The commonest cause of treatment failure is 

                       Non-Compliance of Medical Advice.

Medical advice includes

      1. When to take which medicine andwhat dosage, frequency and timing.

      2. Side effects or not: to confirm certain findings are side effect with the doctor.

      3. Management of the ‘side effect’should be discussed with the doctor instead of just stopping the medication.

      4. When to come back for a follow-up appointment should  be determined by the doctor, based on the treatment plan and expected upcoming problems.

       5. When to stop taking the medication needs to be discussed with the doctor. After the medication is discontinued, follow up should be fairly regular in order to find out if stopping the medication is premature.

Before any management plan is initiated, psychoeducationis the key to get the client and his/ her family to collaborate with the doctor to set the treatment goal.

The factors of successful treatment include the following:

• Effective communication between the professional, family members, the clients, and significant persons of the family/ the client, and the colleagues/ teachers. The professional is available when needed. It is important to discuss openly with the doctor what is on your mind, including your desire of stopping the medicine and why, the financial burden due to the consultation fee and the medical cost, or pressure from lack of support of family members, etc.

• Demystification of the diagnosis and how the medicine works.

• To give ample time for the client and the family to understand the condition and the pros and cons of the medical treatment.

• Medications can jump start the treatment process, but sustainability of the therapeutic effect depends on the compliance of taking the medication and the environmental factors, including un-doing bad habits, building good habits, the client becoming his/ her own advocate.

Medications are not magic potions. They do not make all undesirable behaviors vanish, neither are they poisons that would change one’s personality, or lead to sudden death or cancer.

To maintain the treatment outcome in the long run, with the help of the professional, one needs to go through in-depth examination of one’s own blindspots, self defeating thoughts, weak areas, etc, in order to live up to one’s potentials. It is the behavioral modification that will provide long term therapeutic outcome. 

In summary, medication provides the first arm of treatment, but the subsequent behavioral modification, the second arm of treatment, is equally  or even more important.