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Psychopharmacology for Therapists

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Psychopharmacology for Therapists Why is psychopharmacology important to you? Your client s presenting problem is difficulty attaining an orgasm. – PowerPoint PPT presentation

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Title: Psychopharmacology for Therapists


1
Psychopharmacology for Therapists
2
Why is psychopharmacology important to you?
  • Your clients presenting problem is difficulty
    attaining an orgasm.
  • Your client reports fatigue, isolation, weight
    gain, and suicidal ideations
  • Your client is involuntarily sticking out his
    tongue and smacking his lips

3
Competent therapists are a good thing (Ethics
also include limitations)
  • You, of course, can not prescribe medications
  • You can not recommend stopping, reducing or
    increasing medications
  • You can not suggest any herbal treatments or
    vitamins
  • However, you can recommend the client talk to
    their doctor about the above items

4
Why Coordinate with MDs
  • You see client more often and can track symptoms
    and side effects
  • You will know more about triggers and stressors
    (separating medicine issues from stress reactions
    or personality traits)
  • To ensure you are working on the same page
  • To help the client advocate for them selves

5
Helping the client advocate
  • Bob Taubers handout
  • Skills Training Issues
  • Locating a doctor who matches you
  • What to report
  • Writing down a list of questions
  • Family as advocates and symptom monitors
  • Self-education books, reputable web sites,
    information packages
  • Assertiveness and Role play

6
A Few of the Therapeutic Issues
  • Compliance issues stemming from side effects,
    mood disorders, or personality
  • Who am I now that I am better? Embracing the
    full self
  • Emotional development
  • Separating symptoms from normal moods and
    addressing the fears that accompany normal
    nervousness, sadness, etc.
  • New skills for getting needs met
  • Coping with Embarrassing side effects
  • Previously controlled symptoms/side effects
    re-emerging and the hopelessness and fear that
    follows
  • Substance abuse
  • Response vs remission
  • The meds just aint working

7
Additional Concerns
  • Stigma
  • Reactions from others
  • Cultural Constraints
  • Health Care Coverage
  • Finances
  • Medications
  • Blood work
  • Transportation

8
What if my client doesnt want to see the
psychiatrist or take meds?
  • Are you making progress without meds?
  • In not, consider
  • Talking openly about diagnosis and options
  • Help cl. Gather information
  • Have pt. see psychiatrist for consult
  • Encourage cl. To fill prescription so it is
    available if needed
  • See the psychiatrist together
  • Recruit family
  • Limits around therapy

9
What does the Psychiatrist want to know?
  • Symptoms (includes possible side effects)
  • Over the last two weeks how was mood, anxiety,
    sleep, appetite, energy, concentration,
    irritability, delusions, hallucinations,
    speech/thought rate, Mental Status Exam
  • Response
  • Does the patient seem to be doing better on
    medication? (give it 2-6 weeks before judging)

10
Lets look at a few questions
  • Who uses (ingests) psychotropic medication?
  • Are there certain circumstances in which
    individuals should be required to take
    psychotropic medication? If yes, describe such
    situations. If no, why not?
  • Which is more effective to treat depression in
    adults medication or talk therapy?
  • Should children be prescribed psychotropic
    medication? Why or why not?
  • Why would clients be resistant to using
    medications?

11
Psychodynamic thoughts on meds
  • Generic
  • Stigma I must be really sick and/or have no
    willpower
  • Therapy cant help
  • Meds are addictive (AA)
  • Personal
  • OCPD focus on the side effects
  • Anxiety feel better, but change causes
    anxiety/fear
  • Paranoid worried they are going to lose control
  • Depressed Focus is here and now and bleak future
  • Narcissistic Ive never seen individuals with
    significant narcissism stay on meds for long
  • Moving on to the brain

12
THE BRAIN
13
Frontal Lobe
  • The frontal lobe is considered our emotional
    control center and is tantamount to our
    personality, as well as performing logic
    reasoning
  • Left lobe is typically involved in controlling
    language related movement
  • Right lobe involved in non-verbal abilities

14
Parietal Lobe
  • Two main functions
  • Integrates sensory information to form a single
    perception (cognition).
  • Constructs a spatial coordinate system to
    represent the world around us (integrates visual
    input).

15
Occipital Lobe
  • The occipital lobes are the center of our visual
    perception system.

16
Temporal Lobe
  • The temporal lobes are involved in the primary
    organization of sensory input
  • The temporal lobes are highly associated with
    memory skills
  • Left verbal material
  • Right non-verbal matierical (music drawings)

17
Cerebellum
  • Involved in the coordination of voluntary motor
    movement, balance and equilibrium and muscle
    tone.

18
Brain Stem
  • Plays a vital role in basic attention, arousal,
    and consciousness. All information to and from
    our body passes through the brain stem on the way
    to or from the brain

19
The Limbic System
20
A few structures of the limbic system
  • Hippocampus - at the core of the temporal lobes
    and controls the more primitive pleasure stimuli
    and aversion stimuli pathways and associations,
    also involved in the formation of long-term
    memory
  • Amygdala - mediates both inborn and acquired
    emotional responses (such as fear and agression)
  • Fornix an axon tract that interconnects the
    hyptholamus and the hippocampus
  • Hypothalamus - controls the autonomic nervous
    system and regulates blood pressure, heart rate,
    hunger, thirst, and sexual arousal connected to
    the pituitary gland and thus regulates the
    endocrine system. (Not all authors regard the
    hypothalamus as part of limbic system.)

21
THE NEURON
22
What happens when a neurotransmitter falls in
love with a receptor? - You get a binding
relationship!
23
Some neurotransmitters
Transmitter Derived from Site of Synthesis
Acetylecholine Choline CNS, parasymp. nerves
Serotonin (5-HT) Tryptophan CNS, enteric cells, gut
GABA Glutomate CNS
Histamine Histidine hypothalamus
Epinephrine Tyrosine Adrenal medulla, CNS cells
Norepinephrine Tyrosine CNS, sympathetic nerves
Dopamine Tyrosine CNS, (limbic system)
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