The research team, led by first author Dr. Tim Becker, an assistant professor of clinical psychiatry at Weill Cornell Medicine and a child psychiatrist at NewYork-Presbyterian Westchester Behavioral Health’s Nichols Cottage, an inpatient unit for adolescents, set out to understand how parents of children with mental health difficulties experience stigma in their daily lives. Rather than treating stigma as a vague cloud of shame, the investigators approached it as something rooted in identity: the sense of being a competent, respectable parent that most caregivers work hard to maintain. When a child develops ADHD, depression, or a substance use problem, that identity can come under pressure from multiple directions at once.

To capture those pressures in detail, the researchers conducted interviews with 24 parents whose children had been affected by ADHD, depression, or substance use problems. Dr. Becker led the study as a research fellow in the Shaffer Scholars Program in Child Psychiatry Research at Weill Cornell Medicine and Columbia University Vagelos College of Physicians and Surgeons. The interviews were structured around three central questions. First, what factors made these parents feel respected as a good parent? Second, how did their child’s mental health problems threaten that respect and contribute to stigma by undermining their identity as a good parent? And third, how did they try to manage and reduce the stigma while preserving a positive sense of self?

The answers converged on a recognizable set of parenting ideals. Participants described feeling like good parents when they were able to emotionally support their child, maintain open communication with them, establish appropriate boundaries, serve as a positive role model, and contribute to their child’s overall well-being. These qualities, the researchers suggest, may contribute to parents feeling more secure and respectable in raising their child. Crucially, when a child’s mental health struggles appeared to interfere with any of these ideals — when communication broke down, when boundaries failed, when a parent could not shield a child from harm — participants experienced stigma as arising directly from their perceived failure to meet those core standards.

The judgment did not come only from within. Parents in the study reported feeling evaluated by a wide circle of people around them, including relatives, teachers, neighbors, and health care providers, many of whom they perceived as blaming them for not doing enough to prevent or address their child’s mental health issues. A number of participants spoke passionately about feeling that there is not a lot of support for parents, Dr. Becker said, and they felt isolated and looked down upon. That combination of external judgment and internal self-blame forms the architecture of parental stigma as the study describes it.

The clinical significance of these findings becomes clearer when viewed against the backdrop of prior research. Earlier work has found that parental stigma is related to greater parental depression and lower quality of life, and that it can limit a parent’s willingness to seek help for their child. In other words, the very stigma that follows a child’s diagnosis can become a barrier to the treatment the child needs. A parent who feels judged may avoid contacting a school, may hesitate to return to a clinician, or may conceal the extent of the child’s difficulties — each of which delays care and can worsen outcomes.

This is why the researchers argue that stigma should be a routine consideration when clinicians create a care plan for a child with mental health challenges. Stigma can lead to distress and self-doubt about parenting abilities, and it can quietly undermine a family’s engagement in treatment. A treatment plan that ignores the parent’s wounded sense of competence may be technically sound yet practically fragile, because the person responsible for carrying out much of that plan at home is struggling with shame. To support children, Dr. Becker said, we also need to support parents. A better understanding of parents’ experiences with stigma surrounding a child’s mental health, he added, enables clinicians to more effectively help parents, and more empowered parents likely leads to better outcomes for children.

The standard tool for addressing stigma in clinical settings has traditionally been psychoeducation: clinicians explain the child’s condition, its symptoms, and available treatments, on the theory that understanding the illness reduces blame. Dr. Becker acknowledged the value of this approach but pointed out its limits. Psychoeducation does not address the day-to-day stigma parents face because their child is struggling — the sideways glances at school pickup, the unsolicited advice from relatives, the internal replay of every parenting decision. Parents often want to actively partner with clinicians in providing support to their child, and when clinicians engage parents in concrete strategies to support their child, the researchers suggest, it can help both the child and the parent, restoring a sense of agency alongside the more positive feelings about parenting skills that stigma erodes.

Building directly on their interview analyses, Dr. Becker and his colleagues are now studying a video intervention designed to speak to that lived experience. In the video, an actress portrays a parent of a child with mental health problems. She describes her experience with stigma, how she got help for her child, and how, over time, she restored her sense of being a good parent. The researchers are evaluating whether the intervention reduces parental stigma and improves attitudes toward help-seeking. The design reflects a deliberate shift in emphasis: rather than lecturing parents about a diagnosis, the intervention models a narrative arc in which stigma is acknowledged, help is sought, and parental identity is rebuilt. If effective, such an approach could be integrated into routine child and adolescent mental health care at relatively low cost.

Underlying the entire line of research is a deceptively simple principle: well-being in families is reciprocal. When there are better outcomes for the children, there are better outcomes for the parents — and vice versa, Dr. Becker said. The study’s practical implication follows from that reciprocity. Supporting parents in fulfilling the qualities that make them feel secure and respectable — emotional support, open communication, boundaries, and role modeling — can help reduce their self-blame and stigmatization for their child’s mental health problems, which in turn strengthens the family environment the child depends on. The research was supported by funds from the American Academy of Child Psychiatry and by the National Institute of Mental Health, part of the National Institutes of Health, through grant number R25 MH125775. As child psychiatry increasingly recognizes that caregivers are not bystanders to treatment but participants in it, this work suggests that addressing the hidden weight parents carry may be one of the most efficient ways to lift outcomes for the children at the center of care.

Subject of Research: Parental stigma among parents of children with mental health problems and interventions to reduce it

Article Title: Stigma in parents of children with mental health problems

Article References: Stigma in parents of children with mental health problems. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: parental stigma, child mental health, ADHD, depression, substance use, Psychiatric Services, Weill Cornell Medicine, psychoeducation, help-seeking, parenting identity, video intervention, family well-being

The centerpiece of the October issue of The American Journal of Psychiatry is a special issue on neuromodulation and precision therapeutics, assembled with guest editor William McDonald, M.D., professor of psychiatry and behavioral sciences at Emory University School of Medicine. McDonald joins Ned Kalin, the journal’s editor-in-chief, on this month’s AJP Audio podcast to discuss the collection. The special issue arrives at a moment when neuromodulation, once a niche corner of psychiatry, has become one of its most active frontiers, encompassing transcranial magnetic stimulation, electroconvulsive therapy, vagus nerve stimulation, and emerging techniques that promise to steer electrical activity in deep brain circuits without surgery.

One of the issue’s framing contributions describes the current wave of brain stimulation therapeutic interventions in neuropsychiatry as a Cambrian explosion, an evocative metaphor borrowed from evolutionary biology to convey the sheer diversity of approaches now proliferating. Alongside it, a second perspective article examines artificial intelligence as the computational framework for adaptive closed-loop neuromodulation in psychiatry. Closed-loop systems, which sense neural activity and adjust stimulation parameters in real time, are widely viewed as the next step beyond fixed-protocol stimulation, and the article argues that machine learning provides the mathematical machinery needed to make such adaptive control clinically reliable.

The special issue also features original clinical trials that test whether precision targeting can improve outcomes. One randomized, sham-controlled trial investigates bilateral theta-burst stimulation of dorsolateral prefrontal cortex regions for late-life depression, a population in which treatment-resistant mood disorders carry substantial disability and medical burden. A companion study reports convergent network localization of brain stimulation targets for trait anxiety, an approach that uses converging evidence about brain networks to identify where stimulation might most effectively modulate a given symptom dimension. AJP Deputy Editor Daniel Pine, M.D., highlights both studies in accompanying videos for the journal’s readership.

Two further trials push the precision theme further. The first, the CORRECT-BD trial, compares clinical and cognitive outcomes of right unilateral ultrabrief electroconvulsive therapy against magnetic seizure therapy for bipolar depression, a comparison that speaks directly to a longstanding clinical concern: preserving cognition while retaining the robust antidepressant efficacy of seizure-based treatments. The second is an individualized, connectivity-guided versus conventional targeting trial of accelerated theta-burst stimulation in depression, a randomized, double-blind, parallel-design study that asks whether personalizing stimulation targets to each patient’s brain connectivity outperforms standard coordinate-based targeting.

The issue also revisits one of the most consequential and debated studies in the field. The RECOVER trial of vagus nerve stimulation in markedly treatment-resistant depression is examined in an article on its critical findings, lessons learned, and future directions, with lead author Charles R. Conway, M.D., discussing the results on the AJP Audio podcast. Additional contributions survey precision neuromodulation with a focus on temporal interference stimulation, a technique designed to reach deep brain structures noninvasively by interfering two high-frequency fields at a targeted point. A commentary argues for advancing brain stimulation toward first-line psychiatric therapy through wearable disposable electrotherapy, while another article addresses implantable neuromodulation devices in psychiatry, weighing human fidelity and the implementation challenges that stand between promising devices and routine clinical use.

The October issue of Psychiatric Services shifts the lens from circuits to systems, publishing research on how mental health care is organized, measured, and delivered. Highlights include the Mental Wellness Tool, a brief screener designed to detect mental disorders, substance use disorders, and suicide risk in a single instrument, and a set of recommendations from a participatory policymaking symposium on emergency psychiatric evaluation of people under arrest, an area where clinical practice, law enforcement, and civil rights intersect. Other articles examine VA health care utilization among U.S. veterans through the influence of social determinants of health, and a methodological piece on suicide surveillance and Simpson’s Paradox warns that aggregating data can obscure critical patterns that appear only when populations are disaggregated.

Access and equity questions recur throughout the issue. One study documents wait times and documentation requirements for child psychiatric care across payer and facility types, quantifying the administrative friction families face when seeking help for children. Another reports on public support for state laws requiring addiction programs to offer FDA-approved medications for opioid use disorder, a finding with direct relevance to ongoing policy debates about whether treatment programs should be legally obligated to provide evidence-based pharmacotherapy. Together, these papers illustrate how service-level research complements clinical neuroscience by identifying where the system itself becomes a barrier to care.

The American Journal of Psychotherapy contributes a third perspective, centered on the human relationship at the heart of psychiatric treatment. Articles examine gender and age differences in psychotherapy use among U.S. adults with depression and anxiety, and explore the effects of psychotherapies for posttraumatic stress disorder on anger, an often-overlooked symptom in trauma treatment research. Clinical technique is addressed in a paper on the RFP-C triangle of conflict, which considers how attending to countertransference can help clinicians listen more effectively to children with disruptive behaviors. Cultural adaptation is the focus of an article on interpersonal psychotherapy in the Chinese cultural context, while a study of group acceptance and commitment therapy for adolescent anxiety reports on initial acceptability and outcomes of a group format aimed at expanding access for young patients.

Psychiatric Research and Clinical Practice rounds out the collection with translational and real-world studies. A viewpoint article considers fostering social connection, tracing progress and opportunities within the VA and beyond, a topic of growing public health interest given evidence linking isolation to morbidity. A comparative study assesses the risks of pregnancy complications in women prescribed psychostimulants or atomoxetine during pregnancy following pre-pregnancy stimulant use, addressing a population long underrepresented in psychopharmacology research. The journal also publishes a real-world effectiveness and cost-differential analysis of intranasal esketamine versus intramuscular ketamine, two rapid-acting treatments for depression whose relative value outside controlled trials remains a pressing question for clinicians and payers. Finally, a real-world pilot evaluates the collaborative care model for adults with cognitive impairment and neuropsychiatric symptoms in primary care, testing whether an integrated care framework developed for depression can extend to patients with complex neuropsychiatric needs. Journalists seeking access to the publications can contact the American Psychiatric Association press office at press@psych.org.

Subject of Research: Neuromodulation, precision therapeutics, esketamine, and mental health services research featured across APA journals

Article Title: October 2026 Issues of APA Journals feature new research on neuromodulation and precision therapeutics, esketamine, and more

Article References: October 2026 Issues of APA Journals feature new research on neuromodulation and precision therapeutics, esketamine, and more. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: neuromodulation, precision therapeutics, brain stimulation, esketamine, theta-burst stimulation, vagus nerve stimulation, electroconvulsive therapy, depression, psychotherapy, psychiatric services, American Psychiatric Association, mental health care