Re: Re:PBS Frontlline on medicating children

[Guest guest]

I think that illustrates a point that I have also seen in my work with children in outpatient psychiatry. Medication can be very beneficial because therapeutic work is often unfeasible and even counterproductive until behaviors are stabilized on a biological/physiological level (I add counterproductive only because of the instances when children who want to do well end up feeling very badly when they say they will do better but find that their behaviors are actually out out of their control). The line is very subjective in deciding when the behaviors and symptoms are so severe that they warrant medication to help the child function better on a daily basis. Of course, not every child needs to be medicated, I'd say only about half of the children on my caseload were on meds. Out of those children I'd say that half responded very well, and the other half did not. As for the children who were not medicated, I'd say a good deal of them probably should have tried medication, due to the severity of their symptoms and their resistance to therapy (by resistance to therapy I mean resistance toward building rapport with their therapist due to their symptoms). Its obviously a complicated issue that should be approached on a case by case basis, but I have seen miraculous improvements when the right child receives the appropriate medication and then engages in therapeutic work. On the other hand I am wary of psychiatrists that medicate every single patient across the board. I am especially wary if the child is being medicated primarily for oppositional behaviors or attachment disorders that are not secondary to some sort of major psychiatric disturbance (mood disorder/impulse disorder/psychosis/adhd/etc), since the problem would really be a relational issue best treated in family/individual/group therapy.

-Jonathon Borah, MPS, ATR-BC, LCAT

Obviously you've never had a 6 year old daughter

crying that she wants to die, or a large 10 year old screaming bloody murder

because her computer game was interrupted, or not going to school, or, well, I could

go on & on. We did try therapy first, & I was very disappointed that

being an art therapist, I didn't seem to be able to help her. Medication

gets her to a point where we can work with her and hopefully will help her meet

social milestones so she doesn't get too far behind. We are also doing

therapy, but we need the meds. We went off of them recently, and went back on

them with much relief!

All the Best!

Cook Tyler