Psychopharmacology and Mental Health Treatment – Observations and Recommendations

  • You can read a 600- page text on the biochemistry of psychiatric medications; become enmeshed in the marvels of neuroscience; design highly complex drug regimens for patients; and still not know a thing until the patient swallows the first pill.
  • When it comes to medication, there’s no right or wrong approach – only possibilities.
  • Joe-Wegmann-newThose who have written books describing helpful intervention strategies with clients first tried and tested them. Do the same. And whether you write about your new approaches or not, you will have followed your own bent and not merely walked in lock-step behind the pack.
  • Don’t think of the client as damaged. People come to treatment for all sorts of reasons. Some are simply stuck and need a nudge; others may be looking for validation and a sounding board; still others are acutely ill. Deliver value to them accordingly and be vigilant about providing that value to as many people as can possibly gain from it.
  • Some clients will need cheerleading and a bit of salesmanship    to get them moving, so don’t be passive when discussing strategies which you believe can help them. Just don’t cross the line into coercion.
  • Regardless of how you attempt to help people, compliance with what you’re offering is paramount. If the client becomes resistant, find out why as best you can and get them back on track.
  • There’s a positive intention for every behavior. Help the client identify the intention first; then work toward changing the troublesome behavior.
  • The top two reasons for why people resist psychotropic medications are shame and fear. Shame surfaces because of the belief that mental illness is a character flaw; fear emanates from the belief that medication will alter their personality or drug side effects will be intolerable. Both of these result from faulty logic; do some reframing work here.
  • Provide outstanding “customer” service by bringing honest, believable energy and enthusiasm to your work.
  • Advise your clients to never cede their personal power to improve their plight to a pill.
  • Use the placebo effect to influence client change to your full advantage. Lean forward a bit when addressing a client; take notes discreetly; display symbols of comfort in your office; instill hope and optimism when discussing the prognosis of the presenting problem.
  • The brain is more complex than the body and it will take decades to ascertain what its capabilities are. In the absence of reliable brain scans and quantifiable blood work, clinicians are stuck with client self-report and collateral sources of information to confirm their findings.
  • Medication decision trees are not gospel when it comes to treating clients pharmacologically. When challenged with medication-resistant clients, the art of drug management becomes more important than its science. In such instances, creativity rules.
  • If you dwell on all the clients you don’t help, don’t try to help themselves or just drop out of treatment without notice, you’ll do a lot of dwelling.
  • Taking a detached, aloof or even a neutral approach to client treatment can be perceived as disinterest or even arrogance. Demonstrate in every legal and ethical way possible that you’re in your client’s corner – and there’s nothing wrong with them liking you.
Joseph Wegmann, R.Ph., LCSW is a licensed clinical pharmacist and a clinical social worker with more than thirty years of experience in the field of psychopharmacology. His diverse professional background in psychopharmacology and counseling affords him a unique perspective on medication management issues. In addition to consulting with numerous psychiatric facilities, he has presented psychopharmacology seminars to thousands of clinicians in 46 states.

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