Things you may want to know about seeing a psychiatrist or psychologist
What is the difference between a psychologist and a psychiatrist?
Many people are unsure of the difference between a psychologist and a psychiatrist. A psychiatrist is a physician who has completed medical school and specialized residency training in psychiatry. Because they are M.D.s, psychiatrists can prescribe medication. Most psychiatrists only treat people with medication but a few, like Dr. Boeker, also provide therapy for people who are interested.
Psychologists are not physicians. Their degree is a Ph.D. or Psy.D. Psychologists do not prescribe medications. Most psychologists have intensive training in the treatment of mental illness through a variety of types of therapy. Psychologists usually have a lot of experience providing testing. Child psychologists have specific training in the treatment of disorders often seen in childhood.
Why do people see a psychiatrist?
People come to see a psychiatrist for many reasons. Some people have severe mental illnesses like schizophrenia or bipolar disorder. Some people are simply having trouble coping with the many stresses of modern life. Some people are already seeing a counselor who has suggested that medication might help them feel better. Most people who see a psychiatrist are simply trying to find ways to cope better with difficult feelings or behaviors and see psychiatric treatment as an opportunity to improve their lives.
Why do people see a child psychologist?
As with psychiatrists, child psychologists see some children and adolescents with severe mental illnesses, but most children who see psychologists have a variety of difficulties that are interfering with their ability to succeed in school, get along with friends, or get along with their parents. Sometimes a child's teacher will suggest that a child receive testing to determine whether s/he has a problem that interferes with learning. These types of tests are available through the schools but some parents prefer to have their child seen by a professional who is independent of the schools. Psychologists usually work with parents as well as children to help parents develop strategies for managing a child's behavior or improving their relationships with family members.
When do I know my problems are severe enough to see someone?
We all have times when we are blue or particularly stressed. Usually these times pass and we begin to feel like ourselves again. Sometimes these problems persist a long time or start to interfere with daily life. People may have trouble sleeping, may feel more irritable, or begin to have difficulty in their jobs and relationships. Many of the websites on our links page have checklists that might help you decide if you need to see someone about your mental health. If you are unsure about whether you would benefit from treatment by Dr. Hogan or Dr. Boeker, feel free to call us and describe your problems to see if we can help you make this decision.
I have never had to submit my own forms to my insurance company. How is this done?
If they don't take your insurance, Dr. Hogan or Dr. Boeker will give you a receipt that specifies how much you have paid and what you are being treated for. Most insurance companies then have a form that you fill out and mail to them. We have copies of many of these forms as well as the addresses and phone numbers you can use to get more information from your insurance company. We will do whatever we can to assist you in figuring out this process so that you can be reimbursed by your insurance company.
If I see a psychologist or psychiatrist, does that mean I'm crazy?
No. There is a negative stereotype that many people have that can make them shy about coming to see a psychologist or psychiatrist. Because of this stereotype, many people put off treatment when they could have been feeling better long ago. Seeing a mental health professional really just means that you are struggling with feelings or behavior and would like help. It's no different than if you were seeing an eye doctor because you couldn't see well. Often as part of treatment you will receive a diagnosis. The diagnosis is shorthand to describe the types of problems you have, to qualify you for services from schools or the government, and to help you get reimbursement from your insurance company. We firmly believe, though, that a diagnosis does not define who you are and definitely does not mean anything bad about you. All people are unique and any two people with the same diagnosis are usually very different from each other. So coming to Wilmington Psych does not mean you are crazy and if you take a survey of your friends, family members, and coworkers, you will probably find a large percentage of people who have sought treatment for mental health at some time in their lives.
What causes mental illness?
We know a lot more about the brain than we used to and are learning more all the time. What scientists have found out is that most people with mental illnesses have a predisposition to those problems, just as many people have a predisposition to diabetes or asthma. These predispositions are not a personal weakness. They may be a random difference in how your brain developed, or it may be genetic. We know that many people with depression, thought disorders, anxiety, and learning difficulties (among others) have other family members with the same problems. So we don't know what triggers this predisposition in most people but we do know that most mental illnesses are rooted in how the brain works and not in whether you are a good person.
Will anyone know about what I say to Dr. Boeker or Dr. Hogan?
No. Just like going to other doctors, your records are confidential and we cannot even tell people that you come to us without your permission. We take confidentiality very seriously. There are a few exceptions to this rule. Most insurance companies will need to know a specific diagnosis and may need to know general information about your treatment (for example whether you are receiving therapy or medication management), but they won't know about the specific information you share with your doctor.
Sometimes people share information that indicates they may hurt themselves or another person. If this happens, we are required to share this information in order to keep our patients safe. Also, if you are involved in a legal matter relevant to your treatment, the court can subpoena our records. But these exceptions are rare occurrences. We will never share information without informing you and usually we will need your written permission.
If I bring my child to Dr. Hogan will I know about his or her treatment and what my child says in therapy?
Maybe: You will be part of the decision process in determining what types of treatment are going to be most helpful to your child. Parents are often involved in helping the child transfer what they are learning in therapy to their everyday lives. When the difficulties have to do with parenting problems, the parents are often as active and involved in therapy as the child. As children get older, they are more concerned about privacy and may not want us to tell their parents everything they say. In these cases we will often share general issues about what the child discusses but not specific information. If your child is under 18, you have the legal right to know what happens in your child's treatment but most parents understand and support their son or daughter's right to privacy as this makes treatment more effective and can also create a more trusting relationship between parent and child.
What happens at my appointment?
Mostly you will just talk to Dr. Boeker. He will not perform a comprehensive physical exam, but occasionally Dr. Boeker will weigh you because some medications and some illnesses can affect a person's weight. If Dr. Boeker does weigh you, it is important to keep in mind that Dr. Hogan believes his scale weighs her about 5 pounds too heavy.
If you come to see Dr. Hogan, the appointment activities will vary depending on the age of the child and his or her difficulties. If your child is coming for testing, the appointment may be very structured and involve activities that are a bit like school work. If your child is receiving counseling and is young, counseling is often more successful when it occurs in the context of play activities. With older children and adolescents an appointment may consist mostly of talking, as with adults. But often young people are anxious when discussing their feelings and are more successful sharing if they can do other things while they are talking such as playing a board game, drawing, or fidgeting with something in their hands.
What should I bring to my appointment?
If you are coming to see Dr. Boeker, please bring all your prescriptions (even if they are for other problems) in their bottles so that Dr. Boeker can see exactly how they were prescribed. If you have had previous treatment from a psychologist, counselor, or other psychiatrist please bring those records. If you do not have any records, Dr. Boeker may ask you to sign a release so he can talk to the other people who have worked with you if this is OK with you.In this case, please bring the names and phone numbers of the people who have treated you in the past.
If you are coming to see Dr. Hogan, she may send you some forms to fill out before your appointment. Also, if your child has received any previous psychological testing, privately or at school, it will help Dr. Hogan if you can bring these results. Often child psychologists benefit from knowing about a child's early development. You might want to dig out your old baby books and review them to jog your memory.
If there are any records you want to be sure either Dr. Hogan or Dr. Boeker will review before your appointment, feel free to mail or fax them, or drop them by our office.
What kind of bird is that on Dr. Boeker's page?
Dr. Boeker's bird, Sparky, is a Celestial Parrotlet (also called a Pacific Parrotlet). These are the smallest variety of parrots. Sparky actually thinks he is the biggest bird around. Sparky does not come to Wilmington Psych because he is not a good listener, but Dr. Boeker has observed that many of his patients benefit greatly from caring for and enjoying the companionship of a pet.
Does Dr. Boeker see children?
Dr. Boeker is board certified in adult psychiatry. There is a special type of certification for child psychiatrists that involves extra study in the problems of children. All psychiatrists, however, have training in treating children. Dr. Boeker is willing to see some older adolescents. You are welcome to call to see if your child can be seen by Dr. Boeker. If he does not think it is an appropriate referral, he will give you the names of local child psychiatrists.
Because Dr. Boeker has specialized training and experience related to autism spectrum disorders, he is willing to see older elementary-aged children with these problems. His approach to working with this population is to treat symptoms, such as rigid thinking and behavior, anxiety, or other difficult behaviors. He prefers to provide this treatment in collaboration with other professionals who provide behavioral or educational intervention. He does not try to "cure" autism but has observed that medication can be very helpful if some behaviors are interfering with the child's learning and daily functioning.
What if my child doesn't want to see a psychologist?
Children may be reluctant to see a psychologist for many reasons. Young children are often worried that this is like going to the pediatrician and that they will get a shot. Usually reassuring them that Dr. Hogan does not give shots is enough to reduce their worries. Children also do not always know what a psychologist is and, like anyone, are nervous about new experiences. You might want to tell your child that this is just like going to talk to a school counselor. Showing your child the pictures on this website may also reassure them that this is a friendly place.
Older children and adolescents may have the same worries that adults do. They might worry that they are "crazy", their friends may find out, or that this means that their parents believe a family problem is "all their fault." Reassure these youngsters that what they do with Dr. Hogan will be private and that she may be giving you suggestions of ways to change and not just making those suggestions to your child.
What kinds of toys does Dr. Hogan have?
Dr. Hogan's family is delighted that she has opened this office because now they can buy her toys for Christmas and birthdays rather than boring books and the things adults usually want. As mentioned above, children are often more comfortable talking if they can play at the same time, and young children often share about their feelings through play. Teenagers may think there are too many kid toys, but Dr. Hogan has some great board games that teenagers have assured her are "cool enough." Many teens also enjoy art projects like drawing or beading. With their permission, Dr. Hogan often displays their work in the office. Some teens choose to meet with Dr. Hogan in her regular office where there are no "kid" toys but there are lots of piles of paperwork.
Does Dr. Hogan test very young children for autism?
Yes, Dr. Hogan has helped conduct research identifying the characteristics of autism that can be assessed in children under 3. She enjoys working with young children and helping parents understand the needs and behavior of children who are just beginning to understand the world around them.
What is the difference between autism, Aspergers, and PDD?
These are all diagnostic terms used to describe subgroups of individuals whose developmental difficulties fall under the umbrella of Pervasive Developmental Disorders (PDDs). Included in this group of diagnoses is also PDD NOS which stands for Pervasive Developmental Disorder Not Otherwise Specified. Currently diagnostic research suggests that the broad term Autism Spectrum Disorder (ASD) is the best description of the individuals who receive these diagnoses. Using the term "spectrum" clarifies that people with these diagnoses have in common a pattern of strengths and weaknesses but they also differ in significant ways such as in the severity of their symptoms and their level of cognitive ability.