Here at the Bartky Healthcare Center, we begin our services with an initial comprehensive evaluation process. All facets of the individual are reviewed, which include:
While the process differs slightly for a child, adolescent or adult, the final step at the end of the evaluation is a presentation which may include suggestions such as psychotherapy, medication, referral for specific psychological testing, or a combination of approaches. The Bartky Healthcare Center prides itself in working with the client and family to find optimal solutions that will solve the problems initially presented.
Initial evaluation with a child takes into account the child's age and stage of development. The evaluation usually occurs over three visits. The first visit is with the child's parent(s) or guardian(s). During this initial visit, a history of the presenting problem is discussed. Additional information is gathered regarding the child's personality and physical development, school functioning, personal strengths and interests, social functioning and role within the family.
The second visit occurs with the child. Depending on the child's age and developmental state, the visit may be interview-based or play-based. Often a combination of techniques is used to best assess a child, such as developmentally appropriate interview questions, drawings, and observation of play.
The third visit includes the parent or guardian, along with the child. A diagnostic impression is presented and a treatment plan proposed based on the evaluation findings. A discussion of how progress will be measured will also occur.
Initial evaluations with adolescents usually take place over three visits. Adolescents often have concerns regarding privacy and independence. Therefore, the first visit is reserved for the adolescent. Current concerns, goals for treatment, and encouragement of the teen's perceptions of the problem are addressed.
The second visit is completed with the parent or guardian. During this visit, a history of the presenting problem is discussed. Additional information is gathered to "fill in" aspects of the adolescent's life, including, but not limited to: personality, role within his/her world, school functioning, and personal interests/strengths.
The third visit includes both the parent (or guardian) and the adolescent. A diagnostic impression is presented and a treatment plan is proposed based on the evaluation findings. Furthermore, a discussion of confidentiality will occur as well as how progress will be measured.
Initial evaluations with adults typically occur over two visits. These visits allow the time and opportunity for an individual to express current concerns, any history of the difficulties that have led to the referral, and to allow an ongoing dialog between the patient and clinician to further explore background and current concerns. This approach is very important for correct diagnosis and treatment planning. As with any patient coming to Bartky Healthcare, a diagnostic impression, an agreed upon treatment plan, and discussion of how progress will be measured is key.
Prescription of medication, and ongoing medication management, may be recommended as part of a treatment plan. The process of medication decisions is handled differently for children, adolescents, and adults.
Bartky HealthCare Center clinicians base their medication recommendations on the most current research and thinking in the field. In addition, medication choices are based on the assessment and family history.
A thorough discussion of the risks and benefits of medications is included as part of the treatment plan. Patients are encouraged to ask their clinicians about their medications and take an active role in the decision to start medication.
Bartky HealthCare Center clinicians recognize the often difficult decision to place a child on medication. We will spend sufficient time to listen to all concerns; we pride ourselves on partnering with parents in making difficult medical decisions.
Bartky HealthCare Center is fully compliant with FDA regulations regarding prescribing psychiatric medications, especially antidepressant medications, to children. Patients are provided with a detailed schedule of appointments that follow FDA recommendations. It is important to maintain this schedule to ensure effectiveness and safety of medications.
Adolescents require special care when it comes to psychiatric medication. They often want their independence and may have special or private concerns about medications that they do not wish to share with parents. These concerns are handled by Bartky HealthCare Center in a sensitive manner, while always maintaining safety as a primary concern.
Bartky HealthCare Center is fully compliant with FDA regulations regarding prescribing psychiatric medications, especially antidepressant medications, to adolescents. Patients are provided with a detailed schedule of appointments that follow FDA recommendations. It is important to maintain this schedule to ensure effectiveness and safety of medications. Bartky HealthCare Center encourages adolescents to be mindful of how a medication is working and potential side-effects, and to advocate for themselves if they have concerns.
Medication for adults is often recommended to improve significant life areas, including personal, work, and social functioning. A detailed discussion of risks and benefits takes place before any medication is prescribed.
If medication is prescribed, a schedule of medication management visits will be discussed to maximize effectiveness and maintain proper safety.
Clinicians at Bartky HealthCare Center are available for several consultation services.
Consultations can occur with schools, referral sources, other medical professionals, individual therapists, or treatment programs. For example, we can serve in a consultation role to a school if the school is struggling to work with your child in a given setting. As another example, we can serve in a consultation role to your pediatrician who is managing your child’s medication but has occasional concerns about the treatment.
There are times that after an evaluation at the Bartky HealthCare Center no ongoing treatment is recommended. However, a recommendation for periodic consultation visits to monitor a potential problem might be made. This will allow for quick treatment of any arising issue as needed.
Other consultation services can occur on an organizational level. We can provide an objective assessment of an organization’s treatment services and make recommendations to improve levels of care.
Finally, Bartky HealthCare Center provides second opinions as requested on complex cases.
Psychological and neuropsychological testing may be recommended in several circumstances, and psychologists at the Bartky HealthCare Center are experts at administering and interpreting many such tests . Such testing is helpful in clarifying diagnosis, identifying intellectual strengths and weaknesses, and gaining insight into personality and coping style.
Often, a specific referral question is formulated to be answered with testing. Examples of such questions are,
“Does my child have a learning disability like dyslexia?”
“My child has so many diagnoses. Can we clarify what’s going on?”
“Is my child’s struggle in math due to a learning issue, ADHD, or both?”
“What accommodations would best help my child in school?”
“What might be preventing me (or my child) from making progress in our current treatment plan?”
“Why am I angry all the time? What can I do about it?”
A clinician in the practice may request psychological testing, or an individual may request testing on his or her own. Community agencies or schools may request testing to clarify diagnosis or assist in treatment planning. You do not have to be receiving other services in our practice to have psychological testing completed.
Often thought of as traditional "talk" therapy, it can be structured and active, with both clinician and patient working towards specific goals that are addressed in a collaborative manner. In other cases, psychotherapy may proceed more slowly, allowing for an unfolding process to occur so that patients gain insight and learn to manage their challenges in an independent and empowered manner.
Bartky Healthcare Center clinicians offer several modalities of individual psychotherapy that have been empirically demonstrated to alleviate many psychological concerns. Cognitive-behavioral therapy, interpersonal therapy, psychodynamic therapy, and behavioral therapy (including habit-reversal training, exposure and response-prevention) have been found to be appropriate for specific issues such as: