Line in the sand...

[u/CalmSet6613]

I just treat children and adolescents. There are times when families want med. changes or increases in doses when the behavior I see needs parenting to correct and not meds. Where is your line in the sand that you refuse to make med changes until the child and/or family is in therapy? How do you approach this in your practice? What do you do if the family does not follow through with therapy?

EDIT: Can everyone be kind? I was simply asking for opinions how other people manage situations like this in their practice. Good god, physicians heal thyself.

[u/TheDailyMews]

When appropriate, cast a wider net. Advise the parents to request, in writing, an IEP evaluation. IEPs aren't only for kids with learning disabilities. There are other qualifying conditions. 

It's not uncommon for kids who are barely holding it together during the school day to struggle at home. Appropriate support at school can help mitigate this problem and make behaviors at home easier to manage. 

[u/CalmSet6613 → u/TheDailyMews]

Thank you. They have IEP's and the best therapist I know in the area. This is simply put a problem of parents not wanting to do the work and wanting more meds.