Involving families is a very important part of treating your patients. When the family or spouse is included with the patient in the assessment, decision-making, and treatment planning, the patient’s adherence to treatment improves regardless of diagnosis.

Alison Heru, MD, gives the following additional advice for conducting effective family meetings.

If you want to comprehensively understand your patients and modify variables that might impact treatment and outcome, it’s important to understand families. There has been a lot of research showing that the family environment can have a significant influence on the course of an illness, either in a protective or risk-inducing way.

Discussing medications with adolescents can be challenging. Because there is so much variation in family structure and the problems that kids and families face, it’s important to maintain some flexibility in how clinicians evaluate adolescents.

While I appreciate all of my TCPR subscribers, there’s one subscriber whom I value above all the others: my father. A psychiatrist who practices in the Bay Area, my father has been a loyal subscriber since Volume 1, Number 1, in January of 2003.

In this interview, Dr. Shatkin talks about how the adolescent brain works, and how we can use this understanding to work more effectively in our practices with both adolescents and their parents. There’s a misconception that dopamine equates to pleasure. It’s not pleasure; it’s the promise of pleasure. Dopamine is the idea that something great might happen. And so high dopamine levels drive kids into high-risk situations with high amounts of potential pleasure. This is aggravated by the fact that the frontal cortical areas are not well myelinated yet and not well connected to the limbic system. So, when kids are younger, they have less control over those impulsive drives.

Because of the lengthy period of training, doctors begin their first “real” jobs 8–10 years after many of their friends from college. And, depending on specialty, burnout may cause a physician to retire a few years earlier than the average American. Both these factors lead to a compressed retirement saving timeline.

Prescribing psychotropic medications in patients with intellectual disability (ID) requires certain nuances in approach that may be unfamiliar to some psychiatrists. In this article, we’ll discuss some aspects of assessment and treatment that you may find useful when you encounter and work with such patients.

Psychotherapy is all about communicating, yet people with intellectual disability often have significant limitations in their communication skills, depending on their level of cognitive functioning. Is it possible for us to help these patients? If so, how? Julie Gentile, MD (www.juliegentile.com) has been looking at these questions for 20 years.

Patients with intellectual disability often have difficulty controlling their emotions, which is what leads to so-called “challenging behaviors.” These behaviors include a range of aggressive and impulsive interactions, such as assault to self or others, stealing, fire-setting, sexual offenses, and other problematic situations.