Mental Health Blog

Navigating Parent Concerns About Children’s Medications

• July 22, 2024
• The REACH Institute
• Medication, Parents

“Many parents’ biggest concern about starting their children on medication is committing to an intervention they won’t be able to stop in the future,” explains child and adolescent psychiatrist Laurence Greenhill, MD. 

Research shows that parental beliefs and concerns are a top contributing factor to whether children and adolescents receive proper treatment for mental health disorders. As clinicians work to improve pediatric mental health care understanding how to talk to hesitant caregivers about their concerns is critical. 

We asked Dr. Greenhill to share how he works with worried parents, particularly when it comes to medication for common conditions like ADHD and anxiety. 

Parental Concerns About Starting Medications

Dr. Greenhill has seen several common themes in the worries parents express about starting medication for their child. These include: 

• Worry that medication will become a “life sentence” or lead to dependency and addiction. 
• Concerns about side effects. For example, parents may worry that ADHD medications may increase their child’s anxiety.  
• Belief that a child will “grow out of” the condition, particularly when the child’s condition is not as disruptive in the classroom. 
• Beliefs about “not using pills to deal with problems.” 

Getting to the Root of Medication Hesitation

“If parents can verbalize their concerns about medication, it often lowers their worry level,” explains Dr. Greenhill. 

Clinicians should elicit as much information as possible about where parents’ apprehension originates. What experiences have they had with treatment for mental health issues and with medication for children in general? Have they personally had negative experiences or heard from friends or relatives about negative experiences? 

Dr. Greenhill explains that, in his experience, “a big deciding factor in starting medication is often an older relative.” This means clinicians should consider other relatives besides the parent in the room when educating families about treatment options. 

Helping Families Make the Choice

When working with medication-hesitant families, Dr. Greenhill has found that education, clarity, and setting expectations go a long way. He advises clinicians to: 

• Share educational materials: For example, for youth with ADHD, Dr. Greenhill shares the Parents’ Medication Guide to the treatment of ADHD. He encourages parents, grandparents, and children over age eight to read this guide. 
• Explain how medications work: Parents often feel more comfortable once they know how a medication works and that it can be adjusted over time. For example, stimulant medications for ADHD work quickly and leave a child’s system quickly. Patients can take medication breaks, lower weekend dosing, or use medication only during the school day. 
• Prepare parents and children about what to expect: Parents and patients may be fearful of stopping ADHD medications, if that is recommended by the doctor, because of prior experience when the child became more symptomatic after missing a dose. Explaining in advance that, while ADHD symptoms may increase briefly, they quickly improve, can help alleviate such fears. 
• Emphasize that treatment is a partnership: Clinicians truly need parents’ input to find the right dose of medication or treatment approach. Over time, parents will find more confidence and accuracy in dealing with medication doses and side effects, should they occur. Dr. Greenhill reassures parents that: “You are going to become experts in what your child needs for medication.” 

Adding Non-Medication Interventions

For parents still opposed to medications, there are options to pursue. Indeed, Dr. Greenhill recommends that all parents – even those whose children take medication – take advantage of non-medication interventions. 

Options clinicians can suggest include: 

• Classroom Accommodations: Section 504 enables a range of classroom accommodations, such as modified homework loads, more frequent breaks, or 1:1 work with a tutor. Clinicians can guide parents by becoming familiar with the types of accommodations available and which are most effective for different conditions. 
• Daily Report Card: For children with ADHD especially, the Daily Report Card protocol requires very little time from educators and can provide immediate and ongoing feedback for children and parents. This enables parents to reinforce successes and children to benefit from positive feedback. 
• Cognitive Behavioral Therapy: Research shows CBT is especially effective for teenagers with ADHD and anxiety disorders. CBT can be administered through individual therapy, in group settings, and even through online training resources. 

 

RESOURCES

• For pediatric patients with ADHD, Dr. Greenhill recommends sharing the Parents’ Medication Guide, designed to help families understand the medications available and what to expect.
• For treating patients with anxiety, The REACH Institute offers a one-day course on CBT for Anxiety in Pediatric Primary Care. The course gives clinicians the tools to treat children and adolescents with evidence-based cognitive behavioral therapy (CBT) techniques.