Last month, we briefly introduced you to Dr. Catrina Wilkins (now Dr. Luca), our new child and adolescent psychiatrist. Most recently she was working as a Clinical Assistant Professor at the University of Florida Division of Child and Adolescent Psychiatry. Before that she had been focusing her energy and efforts on her family. During that time, she was also thinking about the kind of psychiatrist she wants to be. Now that she is back in the chair, her vision for herself and the kind of psychiatry she wants to practice sounds sharp and well-defined. It begins with being well-rounded.
“It’s important to know all of the mechanics of medicine and to know the mechanics of how to do an interview.” Luca said. “Anybody can learn that. Anybody can get a checklist and say, ‘This is what I need to know.’ My primary concern is, number one, who you are as a person, because the better I understand that, the better I’m going to be able to come up with a treatment plan that you’re actually going to want to do; and number two, that you view me, not as part of the family, but as someone who is involved not just in your psychiatric care but in your care as a person—definitely a more holistic approach. It’s not unheard of for me to talk about diet, definitely sleep, family dynamics—I want to cover your entire life because all of that is playing a role in what I’m seeing in front of me.”
An important part of this vision for Dr. Luca is an emphasis on therapy. During her residency training, she pushed hard to have more therapy supervisors. While most of her fellow resident physicians had one or two therapy advisors, she had three.
“I was the squeaky wheel, honesty. I just kept asking. I kept making it known that this is what I really want to do.”
This was at time when there was an emerging emphasis on medical interventions in psychiatry, according to Dr. Luca, and she doesn’t feel that this has changed since then.
“It has become even more biologically focused. Medication is being prescribed a lot more.”
Part of that, she believes, is the time crunch many psychiatrists are working under.
“When you put a child psychiatrist in a very time-limited arena, you start shaving off a lot of [therapy]. It becomes, ‘How’s the medication. Is he tolerating it? Are you getting results? Okay, good.’ I don’t think it’s because the physician wants to be like that, but the demands are there. You have a schedule with plenty of patients that need to be seen, but unless you’re spending 30 minutes with each patient, you’re not there.”
As a child psychiatrist, part of being there for children is counseling the parents. Dr. Luca says she sometimes sees parents overcompensating for their child’s illness.
“You’re still the parent.” Luca said. “You still set the boundaries. You still have rules. Do you flex them and bend them some to better accommodate and give the child room? Yeah. But you don’t throw the rules out the window because of some diagnosis.”
Still, her dissent from what she sees as a decline of therapy and an over-emphasis on medication does not mean that she has an aversion to using medications. She does, however, often see that parents are worried about medications changing their children, or worrying that they won’t be themselves. This, she explains, isn’t how it works.
“If they’re depressed, I make them less depressed so they’re able to make better decisions and they’re more available to you to parent. A depressed child is not going to be parented very well. An anxious child is not going to be parented very well.”
At the heart of Dr. Luca’s perspective is a strong desire that she expresses this way:
“I want to see (specifically children) get the care that they need and not be stigmatized.”
It’s what drives her to serve underprivileged populations while maintaining an emphasis on personal responsibility. It’s what drove her work on programs in ADHD and law enforcement, in which she worked with law enforcement officers to help them understand and know how to handle people with ADHD in the justice system. And it’s what drives her work here at Sarkis Family Psychiatry. We are glad to have her here.