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Our remedies are only as good as the way in which we dispense them
That's the central premise of Thinking About Prescribing, a new volume that encourages pharmacotherapists to view the prescribing of a psychiatric medication to young patients not simply as part of a clinical visit, but rather as the beginning of an ongoing alliance with youth and their parents or legal guardians.
The book makes the case for a partnership that doesn't lean on psychiatric jargon or an encyclopedic list of side effects, but instead on measured candor, vulnerability, and—most importantly—time.
Thinking About
Prescribing leverages the knowledge of more than two dozen experts
as it tackles topics that include:
• The essential features of the Common Factors approach and the Y-model
of psychotherapy, which highlights how relational aspects of pharmacotherapy
are key to child & adolescent psychiatric practice, even for brief
visits
• How best to utilize the 30-minute Brief Pharmacotherapy Visit
(BPV), so that the alliance is nurtured and time is most efficiently
utilized
• Techniques, adapted from evidence-based psychotherapies, to
enhance medication adherence in diverse youth populations
• Approaches
to adapt psychoeducation for culturally diverse populations, and consider
why many youth & families may be skeptical of pharmacotherapeutic
interventions
• Strategies to cultivate a pharmacotherapeutic alliance
when engaging with patients and families via telehealth, including in the
school setting
• Tips for pediatricians, advanced-practice clinicians,
and other primary care providers who conduct pharmacotherapy
The chapters feature key takeaways that distill the most salient points and that aid in knowledge retention.
Rather than raise unrealistic expectations (two chapters acknowledge the reality of practicing when time and resources are scarce), the goal of this book is to help pharmacotherapists mitigate the stigma, apprehension, or resignation their patients may have and instead build and maintain a trusting relationship that will be key to successful therapeutic outcomes.
Shashank V. Joshi, M.D., is Professor of Psychiatry, Pediatrics, and Education at the Stanford University School of Medicine and Graduate School of Education, Director of School Mental Health at Lucile Packard Children's Hospital, and a Faculty Advisor at the Center for Comparative Studies in Race and Ethnicity (CCSRE), in Stanford, California.
Andrés Martin, M.D., M.P.H., is the Riva Ariella Ritvo Professor, Child Study Center, Yale School of Medicine, in New Haven, Connecticut. He is Medical Director of the Children's Psychiatric Inpatient Service at Yale New Haven Health, in New Haven, Connecticut.
Uncovered
Prescriber, Prescribe Thyself (By Way of
Introduction)
Chapter 1: Think Again About Prescribing: The Psychology
of Psychopharmacology
Chapter 2: The Many Facets of Alliance: The
Y-Model, Applied to Child, Adolescent, and Young Adult
Psychopharmacotherapy
Chapter 3: Psychodynamics of Medication Use in
Youth with Serious Mental Illness
Chapter 4: "What's in It for Me?":
Adapting Evidence-Based Motivational Interviewing and Therapy Techniques to
Adolescent Psychiatry
Chapter 5: Providing Psychoeducation in
Pharmacotherapy
Chapter 6: #KeepItReal: The Myth of the "Med Check" and
the Realities of the Time-Limited Pharmacotherapy Visit
Chapter 7:
Pharmacotherapy or Psychopharmacotherapy: When Therapist and Pharmacologist
Are Different People, or the Same Person
Chapter 8: The
Pharmacotherapeutic Role of the Pediatrician, Advanced Practice Clinician,
and Other Primary Care Providers
Chapter 9: The Pharmacotherapeutic
Alliance in School Mental Health
Chapter 10: When Time Is Tight and
Stakes Are High: Pharmacotherapy, Alliances, and the Inpatient
Unit
Chapter 11: Telepsychiatry Goes Viral: Psychotherapeutic Aspects of
Prescribing Via Telemedicine Amid COVID-19
Chapter 12: Alliance Issues
to Consider in Pharmacotherapy with Transition-Age Youth
Chapter 13: The
Pharmacotherapeutic Alliance When Working with Diverse Youth and
Families
Chapter 14: The Psychopharmacotherapeutic Alliance When
Resources Are Limited
Chapter 15: Building a Therapeutic Alliance in
Psychopharmacology During Clinical Trials: Ethical and Practical
Considerations
Chapter 16: The Power of Placebo
Chapter 17: The
"Good Enough" Pediatric Psychopharmacotherapist: Practical Pointers in Six
Parables
Chapter 18: Teaching and Mentoring the Next Generation of
Pediatric Psychopharmacotherapists
Gratitude