Costs, reasons for consultation … Go to the shed with your child

With Michael Larrar, child psychiatrist

When should you take your child to a psychologist? This is a real parenting question! How does psychotherapy take place for the youngest? The advice of Michaël Larrar, psychiatrist and psychoanalyst, author of the book “The secrets of our unconscious” (ed. Librinova)

Child psychology: what is the difference between a psychiatrist and a psychologist?

Above all, it is important to make the difference between a child psychiatrist and a child psychologist, as Michaël Larrar points out: “A child psychiatrist is a doctor. He is someone who has studied medicine and specializes in child psychiatry. The child psychologist or child psychologist, for his part, has taken a course in psychology at the faculty and has also specialized in the study of children. In practice, the fundamental difference that child psychiatrists can prescribe medication to children, while child psychologists cannot. In return, the two therapists can set up psychotherapy and make a diagnosis ”.

Toddler Psychologist: At What Age Should You Start Consulting?

At what age can a child start consulting a psychiatrist? Is there any interest if he is very young? Michaël Larrar answers us in the affirmative: “You can go to a child psychologist of any age. The child psychologist can even accompany expectant parents during pregnancy. In the first years of the child, the session will of course take place differently. Under two years, the caregiver will mainly approach the parents. In this situation, the purpose of the agreement will be to make assessments and make a diagnosis if there is a suspicion of delay, or relational problems in the child. For very young children, the child psychologist can also give advice to the parents to help the child’s development ”.

Why consult: When to see a child psychiatrist?

If there is no age limit for consulting a child psychiatrist, in what situations is it so necessary or desirable? From sleep disturbances to incessant crying, the reasons for consultation can be many. Michaël Larrar answers us: “Even now, there is no danger in booking an appointment with a child psychologist. It will not disturb the child. In the worst case, the consultation will be without interest. To determine if the baby needs to see a shrink, you have to trust your intuition. In some situations, there are no objective signs, but it seems that something is wrong. If we have this impression, we can consult. In other cases, there is a repeated request from the child. These are, for example, children with separation anxiety, behavioral disorders or OCD (obsessive-compulsive disorder). Sometimes they even ask the parents to “see a doctor to treat them”. There is also the case where the child has intense disorders, with social consequences, and which last a long time. These are phenomena that often occur during transition periods, but if these disorders last more than a month, you must consult ”.

How much does a session with a psychiatrist cost for young children?

The question may seem trivial, but it is important because not all parents have the same budget. Michaël Larrar explains to us the subtleties of remuneration of child psychologists and child psychiatrists: “Very practically, there are very few child psychiatrists who practice in France. It is therefore complicated to consult and the costs will be high. Also in many cases child psychiatrists will prescribe medication and refer parents “and child to a child psychologist for therapy. In terms of costs, the child psychiatrist is more expensive, but there is partial coverage of social security. Conversely, child psychologists have lower fees, but there is no reimbursement”.

“Monpsy”: 8 sessions refundable

Since April 2022, the Monpsy scheme has provided the opportunity for everyone, adults or children (over 3 years) to be reimbursed for health insurance for conversations with a psychologist. To benefit from it, you need to be referred by a general practitioner who establishes a prescription. Note: not all psychologists participate in this system. More information here.

This is what you have done for a while with the psychologist with your child. What happens during a session? Michaël Larrar explains to us: “Under a classic agreement, the first session takes place in three steps: We first discuss with the parents and the child. Then we talk to the child alone, and finally in a third step we all discuss again. Ideally, we will during the first consultation like to see both parents to get a sense of family dynamics. Of course, this is not an obligation. At the same time, we do not necessarily talk to the parents without the child’s presence, because it is good that he understands that he is at the center of interest and that we are not talking behind his back. That being said, if the parents have to talk to the therapist alone to discuss sensitive elements (illness, couple problems, etc.), the child psychologist will accept it without any problems ”.

If the first consultations are oriented towards evaluating the child’s problems, then how will the following sessions take place? Everything is varied, as Michaël Larrar develops: “In a child’s therapy journey, we can sometimes offer counseling after just a few sessions. In half of the cases, the young patient is better after two or three sessions.. Children really have a real mental flexibility. They are much better as soon as they understand what is happening. As a general rule, the treatment of children is much faster and more effective than for adults. If necessary, psychotherapy can be started. In this case, we receive the child only if he agrees. Every third or fourth consultation, we arrange a joint session with the parents. In the case of a teenager, this type of joint evaluation takes place every quarter ”.

What is the role of the parent in the psychiatrist specializing in pediatrics?

When a child is in psychotherapy, the parents can rightly ask themselves what their role will be: “The parent’s role will be to tell what is happening and what he himself understands. He answers Shrinken’s questions, allowing him to observe the child’s reactions in relation to the family situation and the environment. Seeing his parents think about the problem will also help the child. In a consultation, when the therapy is started, shrink can make recommendations to the parents. It is not because you go to a child psychiatrist with your child that you have failed as a parent. The family should function normally. The family must not be worried about psychotherapy, ”insists Michaël Larrar.

And for teenagers?

For a teenager, you should consult a child psychiatrist or an adult psychologist? “Teenagers are a real specialty. You have to go to someone who is used to it. They are no longer children, but not adults either. In general, it will be specified by the psychologist. When in doubt, we ask before ordering. time, “sums up Michaël Larrar. Adolescence is truly a very special age group with specific problems.

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