Choosing a Child and Adolescent Psychiatrist for Your Teen in Brooklyn
For a teenager, look for a psychiatrist who is board certified in child and adolescent psychiatry, explains clearly at the first visit what stays private and what is shared with parents, works with the school and any therapist, and is careful and explicit about medication risks in young people. Certification tells you about training; the other three you learn by asking.
This guide explains what the credential means, how a child and adolescent psychiatrist differs from a pediatrician or therapist, how consent and confidentiality work for minors in New York, and which questions separate a good fit from a poor one.
What child and adolescent psychiatry board certification means
Child and adolescent psychiatry is a subspecialty that sits on top of general psychiatry. The American Academy of Child and Adolescent Psychiatry describes the path as four years of medical school, at least three years of residency training in medicine, neurology and general psychiatry with adults, and two more years of specialized training with children, adolescents and their families.
To sit the subspecialty exam, the American Board of Psychiatry and Neurology (ABPN) requires a physician to be board certified in general psychiatry first and to complete two full years (24 months) of child and adolescent psychiatry training in programs accredited by the ACGME. So a psychiatrist who is board certified in child and adolescent psychiatry has passed two sets of board exams and trained specifically in development, family work and the conditions that start in childhood.
How to check
You can look up ABPN-certified physicians by name, specialty or location using the board's VerifyCERT tool. A New York medical license can be checked through the State Education Department's online verification system, and board actions against physicians are listed by the Department of Health's Office of Professional Medical Conduct.
Psychiatrist, pediatrician or therapist: who does what
Many teens do not need a psychiatrist first. The right starting point depends on how complex the picture is.
| Clinician | Typical role for a teen | Often the right first step when |
|---|---|---|
| Pediatrician or family doctor | Screening, uncomplicated ADHD, first-line treatment of common conditions, physical causes | Symptoms are mild to moderate and there is one clear concern |
| Therapist (psychologist, social worker, mental health counselor) | Psychotherapy such as CBT or DBT, family work, skills building | The main need is coping skills, family conflict, anxiety or low mood without severe impairment |
| Child and adolescent psychiatrist | Diagnosis when the picture is unclear, medication for complex or co-occurring conditions, coordinating a team | Several conditions overlap, first treatments have not helped, or there are safety concerns |
The AAP's ADHD guideline, for example, expects pediatricians to manage ADHD and to refer to an appropriate subspecialist when they find coexisting conditions they are not trained or experienced to diagnose or treat. Psychiatric nurse practitioners also prescribe for teens; the differences are covered in psychiatrist vs psychiatric nurse practitioner, and the choice between coaching, therapy and psychiatry is in which kind of help you need.
How urgent is it? Matching the timeline to the situation
Families often spend weeks comparing psychiatrists when the situation calls for same-day help, or rush into the first available appointment when there is time to choose well. Sorting the situation first makes the rest of the decision easier.
| Situation | What it usually calls for |
|---|---|
| Talk of suicide with a plan or intent, self-harm needing medical care, hearing or seeing things others do not, or being unable to stay safe | Emergency care now: 988, 911 or the nearest emergency room. Do not wait for an outpatient appointment. |
| New or worsening thoughts of death without a plan, a sharp drop in functioning, not eating, not sleeping for days, or new substance use | Contact the pediatrician or current clinician the same day and ask about urgent evaluation while you look for ongoing care |
| Months of low mood, anxiety, school refusal or attention problems that are steadily affecting school, friendships or family life | A planned outpatient evaluation; this is when choosing carefully pays off |
| A single concern with mild impact, such as worry before exams or a rough patch after a move | Often a pediatrician or therapist first, with a psychiatrist if it does not improve |
The differences between an emergency room, urgent psychiatric care and an outpatient visit in the city are explained in psychiatric emergency vs urgent care in NYC, and safety planning for suicidal thoughts describes what a written safety plan includes. The rest of this guide is about the third row: choosing well when there is time to choose.
Consent and confidentiality for teens in New York
Parents are usually the decision-makers for a minor's care, but the rules are more nuanced than "parents see everything." Two sets of rules apply: New York law on consent, and the federal HIPAA Privacy Rule on records.
New York consent rules
Under New York Mental Hygiene Law section 33.21, a minor is a person under 18, with exceptions such as minors who are married, emancipated or parents themselves. For services in outpatient programs licensed or operated under Office of Mental Health regulations, a mental health practitioner may treat a minor without parental consent only after determining that the minor is knowingly and voluntarily seeking services, that the services are clinically indicated and necessary to the minor's well-being, and that one of three conditions applies: a parent is not reasonably available, requiring parental consent or involvement would harm the course of treatment, or a parent has refused and a physician determines that treatment is necessary and in the minor's best interests. The practitioner must document the reasons, and the minor signs a statement that they are seeking services voluntarily.
Those exceptions are narrow and tied to the type of program. In most private practices, expect parents or guardians to consent to a teen's care. Ask any practice how it applies these rules before the first visit.
HIPAA and records
Under HIPAA, a parent is generally treated as a minor's personal representative, with access to the child's health information. The exceptions are when the minor lawfully consents to the care, when the law allows the care without parental consent, or when the parent agrees to a confidentiality arrangement between the clinician and the teen. In those cases, state or other applicable law decides whether parents may see the records, and where the law is silent, a licensed health care professional makes that call. Separately, HIPAA permits a clinician to disclose information when necessary to prevent or lessen a serious and imminent threat to someone's health or safety.
In practice, a good adolescent psychiatrist explains at the first visit, to both of you, what stays between the teen and the clinician, what parents will be told, and when safety overrides privacy. That conversation builds the teen's trust without leaving parents in the dark.
Questions to ask before you choose
- How will you involve us as parents, and how often will we hear from you?
- What will you keep private between you and our teen, and when would you break confidentiality?
- Do you coordinate with schools, and will you help with an IEP or 504 plan?
- Will our teen see a therapist on your team, or do you work with outside therapists?
- How do you decide whether medication is needed, and what do you try first?
- How do you measure whether treatment is working?
- What happens if there is a crisis between appointments?
- Are you in network with our plan, and if not, what documentation do you provide for reimbursement?
A simple scorecard for comparing candidates
After two or three calls, the answers start to blur. Writing them into a short table helps you compare like with like.
| What to compare | Stronger answer | Weaker answer |
|---|---|---|
| Training | Board certified in child and adolescent psychiatry, or clear subspecialty training | Vague about training with teens |
| First evaluation | Sees the teen alone and with parents; asks for school and other input | One short visit, no outside information |
| Confidentiality | Explains the ground rules to both of you at the start | "Parents will know everything" or "parents will know nothing" |
| Therapy | Can name how therapy fits, whether on the team or with your current therapist | Medication only, with no plan for skills or family work |
| Medication approach | Explains warnings, alternatives and a monitoring plan | Prescribes without discussing risks or follow-up |
| Between visits | Clear way to reach the team, and a stated crisis plan | "Call 911" as the only answer to every question |
| Coordination | Willing to talk with the school, pediatrician and therapist with your consent | Reluctant to coordinate |
No single row decides it. A clinician who is a good fit for your teen's personality, and whom your teen is willing to keep seeing, often matters more than a small difference in credentials. You can check any physician's license and board status yourself, as described in how to check a psychiatrist's license and board certification.
What a thorough first evaluation looks like
Expect the first evaluation to take more than one conversation. A careful child and adolescent psychiatrist usually meets with the teen alone and with parents, asks about development, school, friendships, sleep, screens, substance use and safety, and requests information from the school or other clinicians with your permission. You should leave with a working explanation of what is going on, what else is being considered, and a plan with a date to review it. If the clinician needs more information before deciding on a diagnosis, that is a sign of care, not indecision.
If your teen already has a therapist, the article on keeping your therapist while seeing a psychiatrist explains how split care works.
Working with the school and other clinicians
Teens spend most of their waking hours at school, so the school is often where symptoms show first and where supports make the biggest difference. Good coordination is deliberate, with your consent at each step.
- School to clinician: under the federal education privacy rule (FERPA), a school generally needs a parent's, or an eligible student's, signed and dated written consent that names the records, the purpose and the recipient before it discloses education records, with listed exceptions. Ask the school for its release form if you want report cards, attendance records or testing sent to the psychiatrist.
- Clinician to school: HIPAA requires a valid written authorization for disclosures of health information that the rule does not otherwise permit. Expect the psychiatrist to ask you to sign one before speaking with a counselor or teacher, and to agree with you and your teen on what will be shared.
- Psychotherapy notes, the separate notes some therapists keep about the content of sessions, have extra protection under HIPAA: most uses and disclosures require a specific authorization.
A useful letter to a school describes how a condition affects learning and which supports might help, without detailing private conversations. If your teen may need formal supports, 504 plan vs IEP explains the two main routes.
When your teen has a therapist and a pediatrician too
Many teens have three clinicians: a pediatrician, a therapist and a psychiatrist. Ask who will be the main point of contact, how often the psychiatrist and therapist will talk, and who the school should call. Agreeing on this at the start prevents mixed messages to your teen and to you.
How medication decisions differ for adolescents
Medication can help teens, but the evidence and the warnings differ from adults, which is one reason specialist training matters.
- Antidepressants carry an FDA Boxed Warning that they increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients in short-term studies. In the pooled trials behind the warning, the increase was seen in patients age 24 and younger, and the label asks prescribers to monitor all patients closely for worsening and the emergence of suicidal thoughts.
- Approvals vary by age and condition. Escitalopram, for example, is FDA-approved for major depressive disorder from age 12 and for generalized anxiety disorder from age 7. Use outside an approved age or condition is off-label and should be explained to you.
- Atomoxetine, a non-stimulant for ADHD, carries a Boxed Warning about suicidal thoughts in pediatric patients 6 and older.
- Fluoxetine is FDA-approved for major depressive disorder in pediatric patients from age 8 and for OCD from age 7. Sertraline's established pediatric use is OCD in patients aged 6 to 17; its other approved uses are for adults.
- For stimulants, the AAP flags diversion as a special concern in adolescents and advises monitoring symptoms and refill requests for signs of misuse.
What a good medication monitoring plan includes
The fluoxetine label asks prescribers to advise families and caregivers of the need for close observation and communication with the prescriber. A plan you can actually follow usually answers these questions before the first dose:
- Who watches for changes at home, and what exactly are they watching for: new agitation, restlessness, irritability, trouble sleeping, unusual energy, or any talk of self-harm.
- How to reach the prescriber between visits, and what counts as "call today" rather than "mention at the next visit".
- When the first follow-up is, and how often visits happen while the dose is being adjusted.
- How benefit will be judged: rating scales, school reports, or specific goals your teen chose.
- Who holds the medication, especially for a teen with a history of impulsive behavior or self-harm.
- What happens if a dose is missed, and why the medication should not be stopped suddenly without the prescriber.
Teens should be part of this conversation. A plan they understand, and agree with, is one they are more likely to follow.
A careful psychiatrist will explain the warning, set up a monitoring plan with your family, and tell you which changes to report right away. Never stop or change your teen's medication without the prescriber; some medicines cause problems when stopped suddenly. If you are thinking about suicide or are in crisis, call or text 988 (the 988 Suicide & Crisis Lifeline) or go to the nearest emergency room. The practice's article on treating adolescents with depression covers depression care in more detail, and ADHD medication choices are compared in stimulant vs non-stimulant medication.
Older teens and the move to adult care
Sixteen- and seventeen-year-olds sit between two systems. They often want more privacy and more say, and the law gives them some. In New York, for example, a hospital may admit a person over 16 and under 18 as a voluntary patient on their own application, if the teen knowingly and voluntarily consents, or on a parent's application; under 16, only a parent, guardian or other listed person may apply. That rule is about inpatient admission, not routine office visits, but it shows how the law treats older teens differently.
At 18, your teen becomes the decision-maker for their own care. Under HIPAA, a parent is generally a minor's personal representative, but for an adult it is a person with legal authority to make health care decisions for them, such as through a health care proxy. Unless your young adult signs a release, the psychiatrist will generally stop sharing details with you. Planning for this a year or so ahead avoids a gap:
- Ask whether the psychiatrist continues to see patients after 18, or will help with a referral to adult care.
- Encourage your teen to book their own appointments, refill their own prescriptions and know their medication names and doses.
- Talk together about which information they would want you to keep receiving, and what form they would need to sign.
- If college is ahead, plan where care will happen during the semester; mental health care for college students covers campus, home and telehealth options.
Telehealth for teens
Telehealth can make regular visits easier for busy teens, but privacy at home matters. Ask whether your teen will have a private space, whether a parent needs to be present at the start of each visit, and what happens if the connection drops during a hard conversation. Location matters too. At this practice, for example, telehealth is for patients who are physically located in a state where Dr. Lewis holds an active medical license, and the team confirms eligibility before the first visit. Ask any practice how it handles visits while your teen is away at camp or college. Telehealth vs in-person psychiatry compares the two formats.
If your teen refuses to go
Many teens resist at first. Offering a choice between two clinicians, or between telehealth and in person, can give them a sense of control. If the refusal comes with signs of danger, it becomes a safety question rather than a scheduling one. Helping someone who refuses psychiatric help covers what families can do.
Red flags
- A diagnosis and prescription after a brief visit, with no input from school or parents.
- No clear explanation of confidentiality, or a promise that parents will be told nothing.
- Dismissing the Boxed Warning, or no plan for follow-up after starting an antidepressant.
- Reluctance to talk with the school, pediatrician or therapist when you consent.
- No plan for what to do in a crisis.
How the practice approaches care for teens
Dr. Lewis is board certified in adult psychiatry, child and adolescent psychiatry and integrative medicine, and trained at Columbia University and the NYU Child Study Center. The practice has psychiatrists, psychiatric nurse practitioners, psychotherapists and a health and wellness coach on one team, and its care includes psychiatric evaluation and medication management and psychotherapy, including CBT and DBT. More on its approach is on the child and adolescent psychiatry page and in its article on DBT for teens. For depression specifically, the parent's guide to teen depression treatment compares therapy and medication options. For ADHD questions, see preparing your child for an ADHD evaluation.
A free discovery call by phone or text is the first step, and the team answers questions about care options, scheduling and insurance. The practice is out of network with all insurance plans; if you need care that is in network with your plan, ask the team on the discovery call about options. The guide to choosing psychiatric care covers the other decisions families face.
Frequently asked questions
At what age should a teen see a child and adolescent psychiatrist rather than an adult psychiatrist?
Child and adolescent psychiatrists are trained to treat patients through adolescence, and New York law treats people under 18 as minors. Older teens and young adults can see either, but a child and adolescent psychiatrist is often a better fit when family involvement and school coordination matter.
Can my teen see a psychiatrist without my consent in New York?
Only in narrow situations. New York Mental Hygiene Law section 33.21 allows outpatient mental health services without parental consent in programs licensed or operated under Office of Mental Health rules when specific conditions are met. In most private practices, parents or guardians consent. Ask the practice how it handles this.
Will the psychiatrist tell me everything my teen says?
Usually not word for word. Most adolescent psychiatrists agree on ground rules with the family at the start: general progress and safety concerns are shared, while day-to-day details stay private so the teen will speak openly. Safety always overrides privacy.
Is board certification required to treat teens?
No. Any licensed physician can legally treat teens, and pediatricians and psychiatric nurse practitioners do so every day. Board certification in child and adolescent psychiatry shows additional specialized training and a passed subspecialty exam.
What should we bring to the first appointment?
School reports, any IEP or 504 documents, previous evaluations, a list of current and past medications and supplements, and the family's mental health history. The article on preparing your medication history has a template.
Can the psychiatrist talk to my teen's school without my permission?
Generally no. HIPAA requires a valid written authorization for disclosures it does not otherwise permit, so expect to sign a release before the psychiatrist talks with a teacher or counselor. A good clinician will also agree with you and your teen on what will be shared.
What changes when my teen turns 18?
Your teen becomes the decision-maker for their own care, and the psychiatrist will generally need their written permission to share details with you. Talk about this before the birthday, and ask whether the psychiatrist continues to see young adults or will help with a referral.
Sources
- What is Child and Adolescent Psychiatry?. American Academy of Child and Adolescent Psychiatry, 2026. aacap.org
- Child and Adolescent Psychiatry (subspecialty exam requirements). American Board of Psychiatry and Neurology, 2026. abpn.org
- Check Physician Status. American Board of Psychiatry and Neurology, 2026. abpn.org
- Frequently Asked Questions for Physicians. New York State Education Department, Office of the Professions, 2026. op.nysed.gov
- Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. American Academy of Pediatrics, Pediatrics 144(4):e20192528, 2019. pmc.ncbi.nlm.nih.gov
- New York Mental Hygiene Law Section 33.21 (consent for mental health treatment of minors). New York State Senate, 2025. nysenate.gov
- 45 CFR 164.502(g) Personal representatives. Electronic Code of Federal Regulations (HHS), 2026. ecfr.gov
- 45 CFR 164.512(j) Uses and disclosures to avert a serious threat to health or safety. Electronic Code of Federal Regulations (HHS), 2026. ecfr.gov
- Lexapro (escitalopram) prescribing information. Allergan / DailyMed (NLM), 2023. dailymed.nlm.nih.gov
- Strattera (atomoxetine) prescribing information. Eli Lilly and Company / DailyMed (NLM), 2026. dailymed.nlm.nih.gov
- Prozac (fluoxetine) prescribing information. Eli Lilly (Dista) / DailyMed (NLM), 2026. dailymed.nlm.nih.gov
- Zoloft (sertraline) prescribing information. Viatris / DailyMed (NLM), 2026. dailymed.nlm.nih.gov
- New York Mental Hygiene Law Section 9.13 (voluntary admission). New York State Senate, 2014. nysenate.gov
- 34 CFR 99.30 Under what conditions is prior consent required to disclose information?. Electronic Code of Federal Regulations (U.S. Department of Education, FERPA), 2026. ecfr.gov
- 45 CFR 164.508 Uses and disclosures for which an authorization is required. Legal Information Institute, Cornell Law School (HIPAA Privacy Rule text), 2026. law.cornell.edu
Educational information, not medical, tax or legal advice. Decisions about diagnosis, medication and treatment belong with a clinician who knows your history.
The information provided on this blog is for educational and informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
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