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I spent 13 years as an Occupational Therapist with 9 of them in child/adolescent psych and the other 4 with adult.. mostly inpatient although I worked partial day treatment in adolescent for quite a while. I concur that the child/adolescent psych is much more rewarding. The bottom line is this: In adult psych, most of the problems are more biochemical (schizophrenia, bipolar, clinical depression) so it's "medicate, medicate, medicate" whereas with the kids, while a few are biochemical, more are having situational problems like coping with abuse, dysfunctional families, etc., so therapy is more useful and many of them can work through things and develop healthier coping strategies. Their thought processes are easier to work with also. While therapy definitely helps in conjunction with medication for the more biochemically oriented, it's geared more toward coping with mental illness, the importance of staying on meds, when to call your doctor, etc. Additionally, given the type of disorder, their thought processes are more difficulty to work with in a therapeutic way. Until Mr. Doe stops seeing hallucinations, it's going to be pretty difficult to do much "talk" therapy. Yet, they only get to stay inpatient for 3-5 days these days and that isn't enough time to get anywhere. They used to stay in for two months so you had that whole time to work with the meds, observe differences and side effects first hand, etc. The best psychiatrists I worked with were the adolescent psychiatrists because they were more versed in talk therapy too. They didn't just medicate. I would think it would get boring to just medicate all the time, but that's what a lot of them do.
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