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It used to be called noncompliance, and the patients themselves referred to as difficult. But regardless of the terminology, children's reluctance or failure to commit to prescribed regimens reduces the effectiveness of treatment, often leading to additional care, higher costs, and serious, even deadly, complications. Reflecting a single, authoritative voice, the Second Edition of Adherence to Pediatric Medical Regimens analyzes in comprehensive clinical detail the factors that affect children's and teens'commitment to treatment – from developmental issues to the influence of parents, peers, and others in their orbit – and offers empirically sound guidelines for encouraging adherence. It cautions against viewing young clients as miniature grownups or scaling down adult data, advocating instead for a more nuanced understanding of the population and a collaborative relationship between practitioner and client. Critical areas of interest to clinicians and researchers in pediatrics are brought into clear focus as the book: Provides an overview of adherence rates to chronic and acute disease regimens and examines common adherence problems in children and adolescents. Details consequences of nonadherence and correlates of adherence. Critiques major adherence theories and their clinical implications. Discusses the range of adherence assessment measures. Reviews educational, behavioral and other strategies for improving adherence. Offers ways to translate research into pediatric medical adherence. This updated edition of Adherence to Pediatric Medical Regimens is an essential reference for anyone concerned with improving health outcomes in young people, especially clinicians, researchers, and graduate students in psychiatry as well as pediatric, clinical child, and health psychology.

1. It is incumbent on medical providers that they are asking patients to - here to regimens with demonstrated eficacy, Providers need to remind themselves of the Hippocratic oath:'I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit ofmy patients, and abstain from whatever is deleterious and mischievous'(as cited in Cassell, 199 1, p. 145). 2. Providers need to abandon the'blame and shame'approach to dealing with medical adherence problems. It is tempting to blame patients for adherence failures and shame them into changing their behavior. Providers need to share the blame (or better yet omit blame) and look at their own attitudes and behaviors that impact adherence. For example, failing to simplify regimens or minimize negative side effects can adversely impact patient adherence. 3. Patients and their families are no longer (or maybe were never) satisfied with apassive role in their health care. In fact, the tern compliance lost favor in the literature because it implied for some an authoritarian approach to health care that required unquestioned obedience by patients to provider recommendations (DiMatteo & DiNicola, 1982). Comprehensive and effective health care requires a cooperative relationship between providers and patients and their families. It also acknowledges the following realities, particularly for treating persons with chronic illness:'Doctors do not treat chronic illnesses. The chronically ill treat themselves with the help of their physicians; the physician is part of the treatment.