Psychopharmacology and Mental Health: Some Thoughts and Suggestions

  • 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.
  • 10_things_about_antidepressantsProgress in understanding mental disorders will be painstaking — they’ll be no all-encompassing explanations, nothing “Einsteinish.” To use a golf metaphor, there will be no holes-in-one, some pars, maybe an occasional birdie, and lots of water balls
  • The “chemical imbalance” theory associated with depression is bogus. If this were true, most antidepressant users under competent care would achieve symptom remission, and this is undeniably — not the case.
  • Those 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 using someone else’s strategies.
  • 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 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.
  • give_adviceThe 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 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, over the course of a career, you’ll do a lot of dwelling.

Taking a detached, aloof or even a neutral approach to client treatment can be perceived as disinterest. 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.

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Attribution Statement:
Joe Wegmann is a licensed pharmacist & clinical social worker has presented psychopharmacology seminars to over 10,000 healthcare professionals in 46 states, and maintains an active psychotherapy practice specializing in the treatment of depression and anxiety. He is the author of Psychopharmacology: Straight Talk on Mental Health Medications, published by PESI, Inc.

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