Live Grand Rounds: Thinking about Prescribing: What the Therapeutic Alliance, Evidence-based Psychotherapy and Relational Principles Teach Us about Psychopharmacology with Diverse Youth and Families
This presentation will be an ONLINE VIRTUAL LIVE broadcast on December 13, 2023, from 12:00 pm - 1:00 pm ET. While this activity is LIVE and can only be viewed during the time specified, the evaluation will be available online until January 10, 2024. Go to the Register tab above to learn how to participate for continuing education credit, watch the broadcast and download the slides.
The views and opinions expressed by this presenter in this lecture are their own, and do not represent the views of Sheppard Pratt.
This presentation will explore the relational aspects of psychopharmacological work with youth and families. While technical and scientific knowledge can be taught and examined during medical education, the therapeutic skills also known as “nonspecific” treatment factors or “common factors” are more elusive and harder to describe.
Differences in culture between the prescriber and the patient often lead to differing perspectives and, if not explored, can interfere with the treatment alliance and subsequently with treatment adherence and/or resistance. Cultural concordance is crucial to teach physicians how to appreciate the cultural background unique to each patient in a way that values and honors our similarities and our differences. In keeping with the adage, The formulation must always precede the prescription, recent work has highlighted the use of the DSM-5 Cultural Formulation Interview as an important tool to more fully understand a young person in the context of their daily life, as part of comprehensive treatment planning.
We propose that the term ‘med check’ is not only a misnomer that simply doesn’t exist in child and adolescent psychiatric treatment (as if the patient just comes to us wanting to ‘talk about their meds’), but more importantly it is a disservice to the nature and intention of our work with youth and families. For such time-limited visits where the medication issues are a primary focus, we propose the term, ‘brief pharmacotherapy visits’, which allows us to retain our role as therapists (as an inextricable part of psychopharmacology). An effective pharmacotherapy appointment necessitates the appreciation of many things that inform treatment, and thus pharmacotherapy decisions, including the intricacies of an individual’s culturally informed, biopsychosocial story. It has consistently been shown that strong therapeutic alliances between a patient and their mental health provider, as well as empathy demonstrated by the latter, lead to more positive clinical and functional outcomes- and thus to the primary goal of evaluating and promoting mental health and well-being.
Target Audience
This activity is intended for physicians, nurses, psychologists, social workers and other mental health professionals.
Learning Objectives
At the conclusion of this activity, attendees will be able to:
- Describe the essential features of the Y-model of psychotherapy and how relational aspects of pharmacotherapy are key to child & adolescent psychiatric practice, even for brief visits.
- Identify techniques, adapted from evidence-based psychotherapies, to enhance medication adherence in diverse youth populations.
- List strategies to cultivate a pharmacotherapeutic alliance when engaging with patients and families via telehealth, including in the school setting.
- Define how to best utilize the 30-minute Brief Pharmacotherapy Visit (BPV), so that the alliance is nurtured and time is most efficiently utilized.
Sheppard Pratt’s Professional Education Program is pleased to provide Wednesdays at Sheppard Pratt free of charge as a public service to the mental health community. Your tax-deductible donations will help maintain the outstanding quality of this service.
Sheppard Pratt is dedicated to improving quality of life through mental health, special education, and addiction services for children, adolescents, adults and older adults. Our patient-centered treatment approach, combined with our legacy of clinical excellence, sets us apart from other health systems on both a local and national level. We have been ranked among the nation’s top psychiatric hospitals for 24 consecutive years by U. S. News & World Report. Founded in 1853 by philanthropist Moses Sheppard, Sheppard Pratt Health System still abides by its Quaker traditions and values.
Sheppard Pratt regularly hosts renowned speakers from across the country at our headquarters in Towson. We provide educational opportunities on subjects including psychiatric disorders, issues of behavioral health, systems-based change, mental and somatic co-morbidities, psychiatric effects on health and health outcomes, advances in neurobiology, and clinical developments in concepts underlying drug treatment of psychiatric disorders. We are accredited by the Accreditation Council of Continuing Medical Education, the Maryland Nurses’ Association, the Maryland Board of Psychology, the Maryland Board of Social Work, and the National Board of Certified Counselors.
Please send your contributions to:
Sheppard Pratt Professional Education Program
Grand Rounds Fund
6501 North Charles Street, Baltimore, Maryland 21204
Professional Education Program: 410.938.4593
Conference Center at Sheppard Pratt: 410.938.3900
There is no commercial support for this activity.
About the speaker
Dr. Shashank Joshi is Professor and Director of Training in Pediatrics, General Psychiatry and Child & Adolescent Psychiatry at the Stanford University School of Medicine. He also serves as Director of School Mental Health at Lucile Packard Children’s Hospital Stanford and Senior Associate Vice Provost for Academic Wellbeing at Stanford University.
He is a Distinguished Fellow of the American Academy of Child & Adolescent Psychiatry (AACAP) and a member of the Student Mental Health Policy Workgroup for the State of California. He serves on the advisory boards of the Jed Foundation and the National Center on School Mental Health.
Dr. Joshi's publications focus on interprofessional collaboration, cultural aspects of pediatric health, wellbeing promotion in youth and young adults, and suicide prevention in school settings. He is the lead author of the K12 Toolkit for Mental Health Promotion and Suicide Prevention used by the California Department of Education. His current book, Thinking About Prescribing: The Psychology of Psychopharmacology with Diverse Youth & Families (American Psychiatric Press 2022), examines the relational and psychotherapeutic aspects of medication treatment.
Disclosure Statements
Sheppard Pratt holds the standard that its continuing medical education programs should be free of commercial bias and conflict of interest. In accord with Sheppard Pratt's Disclosure Policy, as well as standards of the Accreditation Council for Continuing Medical Education (ACCME) and the American Medical Association (AMA), all planners, reviewers, speakers and persons in control of content have been asked to disclose any relationship he /she has with any entity producing, marketing, selling, re-selling, or distributing health care goods or services consumed by, or used on, patients, during the past 24 months. All planners, reviewers and speakers have also been asked to disclose any payments accepted for this lecture from any entity besides Sheppard Pratt, and if there will be discussion of any products, services, or off-label uses of product(s) during this presentation.
Shashank V. Joshi, MD, FAAP, DFAACAP, reports receiving royalties from APA Publishing during the last 24 months. He will not discuss any products, services, or off-label uses in this presentation.
Event Planners/Reviewers Disclosures: The following event planners and/or reviewers are reported as having no financial interest, arrangement or affiliation with any entity producing, marketing, selling, re-selling, or distributing health care goods or services consumed by, or used on, patients, during the past 24 months: Todd Peters, MD, Deepak Prabhakar, MD, Elizabeth Ryznar, MD, MSc, Louis Marino, MD, Ehsan Syed, MD, Devi Bhuyan, PhD, Faith Dickerson, PhD, Carrie Etheridge, LCSW-C, Tom Flis, LCPC, Stacey Garnett, RN, MSN, Stephanie M. Robinson, MSN, RN, PMH-BC, NPD-BC, NE-BC , Heather Billings, RN, Lisa Illum, MLIS, MEd, and Jennifer Tornabene.
Physician Statement: Sheppard Pratt is accredited by The Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Sheppard Pratt takes responsibility for the content, quality, and scientific integrity of this CME activity. Sheppard Pratt designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nurse Statement: Sheppard Pratt is approved as a provider of nursing continuing professional development by the Maryland Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. Sheppard Pratt takes responsibility for the content, quality, and scientific integrity of this CME activity. This activity provides 1.0 contact hours for nurses.
Psychologist Statement: Sheppard Pratt is authorized by the State Board of Examiners of Psychologists as a sponsor of continuing education. Sheppard Pratt takes responsibility for the content, quality, and scientific integrity of this CE activity. Sheppard Pratt designates this educational activity for a maximum of 1.0 contact hours for Psychologists.
Social Worker Statement: Sheppard Pratt is authorized by the Board of Social Work Examiners of Maryland to offer continuing education for Social Workers. Sheppard Pratt takes responsibility for the content, quality, and scientific integrity of this CE activity. This activity is approved for 1.0 contact hours in Category I credits for Social Workers.
Counselor Statement: No NBCC Credit Available.
Available Credit
- 1.00 AMA PRA Category 1 Credit™
- 1.00 Category I credits for Social Workers
- 1.00 Psychologists
- 1.00 MNA Contact Hours for Nurses
- 1.00 Participation
This presentation will be an ONLINE VIRTUAL LIVE broadcast on December 13, 2023, from 12:00 pm - 1:00 pm ET. While this activity is LIVE and can only be viewed during the time specified, the evaluation will be available online until January 10, 2024. Go to the Register tab above to learn how to participate for continuing education credit, watch the broadcast and download the slides.
WATCH THE BROADCAST
The codeword will be announced during the live event. The codeword is used to prove you attended the event. You will not need it to access the broadcast.
The broadcast can not be accessed through cme.sheppardpratt.org. You will need to use the link provided below to watch the broadcast.
On December 13, 2023, at 12:00 pm ET, please click on, or copy and paste this link into your web browser to view the lecture online. This link is LIVE at 11:30 am ET. An email address is required to log into the broadcast.
https://onlinexperiences.com/Launch/Event/ShowKey=232746
DOWNLOAD THE HANDOUT.
Use this link to download the handout. This handout will be available for download on Tuesday, December 12, 2023, at 12:00 pm ET.
SIGN UP TO RECEIVE CONTINUING EDUCATION EMAILS
EARN CONTINUING EDUCATION CREDIT FOR YOUR ATTENDANCE
PRIOR TO THE EVENT: Log into your Sheppard Pratt Ethos account and register by taking the pretest. Select the activity by series, title or speaker name. Go to the last tab, REGISTER and select the GREEN RECTANGLE, TAKE COURSE, and follow the prompts. Complete the Pretest and select attendance and you will be registered for this activity. You will not be able to work further until you are marked attended.
DURING THE EVENT: Because you will view this event online, there will not be a sign in sheet. Instead of signing in, a codeword will be given during the lecture for you. The codeword will be announced during the live broadcast. There are two ways to enter the codeword: by text/SMS & through the website. To use the website to enter the codeword to be marked attended, you will go to https://cme.sheppardpratt.org/code and enter the codeword there. To use SMS to enter the codeword, you will text the codeword to 410-291-8061. To save time, add this phone number to your contacts. From this tab you will be able to complete your course.
AFTER THE LECTURE: Click on Pending Courses and then click on the course title. Select the last tab, TAKE COURSE, and select the GREEN RECTANGLE, TAKE COURSE and follow the prompts. Please use the navigation button located in the lower right corner to continue throughout the course for best results. Complete the evaluation and credit designation to earn continuing education hours or credits. You must complete each component of the COURSE PROGRESS BAR to earn credit for the activity. Your transcript will reflect all completed events.
Questions? Please look at our FAQ page https://cme.sheppardpratt.org/content/faq or email cme@sheppardpratt.org.
Required Hardware/software
Optimal System Configuration
Flash Player: Adobe Flash Player 10.1+
Browser: Firefox 3+, Internet Explorer 8.0+, Safari 4.0+, or Google Chrome 7.0+
Operating System: Windows XP+ or Mac OS X 10.4+
Internet Connection: 1 Mbps or higher
Minimum Requirements
Windows PC: 500-MHz Pentium II; Windows XP or higher; 128 MB RAM; Video Card at least 64MB of video memory; Sound Card at least 16-bit; Macromedia Flash Player 10 or higher, audio playback with speakers for programs with video content; Firefox 1.1+, Internet Explorer 7.0+, Safari 1.0+, Google Chrome, or Opera
Macintosh: Mac OS X 10.3 or higher with latest updates installed; 1.83MHz Intel Core Duo or faster; RAM: 128MB or more; Video Card: at least 64MB of video memory; Sound Card: at least 16-bit
Hardware/Software Specifications
This internet-based CME activity is best experienced using Internet Explorer 8+, Mozilla Firefox 3+, Safari 4+. This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Adobe Acrobat, Microsoft PowerPoint, and Windows Media Player.