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Psychopharmacology is common in mental health care. Health service psychologists routinely provide services to clients prescribed psychotropic medications, and work within multidisciplinary collaborations. As a result, foundational knowledge of psychopharmacology is necessary. The primary objectives of this study were to evaluate the number of American Psychological Association (APA)-accredited doctoral programs in clinical psychology that require a course in clinical psychopharmacology in their curriculum and to identify potential barriers preventing programs from offering this coursework. All clinical psychology programs accredited by the APA were surveyed to determine their requirement of a course related to psychopharmacology. Program information was initially reviewed online and in the absence of clear indication within their program websites, survey questions were sent to program administrators. Data were obtained from 216 of the 254 APA-accredited programs (85%). Of these, 66 programs (31%) required a course in psychopharmacology. This equates to 48% of the total number of students from programs where data were obtained. Barriers to coursework being offered were identified in 25% of responding programs, reflecting lack of room in the curriculum, insufficient faculty expertise, and inconsistent student interest. Despite the frequent utilization of psychotropic medications in mental health treatment, less than a third of responding doctoral programs required a course in psychopharmacology in their curriculums. It is argued that a foundational understanding of clinical psychopharmacology may be particularly important for those working in integrated behavioral health care settings. APA accreditation status should include that graduate training curricula require a course in psychopharmacology. [ABSTRACT FROM AUTHOR]

A growing body of research shows that many seriously troubled children and adolescents are reacting to adverse life experiences. Yet traditional diagnostic labels are based on checklists of surface symptoms. Distracted by disruptive behavior, the common response is to medicate, punish, or exclude rather than respond to needs of youth who have experienced relational trauma. Among the most traumatized youth are those removed from family, school, and community and placed in residential settings. Whether in treatment or juvenile justice programs, the focus is more on managing disruptive behavior rather than fostering healing and growth. As trauma expert Sandra Bloom (1997) suggests, the question should not be "What is wrong with you?" but rather "What has happened to you?" This article describes findings from the Adolescent Subjective Experience of Treatment (ASET) study of youth in residential treatment settings. Their exposure to Adverse Childhood Experiences was surveyed. While a majority of youth had experienced serious trauma, the diagnoses they were given usually failed to acknowledge these experiences.

One would like to believe that advances in science have resulted in improved outcomes for troubled youth. Trends in treatment have changed dramatically in two decades. Technology to understand the brain and its functions are highly advanced. But the United States is now medicating youth more than any other country. There is growing concern about the burgeoning use of psychotropic drugs to manage childhood behavior problems. Examining the commonly used stimulant and antipsychotic medications across the last 20 years indicates that people need to re-evaluate their methods of care for their most troubled youth. This article critiques this practice and calls for a reorientation toward relationship-based interventions. (Contains 1 graph.)

Emphasis on neuropsychiatric frameworks of conceptualizing troubled youth is increasing. This focus leads to more biologically-based interventions. As such, the use of psychotropic medications is skyrocketing, while the utilization of psychosocial strategies is diminishing. Yet overall outcomes seem to be faltering. Admissions to outpatient, partial-hospitalization, and residential care have all increased dramatically between 1986 and 2004. In this article, the author stresses the need to re-establish the importance of relationships in care, and incorporate ecological interventions and skill development into treatment strategies. These are aptly represented by the Re-Education principles and evident in all Re-ED practice settings. Even when integrating the exciting science that is available, any additional strategies should be developed on the platform of the strength-based models of Re-ED and the Circle of Courage (Brendtro, Brokenleg, & Van Bockern, 2001).

There is increased use of medications with troubled youth and a corresponding increase in research about these drugs. However, even the most exhaustive efforts to demonstrate the effectiveness of medication strategies have resulted in less than robust outcomes. A critical review of the most prominent studies highlights this questionable trend in the common diagnoses of attention deficit hyperactivity disorder and pediatric bipolar disorder. (Contains 1 figure and 2 tables.)

Advances in neuroscience are providing fresh insights about emotional and behavioral problems of children and youth. However, the flood of brain-related articles is a mixed blessing. Some popular authors on the brain, as well as certain researchers, take a very narrow view of attributing complex social problems to brain disorder. The effect is to narrow solutions to drug dosing or assume such youngsters are but fledgling psychopaths. This article looks at the sometimes excessive claims about the bio-behavioral basis of problems of youth given the labels of conduct disorder.

Children who have experienced relational trauma present a host of problems and are often diagnosed with psychiatric disorders and then medicated. But there is evidence that commonly used drugs interfere with oxytocin or vasopressin, the human trust and bonding hormones. Thus, psychotropic drugs may impair interpersonal relationships and impede forming a therapeutic alliance. One prominent characteristic of trauma is that the safety within interpersonal connectedness is disrupted. These breaches of trust, respect, safety, and collaboration with adults further impair children's ability to recover from traumatic experiences. They become dysregulated, impulsive, moody, aggressive, untrusting, and withdrawn. These troubled youth become wary of adults. They receive wide-ranging diagnoses. A youth who becomes too impaired (or symptomatic) is often swept up into the realms of psychiatric and psychological treatment. Moreover, it is often believed that the combination of these disciplines can result in optimal outcomes for these children. This article provides a brief overview of the different classes of medications that troubled youth are typically prescribed. The use of medications in youth is not well researched and becomes particularly complex when considering developmental aspects of children, their histories, the use of multiple, concurrent medicines (polypharmacy), and the supportive networks in their lives. Nonetheless, research does provide some insight as to how these medications may affect the ability of a child to connect when in treatment.

In 2013, the American Psychiatric Association will release its newest Diagnostic and Statistical Manual, 5th Edition (DSM-5). This tome has evolved over the decades, originally including just 112 diagnoses across 128 pages. The upcoming edition is expected to eclipse the 943 pages, and 350+ disorders of the current DSM-IV-TR, offering a variety of new diagnostic labels such as the Callous and Unemotional subtype of Conduct Disorder, Disruptive Mood Dysregulation Disorder, Gender Dysphoria, and Premenstrual Dysphoric Disorder, to name a few. Each new edition of the Diagnostic Manual adds new "disorders" which provide a ready market for the use of medication. This medicalization of human unhappiness is now being aggressively marketed to other cultures which have very different traditions of tending to persons in distress.

Everyone experiences stress and needs extra help at times. Often this involves informal support, but in certain circumstances, help comes in the form of therapy. Sometimes there is a negative impression about "needing" therapy. But when the going gets tough, sometimes the tough go to therapy. With a wide range of factors working against them, youth in residential care have endured tremendous stress. The likelihood that they have faced trauma is significantly increased; however, many have fewer resources to assist in coping with stress. Typically, a multidisciplinary team provides treatment experiences for troubled youth. But what do teens think of this treatment? Specifically, what do those placed in residential care think of being in therapy? Surprisingly, teens in residential care are rarely seen as important sources of data on treatment. Yet professionals can learn valuable lessons from them, in particular what they think works and what they think does not. Young people in residential treatment participated in the Adolescent Subjective Experience of Treatment (ASET) study. This article presents the findings of the ASET survey. Most responses indicated a high value on involvement in individual therapy. (Contains 1 graph and 1 table.)

There are major differences in perspective between the traditional medical model of treatment for troubled children and more recent strength-based approaches. This is particularly evident when widespread use of psychoactive drugs becomes a substitute for interpersonal therapeutic interventions. Drugs and relationships both impact the brain, but in markedly different ways. Medications may impact the brain in ways that facilitate short-term management of behavior. Long-term positive changes come as corrective interpersonal relationships serve to rewire the resilient human brain. More research is needed in order to understand how psychiatric medications and therapeutic interventions can be balanced for the benefit of troubled children.

Certain symptoms in disturbed or problematic children are believed to be the result of experiential difficulties. Other symptoms are attributed to biological factors, only to be remedied by medications. It is argued here that all psychological symptoms--even those as severe as delusions and hallucinations--have meaning and are directly related to unmet needs within these children and youth. In this article, the author describes how addressing the Circle of Courage needs of belonging, mastery, independence, and generosity may foster positive growth, even when symptoms can relate to brain-based disorders.

A parent's goal is to be sure each teen stays safe, makes responsible decisions, and respects others. But the influence of peers, the temptation of freedom, access to alcohol and other drugs, and unsupervised activities cause parents to fear that their teen may be ill-equipped to negotiate the complicated world. The transition from dependence to independence poses new challenges to both teens and parents. Adolescence brings greater access to the world and its risks. But being overly protective does little to teach responsibility. Technology is providing more ways for parents to keep tabs on their kids. Does this surveillance foster positive behavior or fuel distrust? The author contends that there is no easy answer for how much to monitor a teen. Some parents make decisions based on unfounded concerns about peers, memories of their own turbulent teen years, or day-to-day family stress. Whatever the level of monitoring, this has impact on teens, their independence, and the relationship with their parents.

The article addresses the effects of trauma on adolescent behavior. It examines the results of the Adolescent Subjective Experience of Treatment (ASET) study of youth in residential treatment settings in which their exposure to Adverse Childhood Experiences was determined. The opinion of trauma expert Sandra Bloom on the management of disruptive behavior is also cited.

There is growing concern about the burgeoning use of psychotropic drugs to manage childhood behavior problems. This article critiques this practice and calls for a reorientation toward relationship-based interventions. [ABSTRACT FROM AUTHOR]

The article offers information on the usage of re-education principle in the field of evidence-based standards to manage child behavior problems. It focuses on the efforts of the clinicians to utilize evidence-based treatment (EBT) strategies in challenging the widespread use of drugs, which have demonstrated their effectiveness in controlled research and in managing troubled children and youth. It suggests that treatment providers should continually evaluate the effectiveness of their dugs in their efforts to stabilize and strengthen the youth and the families they care.

A universally accepted operational definition for the term "disease" is not yet established in contemporary psychiatry. In clinical psychology and psychiatry, disease has been used indiscriminately. The term disease has been invoked (even when no systemic etiology or pathology has existed) to describe addictions, a cluster of bizarre symptoms, and to justify crude medically based treatments (e.g., electroshock, lobotomy, involuntary commitment, medication prescription). More recently, sophisticated machines such as CAT scans, PET scans, and MRIs have been used for questionable research conducted to try to identify supposed diseases, to justify the overuse of psychotropic drugs. Economic and industry interests have superseded scientific concerns. To establish scientific rigor in psychiatry and clinical psychology research, an operational definition of disease is proposed. [ABSTRACT FROM AUTHOR]

The article discusses the addition of new disorders to the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association (ASA). The callous and unemotional subtype of conduct disorder, disruptive mood dysregulation disorder, gender dysphoria and pre-menstrual dysphoric disorder have been added to the manual. The proposed modifications to the manual include a cultural formulation interview (CFI). In addition, the article revisits the concept of ethnocentricity and the concept of depression in Japan.

The article discusses the results of the Adolescent Subjective Experience of Treatment (ASET) study on the experiences troubled youth have with therapy by the Chicago School of Professional Psychology in Chicago, Illinois. The results indicate that the majority of youth surveyed have positive views of therapy, suggesting that they feel understood by their therapists. The survey also shows data relating to the management of their feelings, the allegiance and collaboration with their therapists, and their relationship with their therapists.

The article focuses on the impact and association of parent monitoring and invasion of privacy among teenagers. It states that parents' goal is to make sure that their teenagers are safe, respect others, and make a responsible decision, which lead them to become more strict and attentive with their daughters' activities. It says that the transition of teenagers from dependence to independence could pose new challenges to both parents and teenagers. It relates that privacy is a key part of someone's development and it should not be taken for granted because as it lost, this slower someone's personal integrity. It also discusses a study which calculated the parent's frequency of using technologies in gaining information on their children.