Evidence-Based Thinking and the Alliance With Parents

Abstract

The practice of child and adolescent psychiatry is more complex now. More is known about the neurobiology of common psychiatric disorders. Sophisticated diagnostic systems can be downloaded for nonprofit use from the Internet (e.g., Kaufman et al., 1997 Kaufman J Birmaher B Brent D et al. Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry. 1997; 36: 980-988 Abstract Full Text PDF PubMed Scopus (7114) Google Scholar ). Treatment alternatives for a single disorder have proliferated (e.g., Clarke et al., 1999 Clarke GN Rohde P Lewinsohn PM Hops H Seeley JR Cognitive-behavioral treatment of adolescent depression: efficacy of acute group treatment and booster sessions. J Am Acad Child Adolesc Psychiatry. 1999; 38: 272-279 Abstract Full Text PDF PubMed Scopus (377) Google Scholar ; Emslie et al., 1997 Emslie G Rush A Weinberg W et al. A double-blind, randomized, placebo-controlled trial of fluoxetine in children and adolescents with depression. Arch Gen Psychiatry. 1997; 54: 1031-1037 Crossref PubMed Scopus (885) Google Scholar ). Self-help pediatric mental health consumer groups are now common, often with Web sites such as http://www.chadd.org. Often multiple choices exist, some of them vastly disparate, with each choice professing at least some efficacy. A wilderness camp experience and an atypical antipsychotic may each show at least some usefulness for the same disorder. With more choices and more information, decision-making is more complex.