (SCF).
Educational Goals of the Clinic
As part of our mission, teaching and learning are priorities in the Child and Adolescent Psychiatry Outpatient Clinic. Physicians seeking advanced training to become specialists in child and adolescent psychiatry are called child and adolescent psychiatry residents or fellows; whereas, physicians seeking basic training in this field as part of their general psychiatry program are called general residents. Other trainees, such as medical students, psychology interns, or social work students, may also be receiving training in the clinic. All fellows, residents, students and counselors are directly supervised by child and adolescent psychiatrists who are licensed physicians, OHSU faculty members and certified by the American Board of Psychiatry and Neurology.
Information you provide during treatment is recorded in your child's medical chart. These charts are stored in the Outpatient Medical Records Department, and therefore, are available to other OHSU clinicians. However, other OHSU employees are prohibited access to these charts.
Sensitive issues which you, your child or your therapist do not want recorded in the medical chart may be kept in a separate, private chart maintained in your therapist's files. Specific information, such as place of work and residence will only be kept in confidential hospital and clinic records. Patient information usually will not be released to anyone outside of OHSU without your written permission. There are some exceptions. For example, if your child is in danger, or if your child reveals that he or she is being abused; or if your child poses a danger to someone else, then we are obliged by Oregon law to report these issues to you and/or appropriate authorities.
However, if your therapist needs to break confidentiality, he or she will generally inform the child or adolescent prior to discussing it with the parent. Also, the therapist usually will discuss the issue with parents prior to informing authorities. In addition, if a court subpoena legally demands records, we are obliged to release them. Finally, if bills are not paid or are seriously delinquent, patient information may be turned over to a collections agency.
Therapy sessions may be held individually with a youth or concomitantly with a parent and/or other family members. There are several reasons for this. First, under Oregon law, adolescents have the right to confidentiality. For younger persons, your therapist also may want to maintain separate confidentiality for both the parents and the youth. That is, information obtained while talking with the youth may not be told to the parents and vice versa. The reason for this is to encourage both youth and parents to talk openly about themselves.
Second, certain types of problems may be best treated with specific types of therapy, e.g. individual counseling, family therapy or medication, etc. Your therapist will decide with you what is the most appropriate form of treatment for your child and whether this is best done in individual, parent-child or family sessions.
Forms and Tests
Parents and youths may be asked to complete forms and questionnaires at the beginning, during or at the end of therapy. Many of these forms are helpful in planning treatment, in determining how effective treatment was, or in improving families's satisfaction. If you wish, your therapist will identify the procedures and explain the reasons for them. Please feel free to ask questions.
Recordings and Observations
Both for teaching and therapy purposes, some sessions may be audio- or videotaped, and some sessions may be observed through a one-way mirror. You will be informed and your written consent obtained before such procedures are used. Because these recordings and observations are important for learning and treatment, all patients are asked to give permission. However, you are free to refuse such procedures. We will not pressure you to comply. In addition, patient care is often discussed during the therapist's supervision, conferences and staff meetings. If you believe that problems might arise from being observed or having your case discussed (such as acquaintances among the faculty, trainees, or staff), you should discuss your concerns with your therapist.
Appointments and Cancellations
It is the policy of the Child and Adolescent Psychiatry Clinic that if an appointment cannot be kept, either the therapist or the clinic receptionist must be informed within 24 hours of the appointment, and an alternative meeting should be arranged. The clinic phone number is 418-5775 unless your therapist gives you a different number. Please note that the clinic telephones are not answered outside of business hours (8:30 a.m. to 5:00 p.m.), but you will be able to leave a message on the clinic voice mail. For emergencies after hours and on weekends, please call 494-9000 and ask for the on-call child and adolescent psychiatrist.
It also is a clinic policy to close cases when patients are not compliant with appointments. If multiple cancellations occur, your therapist will discuss several options with you, e.g. continuing treatment now versus waiting until another time, or pursuing treatment at another facility. In general, multiple, short-term cancellations leads to a termination of treatment in the clinic. We will inform you if and when treatment is to be terminated early.
Invitation to Questions
If you have questions, please ask your therapist or clinic staff at any time. If major problems develop during your treatment in the clinic, you may discuss these problems with your therapist, your therapist's supervisor or the clinic director, Keith Cheng, M.D.