One would like to believe that advances in science have resulted in improved outcomes for troubled youth. Trends in treatment have changed dramatically in two decades. Technology to understand the brain and its functions are highly advanced. But the United States is now medicating youth more than any other country. There is growing concern about the burgeoning use of psychotropic drugs to manage childhood behavior problems. Examining the commonly used stimulant and antipsychotic medications across the last 20 years indicates that people need to re-evaluate their methods of care for their most troubled youth. This article critiques this practice and calls for a reorientation toward relationship-based interventions. (Contains 1 graph.)