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From: Nathan E. Lavid, MD
Date: 08 Oct 2009
Time: 16:43:42 -0500
Remote Name: 75.142.104.151
In light of the premise of your question, I fully agree that a referral is appropriate. Simply put, if a patient is not improving, I will seek a second opinion from a colleague or will refer for an assessment from a nonpsychiatric clinician. And, this type of clinical decision making is appropriate for those who care for a patient who stutters. For example, if a patent who stutters has more anxiety than typical and is refractory to speech therapy, a referral to a mental health professional is appropriate. In this scenario, the referral would be to answer the question if the anxiety is a product of a primary anxiety disorder and to consider treatments directed primarily at the anxiety.