Easy Tips for Improving Conversation with Therapists or Psychiatrists

One recent afternoon, the parent of a successful yet anxious high school junior asked me, “What do I say to the psychiatrist about my son?” What followed was an hour of coaching the teen as he prepared for his new patient visit.

Understanding Symptoms and Signs

It’s clarifying to consider and report emotional and behavioral health concerns in terms of signs and symptoms. Similar to going to the physician when asked, “What are your symptoms?” You might reply, “A sore throat and throbbing headache.” Symptoms can only be identified by the patient because they are not outwardly seen by others (racing heart, tingling, upset stomach, low thyroid). Signs, on the other hand, are recognizable by others (dilated pupils, dry skin, flushed cheeks, cough).

Parents and children as well as teens and young adults will improve communication with their medical or mental health provider when they report in terms of signs and symptoms.

Domains of Life: Physical Wellbeing, Intrapersonal Communication, Relationships, School or Work Participation

Another tip is to frame the concern, or signs and symptoms, within some of the major domains of life: physical wellbeing, intrapersonal communication, relationships, and school/work participation.
After coaching, the teen was able to verbalize:

I am here because I have a lot of anxiety, even during the summer. I get caught up in worrying about things that don’t concern me. It never goes away, even when I have good grades in my AP classes. I have trouble making decisions like what to wear to school and then I get upset. I take it out on my family and pick arguments when I’m upset. I think I get enough sleep but it is very hard to wake up in the morning. I’m often late to school. I gained some weight at camp last summer but I can’t get motivated to go to the gym. I’ve tried therapy when I was a kid. On the positive side, I have good grades, I’m active in clubs, I work a few hours a week, and I have friends. I don’t use drugs or drink alcohol. I’m wondering if there is some medication that might help. The main thing I want is to get rid of the constant anxious feeling. I want to figure this out before I go to college.

I was thrilled when the teen was able to summarize his thoughts and felt less nervous about his first visit. Even better, the parent didn’t have to chime in. This teenager’s self-awareness paved the way for a successful conversation with the professional.

Think, Says, Does

There are other ways to categorize emotional or behavioral health concerns. Julie Fast, a bipolar specialist, gives a tip when she suggests creating a “thinks, says, does” list for assisting parents and their children of all ages to better recognize and talk about symptoms. A “think, says, does” list works this way: Parents will list out the things their child says when they are having a hard time, the things that they report thinking when they were struggling, and the specific things they have done that are troubling or concerning. By breaking down the problem in this way, it becomes easier for parents, children, and therapists to discuss and can provide greater understanding as to why a child is behaving in certain ways.

It is possible to have a good relationship with medical and mental health professionals. Parents can clarify their observations. Young people can learn how to successfully speak about their needs. Framing conversation in terms that best assist your professional makes it easier for them to assist you in return.

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