Racism and Psychiatry

Topics: Black youth | Disparities | Diversity | Patient relationship | Race | Respectful Care

TCPR: What does a psychiatrist need to know about race in this era? Dr. Cyrus: Race and identity are hot topics, even for White people, so psychiatrists need to find a better way to talk about it. The pandemic brought the dynamics of oppression and inequality to the forefront in medicine. Racism is not just happening in the news, the protests, and the

Patient Reviews of Substance Use Services

Topics: Connection | Internet | Patient relationship | treatment | Treatment planning

Review of: Agarwal AK et al, J Gen Intern Med 35(6):1647–1653 When a patient or family member is looking for a specialized drug treatment facility (SDTF), they will often turn to online review sites to get information about facilities in their area. These reviews can drive patients’ choice of facility, but they often don’t focus on the same the

SAMHSA Relaxes Regulations on Methadone and Buprenorphine During COVID-19 Emergency

Topics: Buprenorphine | Coronavirus | COVID-19 | Methadone | Opioid epidemic | Opioid Use Disorder | Opioids | Outpatient | pandemic | Patient relationship

The Substance Abuse and Mental Health Services Administration (SAMHSA) has changed some prescribing rules to help minimize in-person contact while maintaining access to medications for opioid use disorder (OUD). Methadone Patients starting methadone continue to require an in-person medical evaluation at an opioid treatment program (OTP) prior to sta

Working With Severe Personality Disorders

Topics: Borderline Personality Disorder | BPD | Patient relationship | Personality Disorders | Psychoanalysis | Psychodynamic therapy | Psychotherapy

TCPR: People with severe personality disorders are notoriously difficult to treat. Can they benefit from psychotherapy? Dr. Buie: Nearly all seriously ill patients can benefit from some form of psychotherapy. Supportive psychotherapy, group skills training, and behavioral treatments can be helpful in almost any illness, including psychotic disorders. P

How to Write an Open Note

Topics: Computers in Psychiatric Practice | Confidentiality | EHR | Electronic Health Records | electronic use | Engagement | HIPAA | Patient relationship | Privacy | retention

“A physician should at all times deal honestly and openly with patients.” —AMA Code of Medical Ethics Beginning April 4, 2021, the Department of Health and Human Services (DHHS) instituted a new policy stating that all clinical notes must be open to patients for their review in a timely fashion. Since that announcement, I have heard physician

When Further Medication Trials Seem Futile

Topics: Depression | Depressive Disorder | MAOIs | Patient relationship | Pramipexole | Psychiatric interviewing | Therapy during medication appointment | Therapy with Med Management | Treatment-Resistant Depression

TCPR: When it comes to medication trials, how do you know when enough is enough?Dr. Goldberg: I don’t think I would ever say “enough is enough,” but there is a point at which the probability of medicines having a big effect becomes very, very low. In depression, that point is pretty black-and-white in my mind: 5 trials. In a study from Massachuset

A New Way to Talk to Patients about Medication

Topics: Collaborative care | Medication adherence | Patient relationship | Psychiatric interviewing | Psychotherapy | Therapy with Med Management

TCPR: We all want to communicate better with patients, particularly around medications. You’ve lead workshops on this for several decades. Tell us about the model you developed out of that work. Dr. Shea: The Medication Interest Model (MIM) is a set of over 100 interview techniques that create shared decision making regarding all disease states from