That's almost the right question as parents would agree. The technique of result guided substance additions is as important as genetics, behavior. I would start by looking at the causes of good, bad and differential behaviors and for diagnosis, the beneficial substances known to work-like hormones, ways to supplement (all) methylation and other systems, food essentials! As chemists we must remember that all cells obey the laws of chemistry and that the right combination of ingredients and amounts makes for the best yield. For example, serotonin and mood goes awry when 5-HT levels plummet, thus the need for SSRIs. One could eat more Tryptophan now that it's again been made available after several decades (due to Patent time?). However, if taken with high Leucine & Phenylalanine containing foods it is not kinetically favored for cell entry. So one must find the impossible: foods with less L+F (I dare you to find them). 5-HydroxyTryptophan (5-HTP) then becomes a good alternative, except that it is recognized by tryptophanyl-tRNA synthase and incorporated into growing protein potentially disrupting tertiary structure and enzymatic activities peripherally as well as centrally. So? Just take a lesser amount.

There may be situations where boundaries may not be contained naturally and so SSRIs in low doses, according to season and reason may be employed. Also, interfering food substances may need to be avoided to allow the stoichiometric diet to work. These nutritional arenas are severely underepresented. There are industries in contention, like Agrobusiness, Pharmaceutical, all of which make difficulty to overcome a profiteering bias. Even the Medical-Scientific complex is overbearingly difficult to convince. The right question? If we have the right answer why would we need to ask? The question is authority and then, there is the question of truth.

There is some interesting research on the relationship between trust in the therapist related to adherence when it comes to medical advices. Building a trustful relationship to both the therapist(s) and the insititution isn't a quick fix, however. David Thom (2004) sums up three major dimensions that the patient evaluates: the technical/medical competence of the therapst, 2) the communicative competence and 3) agency - do the therapist really wish me well?

Personally, I take interest in how patient education and user participation can promote trust. Adherence is an interesting field, but should be seen in a collaborative perspective. If the patient feels involved in the treatment process the possibilitie for better adherence should improve. But, there are a number of little useful intervensions around, so proper, cross-professional and tailor-sewed effort seems to be needed.

Some litterature: Thom DH, Hall MA and Pawlson G (2004): Measuring Patients’ Trust in Physicians When Assessing Quality of Care. Health Affairs, 23, no.4(2004):124-132.

Ratanawongsa N, Karter AJ, Parker MM, Lyles CR, Heisler M, Moffet HH, Adler NE, Warton M & Schillinger D (2013): Communication and Medication Refill Adherence. JAMA Intern Med. 2013;173(3):210-218.

I agree with Michelle, and that is one of shortcomings of subspecilasation resulting in biological, CBT and other treatment strategies. I am biologicaly oriented psychiatrist as well CBT psychotherapist. In my clinical experience adolescent population is adherent if they have trustful and open relation with therapist. Most of all they appreciate education about posible treatment strategies including psychopharamcotherapy without mistification. I often prescribe different psychopharmacological treatments, but realy rare in first few appointments but I mention that possibility. At the and if needed patients alone ask for psychopharmacological treatment and then they share sense of involvement in their treatment, and they are more adherent. Of course in the mean time CBT appointemnets are more frequent but last also paralel with psychopharacological and often after it.

I think that parents' beliefs about psychopharmacological therapies is an important component in adherence to such drug category. I am afraid that most parents have negative views and negative beliefs about psychopharmacological medicines which affects adherence of their children to their medications