Lauren W.M. Swager, MD
Board Certification: Child and Adolescent Psychiatry; General Psychiatry
Medical School: West Virginia University
Residency and Fellowship: University of North Carolina
Faculty Rank: Assistant Professor
Special Clinical/Research Interests: Child development; Childhood mood and anxiety disorders, Childhood Psychotic Disorders, Teaching, and Effects of Xerostomia ("Dry Mouth") in psychiatric populations.
Is there a particular population of students (e.g., ethnicity, spiritual, sexual orientation) that you would particularly like to advise?
Enthusiastic Learners of all types!
What does a typical day in the life of a child and adolescent psychiatrist include?
I mostly work in an outpatient clinic setting and through school consultation programs at local schools. Many child psychiatrists work in residential setting or inpatient settings as well. Child psychiatrist often work in teams with other providers like pediatricians, school teachers, therapists, counselors, Social Workers as a multidisciplinary approach to patient care. We see children and teens who are struggling with adjustment issues, anxiety, depression, relationship problems, trauma, psychosis, developmental delays/autism, school difficulties, behavioral problems, ADHD and family difficulties. In addition to considering medication options and medical causes for illness, child psychiatrists are typically outstanding individual and family therapists that offer advice and try to shape behaviors. We probably should be called "family psychiatrists". I am never bored. I see people in distress and crisis but also have the reward of seeing people longitudinally and seeing dramatic improvements in functioning over time in both kids and families. I LOVE my job!
What is the biggest challenge of being a child psychiatrist?
Children are sometimes puzzles and don't come out always say what the problem is. Answers are not always clear cut and it requires patience and time sometimes to get to the root of the problem. Child psychiatrists are often detectives and in addition to helping a child find ways to communicate often we have to collect and decipher data from many other sources. You have to be an expert in development to understand the difference between normal developmental process and true psychiatric illness/dysfunction. Treatments are also often slow for people to accept and sometimes improvements are seen over weeks to months instead of days. Patience is important! The reward is that you really get to know your patients over time and make a difference.
How do you foresee child psychiatry changing over the next 20 years?
As an underserved pediatric specialty the movement is growing for more collaboration with pediatrics and primary care to meet patient care needs. I think child psychiatry will probably grow in both the schools and be more of a presence in consultation with office based pediatricians in the future. It is very much a profession in demand and that will probably continue.
What advice would you give a student who is considering a child and adolescent psychiatry fellowship?
A child psychiatrist must complete 3-4 years of a general psychiatry program and then apply for a 2 year child psychiatry fellowship. The commitment is a minimum of 5 years. Interested students need to be curious, empathetic, enjoy hearing the patients "story" and like to play on the floor at times too. Medical students do not get much exposure to child psychiatry in medical school and many do not have the opportunity to really know what we do. If you might be interested, consider choosing us for a 4th year elective.