When I was a kid, I was a junior member of the NY Historical Society—the Yorkers. We dug up our town of Williamsville and put artifacts in our new museum on the site of a defunct Nike ICBM missile base, including the rusted chassis of a Model T and, digging deeper, the bones of our town founder Jonas Williams. At Carlat we also dig deeper: Last fall it was the possibility of suicidality with antidepressants when we see the real data; this winter, it was the lack of clinical relevance of CYP enzyme testing when we use medications carefully; and this spring, beneath the apparent weight of thousands of studies that turn out to be flawed, we found an absence of a definable effect size for the massive $17 billion applied behavioral analysis industry.

We didn’t believe it. We had the statistical methodology verified and then sent our interview out for peer review. Our usually spirited group of colleagues uniformly concurred with the findings of the article.

How to respond to this seismic shift? With better informed consent: We’ve supplemented with an article on the three main kinds of autism treatment so that you’ll be prepared to help families know that they have choices.

Also in this issue are research reviews on the efficacy of ECT and on the best timing for gender-affirming care for children and adolescents. As always, let us know what you think.