Bennett Leventhal, M.D., director of child psychiatry at the University of Chicago, has received the Outstanding Physician Communicator Award from the Bayer Institute for Health Care Communication in West Haven, Conn. The institute is a nonprofit foundation that was set up by the Bayer Corporation in 1987 "to enhance the quality of health care by improving communication between clinicians and their patients."

Leventhal was nominated for the award by Lauren Wakschlag, Ph.D., a psychologist with whom he works. She praised him for "the genuine partnership he forms with parents and his gift at communicating with even the most troubled child" and for his conveying "boundless empathy through his unwavering presence in the darkest hours, despite many clinical/academic responsibilities." The selection committee for the award was composed of internists and family practitioners.

What is one of the greatest communication challenges that this "outstanding communicator" faces in his practice? It is the difficulty of telling parents that their child has a serious and likely incurable disorder such as autism or mental retardation, he told Psychiatric News. The challenge, he said, is enormous because parents don’t want to hear the words, and when they do, they fear that the words spell the end of their hopes and dreams for their child.

So how does he handle it? Leventhal said that one of the toughest cases he has dealt with concerned a child whose parents were having significant marital problems, in part because they disagreed so vehemently over whether the child was mentally "normal." But in fact both parents were wrong: The child was not as normal as one parent thought, yet not so profoundly impaired as the other contended. So if he simply gave them the diagnosis, Leventhal realized, it would alienate both of them, and if that occurred, it might very well mean that he could not form an alliance with them in the care of their child.

Therefore, what he did instead was first talk with the couple about themselves and about their hopes and their ambitions for their child. "While people may bring in their child because they need you to give them a diagnosis and a treatment plan," he explained, "oftentimes they are really asking you to help them organize themselves to be prepared to get that news. . . . I remember this couple, how they sat there and started crying, and how we were able to support them first before we got to the nitty-gritty of just saying, ‘Your child is mentally retarded or autistic.’ "

But even when Leventhal gets to the nitty-gritty, he continued, he presents it in a special light—that it is not a death sentence and that "just because your child has a diagnosis of something chronic doesn’t mean that you can’t love your child and that your child doesn’t have personality and have things that are incredible in terms of parenting."

He also talks and plays with the child to demonstrate that, in spite of his or her handicap, the child is "still sweet and cute and fun and enjoyable."

What is the most important thing that a child psychiatrist can do to communicate well with patients and their parents? Leventhal replied: "Child psychiatrists are physicians, and I think that the things we do to communicate with families are the same things that all physicians should be doing. . . . The starting point of good communication is, first of all, to know what we know as physicians and be prepared to deal with these things. And secondly, to learn from the family what they know and don’t know and the language they use to express that. So that thirdly, when we tell them what we know and don’t know, we do it in a framework, not only in terms of words, but also in a context that is meaningful and understandable to them."