What is the difference between Elizabeth, the psychiatric nurse practitioner, a psychologist or a psychiatrist?
A psychiatric nurse practitioner is a Registered Nurse who has obtained an advanced degree as a nurse practitioner. In order to obtain this degree, the Nurse Practitioner must complete, at minimum, a Master's degree with specialized knowledge and clinical training in their specialty field. In order to practice independently, Nurse Practitioners must comply with state licensing standards and be Board Certified in their specialty.
Psychiatric Nurse Practitioners are licensed to provide psychotherapy and are licensed to prescribe medications.
A psychologist holds an advanced degree (either a PhD. or a PsyD.) in clinical or educational psychology. Their training involves an internship and some psychologists possess additional education and training in a specialized area such as neuropsychology. They must pass a state licensing examination and hold board certifications. Psychologists are trained in various methods of psychotherapy including group, family and individual psychotherapy. Most psychologists are also licensed to conduct psychological testing including personality assessment, IQ testing and more complex testing such as neuropsychological testing. Some psychologists also conduct research and they often study how individuals think, feel and behave from a scientific viewpoint.
A psychiatrist is a medical doctor who has completed medical training as well as an internship and a residency in psychiatry. Because of their medical training, the psychiatrist is able to understand the body's function as well the complex relationship between emotional illness and other medical illnesses. Some psychiatrists obtain additional education, training and complete additional years of training in specialties such as Addiction psychiatry, Geriatric psychiatry, Forensic psychiatry or Child and Adolescent Psychiatry.
When can we get an initial appointment ? My child is having problems now and can't wait six weeks to be seen by the NP.
Because Elizabeth provides individualized care to each child in her practice, there are times when the wait time for a new patient appointment can seem long. We always provide our new patients with the option of being placed on a cancellation list. If we have a cancellation and you are able to bring your child into the office with only one or two days advance notice, most times you will not have to wait so long.
What can I expect during the first appointment?
During the initial appointment, which is often referred to as a psychiatric evaluation, Elizabeth spends time getting to know your child. He or she is incorporated in the treatment decisions. As parent or legal guardian, you have the authority to consent to treatment and Elizabeth respects and honors your role in the decision-making. However, over the years, Elizabeth has discovered that children and adolescents are more accepting of treatment when they feel that they are a part of it.
The initial appointment typically lasts about 60 minutes. Elizabeth will want to know about your child's development as well as your pregnancy. She will want to know about any medical conditions that your child may have as well as any medications that your child is taking. She will want to know about your child's social development; is your child able to make friends and keep friends or are peer relationships difficult for your child? She will want to know about your child's educational experiences. And she will want to know about any issues of abuse or trauma which may be in your child's background. Following her assessment of your child's current level of functioning, she will explain the treatment options to you. These may include medication or she may refer you for family or individual counseling or both. Research consistently demonstrates that a multi-modal approach incorporating therapy, educational intervention and medications if needed is the most effective intervention for psychiatric or behavioral issues in children and adolescents.
ELIZABETH A MCMORRAN, NP
Why is the office no longer accepting any insurance?
Insurance companies will only pay for quick, short visits and "Dr. Liz" believes that you deserve comprehensive psychiatric care which is delivered on an individualized basis. This allows us to review symptoms and any previous treatment history as well as providing brief supportive and cognitive therapy during the appointment time. We are able to fully discuss treatment options including medications and risks and benefits of any treatments.
Yes, Elizabeth can conduct an assessment, provide a diagnosis and provide certain types of treatment for children with autism. If you are interested in a diagnosis for the purpose of the Division of Developmental Disabilities (DDD), the agency will only accept a diagnosis from a medical doctor. We can provide you with a referral to a developmental pediatrician, a licensed psychologist or a child psychiatrist to obtain the diagnosis which is acceptable to DDD. In terms of treatment, Elizabeth does not provide any ABA therapy but is able to assess for symptoms which might indicate the need for medication. If medication is prescribed, Elizabeth can monitor for effectiveness and any potential side effects. There is no medication that "treats" autism, but symptoms such as self injury, rage or inattention and impulsivity can be safely and effectively managed with medication.
Reading through all of this, it seems like all Elizabeth does is prescribe medications. What if I don't want my child on medication?
The decision to recommend medication as part of a treatment plan is never taken lightly by Elizabeth. Her evaluation and assessment is thorough and her recommendations are based on years of experience and clinical training. Elizabeth will take the time to explain all treatment recommendations to you and respects your decision-making with regard to your child. If medication is necessary, Elizabeth works closely with you to obtain the desired effects with the least amount of medication possible. As a mother and a health care professional, she understands what it means to only want the best for your child.
What about follow up appointments?
Follow up appointments typically last about 20 minutes. During these appointments, your child's progress in treatment will be assessed and any changes which are warranted will be discussed with you and your child. In the beginning of treatment, your child will need to come into the office more frequently so Elizabeth can closely evaluate the appropriateness and/or effectiveness of medications and any possible side effects. Once your child's progress is stabilized, there are less frequent appointments. These are general rules and certain circumstances require closer follow up (a child younger than eight years old, a child with a history of suicidal thoughts or a history of trying to harm themselves or a child who is experiencing any symptoms of psychosis such as hearing or seeing things). If Elizabeth is prescribing medication for your child and your child's condition is stable, she will need to see the child at a minimum of every three months.
Our practice specializes in treating mental health issues in children and adolescents. Psychiatric nurse practitioners like Elizabeth utilize a holistic approach to mental health care. They focus on the whole person: not just a set of symptoms. Your child is more than his impulsiveness or his hyperactivity. He is a fine young man who needs some help with concentration and some help learning to think before he acts. Psychiatric nurse practitioners are able to evaluate, formulate a diagnosis and provide psychiatric treatment including medications for childhood disorders such as ADHD, depression, anxiety or other mood disorders. They monitor any prescribed medications to ensure efficacy and monitor for any possible side effects. They adjust doses or change medications to ensure the best outcome for your child. Psychiatric nurse practitioners are able to perform physical examinations if needed and they can order and interpret laboratory testing and results.