Hi everyone,
First, I appreciated Bromfield's considerations around medication. Essentially, he posited that in some cases it is important to wait and try talk therapy before introducing meds, and in other situations clinicians may want to start medication early because the medicines need time to build up in the child's system before becoming effective. In other words, medication should be considered on a case-by-case basis. I did appreciate his note that just starting medication and therapy at the same time can be confusing as to which benefits or negative side effects should be attributed to which intervention. And he noted too that it is important to talk through feelings around medication with parents and kids, even if, after much work here, they try medication only to find it isn't effective, which can be a big let down.
Finally, around Bromfield, there was part where he mentioned that parents start to attribute "good days" for the kids to the medicine, and "bad days" to when the medicine is lacking. This signals to the child that they don't have to take responsibility for their actions on days when they're not medicated. What an interesting problem! I think this kind of technology-will-save-us mentality applies here and can lead to such dependence on substances that may or may not serve in the long run.
Also, the Belendiuk and Riggs article was an interesting overview of different therapeutic and medicinal treatment options for working with substance use disorders (SUDs) with adolescents. I did find this one line a bit sad and frustrating, which said that for every dollar invested in addiction treatment, it saves $4-7 in costs for crimes, theft, and the criminal justice system. It was a bit heartbreaking that the researchers felt like an appeal to the pocketbooks of powerful people would be the most motivating way to get them to invest in treatment options for teens in need--not that I think they were wrong to do this! This really spoke to me of our backwards priorities as a society. The cost is what matters. The appeal to saving money is what saves kids lives. While this wasn't mentioned in the Smith et al. article, I did feel a similar way. If our society protected the most vulnerable among us from the start, we could see less trauma, less crime, and less negative health effects. Instead we seem to choose punishment and money. I'm not sure what the solution is, but I'd love your thoughts.
Best,
Melissa