• We 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.
  • Progress in understanding some mental disorders will be painstaking — they’ll be no all-encompassing explanations, nothing “Einstein Ish.” 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.
  • Our clients aren’t 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.
  • Some clients will need some nudging to get them moving, so don’t be passive when discussing intervention strategies with them.
  • 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.
  • Provide outstanding client service by bringing honesty as well as  believable energy and enthusiasm to your work.
  • Explain to clients that psychotropic medications are not panaceas and thus are unable to do the “work” of getting better.
  • 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 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.
  • Demonstrate in every legal and ethical way possible that you’re in the client’s corner.
  • 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.

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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.

To learn more about Joe’s programs, visit the Programs section of this website or contribute a question for Joe to answer in a future article: joe@thepharmatherapist.com.