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Published Online: 18 January 2022

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Publication: Thinking About Prescribing: The Psychology of Psychopharmacology with Diverse Youth and Families

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Page numbers printed in boldface type refer to tables or figures.
Acceptance, and therapeutic alliance,
6, 168
Acceptance and commitment therapy (ACT), and psychopharmacology for adolescents,
65–76
Access, to mental health care in LMICs,
252–254
Accreditation Council for Graduate Medical Education (ACGME),
320, 326, 329, 331
“Achievement by proxy,” and parents,
12
Acquiescence, compared with trust,
xxiv
“Addressing Mental Health Concerns in Primary Care” (AAP),
141–142
Adherence
brief pharmacotherapy visit and,
108–111
definition and components of,
232
expectations about treatment benefit and,
293
medical communication and,
61
motivational interviewing for adolescents and,
60
psychoeducation in inpatient setting and,
179–181
recommendations of techniques to enhance,
13–14
as significant issue in child and adolescent psychiatry,
26–27
transition-age youth and,
222
Adolescent(s)
. See also Child and adolescent psychiatry; Children; Development; Serious mental illness; Transition-age youth
brain development in,
61–63, 216
confidentiality and provision of mental health care by primary care physicians,
142, 149
factors influencing adherence in,
27, 109–110
importance of therapeutic communication in psychopharmacology for,
59–61
individuation and,
122
information from social media and internet,
15
motivation and cognitive-behavioral strategies for psychopharmacology in,
66–76
positive psychology approach to pharmacotherapy for,
206207
process-oriented clinical models for engagement and treatment adherence,
63–66
therapeutic alliance and,
28, 32
Advertising, by pharmaceutical industry,
xxx, 93, 113. See also Marketing
Affordable Care Act,
15–16, 218
African Americans
. See also Black, Indigenous and Persons of Color; Race
differences in medication use and,
235
implicit bias in mental health care for,
237
Agency, and infant development,
47
Aggression, in case examples,
52–53, 80
Allergy, in case example,
26
Ambiguity tolerance, as skill deficit,
328
Ambivalence, and motivational interventions for adolescents,
72–73
American Academy of Child and Adolescent Psychiatry,
16, 82, 141, 218, 228
American Academy of Pediatrics (AAP),
138, 139, 141–142, 150, 151
American College of Cardiology,
276
American Foundation for Suicide Prevention,
186
American Heart Association,
276
American Psychiatric Association,
16, 17
American Society of Pediatric Hematology/Oncology,
13
American Time Use Survey,
158
Anticipatory guidance, and transition-age youth,
221
Antidepressants
. See also Tricyclic antidepressants
clinical trials of,
271
contemporary treatment approaches and,
264
risk of suicidal ideation and,
xxvii
Anxiety
. See also Anxiety disorders
in case examples,
80, 124, 149
telepsychiatry and,
205
Anxiety disorders
. See also Anxiety; Generalized anxiety disorder
antidepressant use for children with,
264
placebo response and,
288–289, 290, 292–293, 294, 296
Apprehensive stance, and trials of medication,
xxiv
Arousal, and psychodynamic psychopharmacology,
50
Asian Americans, and differences in medication use,
235–236. See also Culture; Race
Atomoxetine,
273
Attention, and mental health care by primary care physicians,
147
Attention-deficit/hyperactivity disorder (ADHD)
adherence and,
110
in case examples,
18, 52, 80, 81, 127, 146
questionnaire to assess psychoeducational needs of parents,
94
repurposing of medications for,
273
telepsychiatry and,
205
Attitudes, and behavior change,
83
Autism spectrum disorder,
80, 205
Autonomy
culture and views about mental health care in LMICs,
246–247
motivational interventions for adolescents and,
70
therapeutic alliance and,
39
Behavioral change
. See also Aggression; Cognitive-behavioral therapy
as objective of motivational interventions,
66–67
psychoeducation and,
82–91
Behavioral management interventions, and primary care physicians,
151
Beliefs, and behavior change,
83–84
Belmont Report (National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research 1978),
269
Beresin, Eugene,
146, 147
“Beyond ‘Med Management’” (Torrey et al. 2017),
17
Bibace, Robert,
49
Biomedical explanation, of mental illness,
111
Black, Indigenous and Persons of Color (BIPOC), and transition-age youth,
217. See also Race
Blackwell, B.,
4
Blaming the Brain (Valenstein 2002),
14
Bordin, E.S.,
123
Bostic, J.Q.,
160
“Bottoms up” strategy, of psychodynamic psychopharmacology,
50
Boundaries
telepsychiatry and,
205
transition-age youth and,
226, 227
Brain, development of adolescent,
61–63, 216
Brazil, mental health care and public health system in,
244, 253
Brief pharmacotherapy visit
establishment of rapport,
104, 106
future research on,
114–115
proposal of term,
103
sequence of steps for,
105, 106–114
Burnout, and school mental health programs,
165
CAFÉ model (Collaborative Attending Fellow Educational),
337
Cardiovascular clinical research,
275–278
Case examples
of developmental issues,
26
of integrated treatment,
124–125, 132–133
of meaning of medication,
6–7, 7–8
of mental health care by primary care physicians,
146, 148, 149
of mental health care for transition-age youth,
217
of psychodynamic psychopharmacology,
52–53
of psychoeducation,
79–81
of racial and cultural issues in mental health care,
237, 238
of school-based mental health programs,
164, 166–167
of shared treatment,
18
of split treatment,
127, 130, 132–33
of therapeutic alliance,
37–40
Causal relationships, and child development,
49
Cell phone apps, and telepsychiatry,
202
Center for Connected Health Policy,
200
Centers for Disease Control and Prevention,
120
Change
motivational interventions in adolescent psychopharmacology and,
69, 75
signs of readiness for,
65
Chaos theory,
46
“Checklist psychiatry,”
102
“Chemical imbalance,” questions from parents and,
14
Child/Adolescent Anxiety Multimodal Study (CAMS),
289, 292, 297
Child and adolescent psychiatry
. See also Adolescents; Children; Mental health care; Psychotherapy
adherence as significant issue in,
26–27
clinical trials and therapeutic misconception in,
273–278
impact of shortage of on pediatric psychopharmacology,
xxii–xxiii
learning objectives of fellowship programs in,
320
systems of care and,
327–328
Child protective services, and involuntary administration of psychotropic medications,
xxvii
Children
. See also Adolescents; Child and adolescent psychiatry; Development
clinical trials and,
262
concepts of childhood,
46
educational needs of,
91
percentage of using prescription medications for emotional or behavioral issues,
120–121
precision medicine for,
272–273
prevalence of mental health disorders in,
137
thinking about medications by,
9, 170
Chlorpromazine,
278
Clabby, J.F.,
151
Clinical equipoise, and drug trials,
268–269
Clinical examples
. See Case examples
Clinical trials, of medications
. See also Placebo response
ethics and,
266–271
future directions in,
278–279
historical context for contemporary treatment approaches,
263–265
lack of adequate pediatric,
262
practical applications and strategies for,
271–273
strategies for mitigating therapeutic misconceptions,
273–278
Clozapine,
278
Cognitive-behavioral therapy (CBT)
adolescent psychopharmacology and,
64, 66–76
placebo response and,
289, 292
primary care physicians and,
144–145
Coherence, as goal in psychodynamic psychopharmacology,
57
Collaboration
care models in LMICs and,
250
clinical trials and,
275
of primary care physicians with other providers,
150
Collateral sources, of information,
131, 144
College, and transition-age youth,
216–217, 218, 220, 226, 227
Co-located care, and primary care physicians,
151
Comanagement, and primary care physicians,
150
Combined treatment, efficacy of,
120, 126
Common factors
provision of mental health care by primary care physicians,
150–151
therapeutic alliance and,
36–37, 87
Communication
. See also Language
implicit bias and,
233
importance of in adolescent psychopharmacology,
59–61
integrated treatment model and,
130–131
mental health care by primary care physicians and,
148–149
psychoeducation and,
85–91
split treatment and,
129, 130–131
therapeutic alliance and,
28, 38
treatment adherence and,
61
Community participation, in clinical trials,
275
Comorbidities, of mental health disorders,
140
Compassion fatigue, in school staff,
165
Compliance
. See also Adherence
brief pharmacotherapy visit and,
108
implications of term,
xix
Confidentiality
adolescent psychopharmacology and,
76
mental health care for adolescents provided by primary care physicians and,
142, 149
treatment frame and outlining of limits for,
31
Conflict
of interests of medical providers and researchers in clinical trials,
274
parenting styles and management of in care for transition-age youth,
225–227
resolution of in integrated and split treatment models,
132–133
Context
psychological meaning of medication and,
12–15
of psychopharmacotherapeutic alliance in LMICs and,
251–252
Cost, of medications
. See also Financial resources; Socioeconomic factors
adherence and,
14
meaning of medication and,
10
Counseling, and brief pharmacotherapy visit,
105, 106
Countertransference
clinical trials and,
266
integrated treatment and,
128, 131–132
mental health care by primary care physicians and,
147
split treatment and,
129–130, 131–132
telepsychiatry and,
207
treatment frame and,
31
Cover design, for current volume,
xvii–xviii
COVID-19 pandemic, impact of on mental health care,
xxii, 158, 195–196, 209–210
Cultural Formulation Interview,
247
Cultural humility, importance of in doctor-patient relationship,
233, 236–239
Culture, and ethnic diversity
framework for clinical encounters and,
xxiii–xxiv
future research on,
239
perceptions about psychiatric care and medication in LMICs,
246–248
psychoeducation and,
90
school-based mental health interventions and,
159–160, 164, 166
treatment alliance and adherence,
252–253
Davis, M.,
222
Decision making, culture and views of mental health care in LMICs,
246–247. See also Shared decision making
Dell, M.L.,
160
Delusions, cultural beliefs misinterpreted as,
236
Demos, Virginia,
47
Depression
. See also Major depressive disorder; Persistent depressive disorder
in case examples,
124, 149
school-based programs for,
159
Development
of adolescent brain,
61–63, 216
education in pediatric psychopharmacology and,
325–326
integrated or split treatment models and,
121–122
mental health care by primary care providers and,
141–142
placebo response and,
296–297
psychodynamic psychopharmacology and,
47–49
psychology of psychopharmacology and,
8–10
therapeutic alliance and,
25–28, 32, 179
Diagnosis
mental health care provided by primary care physicians and,
140
telepsychiatry and,
205
therapeutic alliance and,
33, 34
Dialectical behavior therapy (DBT), and adolescent psychopharmacology,
65, 66–76
Differentiation, and development,
48
Direct-to-patient (DTP) marketing of medications,
13, 16
Discharge planning, use of medications within context of,
183–184
Discontinuation, of treatment and psychoeducation,
89. See also Termination of care
Dosages, of medications
adherence and simplicity of,
14
potential meanings of frequency,
10
Drug Attitude Inventory,
109–110
Drug monitoring, and clinical trials,
278
Dynamic systems theory, and concept of childhood,
46
Education
. See also College; Psychoeducation; Schools; Supervision and supervisors; Teachers
evidence-based practice and,
323–324
executive functions of transition-age youth and,
221
“good enough” as goal of for pharmacotherapists,
xxix–xxx
Milestone Goals and Objectives for,
329, 331, 332335
model components of psychopharmacology curriculum,
336337
systems of care and,
327–328
roles of teachers and mentors in psychopharmacology,
328–329
therapeutic relationship and meaning of medication,
324–327
training curriculum in pediatric psychopharmacology,
321–323
Y-model and,
41
Electroconvulsive therapy, and inpatient hospitalization,
185
Emergency cases, and informed consent for medication,
182
Emotional avoidance, and motivational interventions for transition-age youth,
68, 70
Empathy
mental health care by primary care physicians and,
150
telepsychiatry and,
203
therapeutic alliance and,
32–33
Empowerment, and psychodynamic psychopharmacology,
57
Engagement, and therapeutic alliance,
87–88, 143–144
Environmental influences, and brief pharmacotherapy visits,
105, 106
E-prescriptions,
xxii
Equipoise, and clinical trials,
268–269
Ethics, and clinical trials,
266–271
Ethnicity, and differences in medication use,
235–236. See also Culture; Race
Ethnopharmacology, and cultural meaning of side effects,
247
Evaluation, in inpatient psychiatric setting,
178–179. See also Diagnosis
Evidence-based practice
education in pediatric psychopharmacology and,
323–324
therapy models for adolescent psychopharmacology and,
63–66
Executive functions, and transition-age youth,
221
Expectancy theory, and placebo effect,
11–12
Expectations
behavior change and,
83
mental health care by primary care physicians and,
147
of patient for treatment,
29
placebo response and,
293–295
Explanatory models, for signs and symptoms of mental illness,
247
Exposure therapy, and virtual reality,
208
Eye level, and eye contact
children as patients and,
145
telepsychiatry and,
201, 203
Facial expression, and telepsychiatry,
203
Family, and mental health care for transition-age youth,
223–225, 227. See also Parents
Financial resources, and mental health care in LMICs,
248–251. See also Cost; Reimbursement; Socioeconomic status
Fonagy, Peter,
35, 51
Food and Drug Administration (FDA),
15
Frank, J.D. & J.B.,
29
Freud, Sigmund,
10, 123
Fried, Charles,
268
Functional contextualism, in acceptance and commitment therapy,
65–66
Functional domains, and treatment planning for transition-age youth,
218, 219
Future, therapeutic alliance and sense of,
6, 168. See also Research
Generalized anxiety disorder
. See also Anxiety disorders
in case examples,
130, 132, 148, 299
placebo response and,
288–289, 291–292
Genuineness, and therapeutic alliance,
34, 74
“Good enough,” a goal of education for pharmacotherapists,
xxix–xxx
Hasselmo, Simone,
xvii–xviii
Havens, Leston,
5–6, 168
Health belief model, of behavior change,
83
Health care
. See Primary care providers
education in child and adolescent psychiatry and systems of,
327–328
clinical trials and,
269–271, 273–278
impact of COVID-19 on,
195–196, 197, 198
Health Insurance Portability and Accountability Act (HIPAA),
198, 200
Helicopter parenting,
225–226
HELP mnemonic,
150–151
Hinshaw, Stephen,
xxix
Hispanic Americans
. See also Culture
differences in medication use and,
235, 236
physician dominance in communicating with patients,
238
Holding environment, and split treatment model,
327
Homework
positive psychology approach to pharmacotherapy for adolescents and,
206207
psychoeducation and,
93
Hope
mental health care by primary care physicians and,
150
motivational interventions for adolescent psychopharmacology,
75
Hospitalization
. See Inpatient psychiatric setting
“Hot spots,” and psychodynamic psychopharmacology,
51
Identity formation, and development of adolescents,
62
Implementation science models, for clinical trials,
275
Implicit association testing (IAT),
234
Implicit bias, and race,
233–234, 237
Individuals with Disabilities Education Act (IDEA),
165
Individuation, and development of adolescents,
122
Informed consent
inpatient unit and,
182
pediatric clinical trials and,
267–268, 269–270, 275
Inpatient psychiatric setting
evaluation in,
178–179
future research on,
189–191
increased use of,
177
initiation of treatment and treatment planning,
179–184
stigma and,
184–191
Institute of Medicine,
221
Integrated care models
communication and,
130–131
development considerations in,
121–122
implications for treatment,
122–130
professional development and,
330
resolving of conflict and,
132–133
respect and countertransference in,
131–132
Interdisciplinary team, and inpatient units,
187–188
Internet
. See also Telepsychiatry; Websites
model toolkits for mental health care by primary care providers,
138
as source of information on medications,
15
Interprofessional education, and systems of care,
327–328
Interviews, and telepsychiatry,
202, 204–205, 207–208
“Investing in the Health and Well-being of Young Adults” (Institute of Medicine and National Research Council 2014),
221–222
Involuntary administration, of medications,
xxvii
Jed Foundation: Set-to-Go,
228
Joshi, S.V.,
161
Kandel, Eric,
40
Katz, Jay,
266
Kavanagh, E. P.,
322
Kleinman, Arthur,
40
Knowledge, and mental health care in LMICs,
246
Kognito: At Risk for Educators Program,
165–166
Kubie, L. S.,
29
Language
. See also Communication description of side effects and,xxvi
mental health care provided by primary care physicians and,
148–149, 150
therapeutic alliance and,
5
use of interpreters,
238–239
Learning, core principles for adult,
322
Legal issues, and telepsychiatry,
199–200. See also Informed consent Lending library, and psychoeducation, 92
Life skills, and transition-age youth,
220
LMICs
. See Low- to middle-income countries
Lin, K.-M.,
159
Listening, and mental health care provided by primary care physicians,
148–149
Lithium,
278
Low- to middle-income countries (LMICs)
access to mental health care in,
252–254
availability of mental health care for children and adolescents in,
244, 245–246
context of psychopharmacotherapeutic alliance in,
251–252
influence of culture on perceptions about psychiatric care and medication in,
246–248
time as resource for mental health care in,
249–250
Magical thinking,
8
Major depressive disorder
. See also Depression
in case examples,
39, 130, 298
clinical trials and,
271, 290
placebo response and,
288–289, 293, 296
Managed care, influence of on prescribing,
16–17
“Marked mirroring,” and psychodynamic psychopharmacology,
51
Marketing, and influence of pharmaceutical industry on prescribing,
13, 16. See also Advertising
Martin, A.,
328
McCullough, M.,
164–165
Meaning, of medication
education in pediatric psychopharmacology and,
324–327
psychology of psychopharmacology and,
6–8, 10–15
shared forms of,
xxviii
Measurement problems, and placebo response,
291–292
“Med check.” See also Brief pharmacotherapy visit
psychodynamic psychopharmacology and,
55–56
splitting of patient care and,
102–103
therapeutic alliance and,
16–17
time constraints and myth of,
xxi
use of term,
7
Medicaid,
235
Medication(s)
. See also Adherence; Clinical trials; Dosages; Meaning; Psychopharmacology; Side effects
cultural aspects of psychiatric,
247
differential use of based on race or ethnicity,
235–236
inpatient units and,
181–183
“Medicines,” use of term,
xxvi
Mental health care
. See also Child and adolescent psychiatry; Inpatient psychiatric setting; Primary care providers
barriers to for transition-age youth,
216–218
for children and adolescents in LMICs,
244, 245–255
Mental health disorders
. See also Anxiety; Attention-deficit/hyperactivity disorder; Autism spectrum disorders; Comorbidities; Depression; Mood disorders; Obsessive-compulsive disorder; Panic disorder; Personality disorders; Posttraumatic stress disorder; Psychotic disorders
prevalence of in children,
137
school-based manifestations of,
168–171
Mental Health Gap Action Programme Humanitarian Intervention Guidelines,
247
Mentalization, and therapeutic alliance,
35–36
Mentors, and education in pediatric psychopharmacology,
329, 330 Meprobamate, 120
Methylphenidate,
8–9
Milestone Goals and Objectives (ACGME),
329, 331, 332335
Mindfulness, and motivational interventions for adolescent psychopharmacology,
75
Model List of Essential Medicines (World Health Organization 2019),
254
Mood disorders, in school settings,
169, 172173
Motivational interviewing
adolescent psychopharmacology and,
60, 64–76
inpatient units and,
180
overlap with cognitive-behavioral therapy,
64
treatment planning for transition-age youth and,
221
Y-model and,
33–34
Multidisciplinary teams, shortage of child psychiatrists and role of in prescribing,
xxii–xxiii
Multimodality, and clinical trial design,
265
Murray-García, Jann,
236
Mutual regulation, and psychodynamic psychopharmacology,
48, 51–52, 57
National Institute for Health Care Management,
16
National Institute of Mental Health,
45, 279
Negative Affect Self-Statement Questionnaire (NASSQ),
292–293
Negative transference, and clinical trials,
267
Networking, and career development,
329
Nocebo effect, and therapeutic alliance,
xxvi, xxvii, 324
Norms, and behavior change theories,
84
Obsessive-compulsive disorder,
288–289, 290
Off-label prescribing, prevalence of in child psychiatry,
265
Openness, and motivational interventions in adolescent psychopharmacology,
74
Oppositional defiant disorder,
52
Osler, William,
115
Palatability, of medications for children,
14
Panic disorder,
132
Papakostas, G. I.,
291
Parents
. See also Family
“achievement by proxy” and,
12
clinical trials and,
266–268
inpatient hospitalization and,
181
management of conflict with transition-age youth,
225–227
mentalization and,
35
psychodynamic psychopharmacology and,
50–52, 55
psychological meaning of medication and,
12–15
role of in child development,
48
school mental health programs and,
164–165
support groups for,
90–91, 92
telepsychiatry and,
210
therapeutic alliance between clinician and,
28
Patient(s)
. See also Adolescents; Children
preparation for telepsychiatry visits,
204
therapeutic alliance and expectations of for treatment,
29
Patient-centered approach, and meaning of medication,
326
Pediatricians
. See Primary care providers
Pediatric Anxiety Rating Scale (PARS),
292
Pediatric psychopharmacology
. See also Adherence; Child and adolescent psychiatry; Education; Medication(s); Pharmacotherapists; Pharmacotherapy; Psychodynamic psychopharmacology; Psychoeducation; Psychology; Research; Side effects; Therapeutic alliance; Time
common misconceptions about,
312, 313
drug development and,
279
historical context for contemporary treatment approaches,
263–265
“nail soup” treatment model for,
309–310
placebo effect and,
xxvi–xxviii
responses to COVID-19 pandemic and,
196, 198
in school context,
157–168
stance regarding treatment and,
xxiv–xxvi
stigma of mental illness and,
xxviii–xxix
Peer mentorship, and career development,
329
Persistent depressive disorder,
80
Personality disorders, and telepsychiatry,
205
Personalization, of psychoeducational and communication process,
87
Peterson, B.S.,
30, 36
Pharmaceutical industry
. See also Advertising
clinical trials and,
276
influence of sales force and “drug reps” on prescribing,
15, 16
pervasive influence of on therapeutic relationship,
xx
Pharmaceutical Research and Manufacturers of America,
15
Pharmacotherapists
. See also Pharmacotherapy
adolescent psychopharmacology and,
64
developmental trajectory in career of,
311–312
“good enough” as goal for education of,
xxix–xxx
“nail soup” treatment model and,
309–311
saying “no” to psychopharmacological intervention,
315, 316
use of term,
xx
Pharmacotherapy
. See also Brief pharmacotherapy visit; Pediatric psychopharmacology; Pharmacotherapists; Psychopharmacology
definition of,
4
mental health care for transition-age youth and,
221–223
positive psychology approach to,
206207
preconceptions, misconceptions, and perceptions about,
312, 313
Pharmacy, and prescribing within telepsychiatry,
xxii, 207
Placebo-controlled trials, and ethics,
270–271
Placebo effect
. See also Nocebo effect; Placebo response
clinical trials and,
271–272
impact of in pediatric psychopharmacology,
xxvi–xxviii
psychological meaning of medication and,
10, 11–12
Placebo by proxy,
297
Placebo response
. See also Placebo effect
anxiety disorders and,
288–289, 292–293, 294, 296
definition of,
287, 288
design of clinical trials and,
290–291
development and,
296–297
expectation and,
294–295
factors associated with enhanced response,
300, 301
implications for treatment,
298–299
major depressive disorder and,
288–289, 293, 296
mechanisms of,
297–298
nonspecific factors affecting,
288
obessive-compulsive disorder and,
288–289
therapeutic setting and,
295–296
unidimensionality and measurement of improvement,
291–292
Plakun, E.M.,
29, 30, 34, 40
Planned behavior, theory of,
83
Polypharmacy
brief pharmacotherapy visit and,
113
clinical trials and,
265
Positive parenting interventions, and primary care physicians,
151
Positive transference, and clinical trials,
267
Postpartum depression (PPD),
141
Posttraumatic stress disorder (PTSD),
159, 238
Practice-based learning methods, in medical education,
331
Precision medicine, and drug discovery,
272–273
Prescribing
. See Pharmacotherapy; Psychology; Psychopharmacology
Primary care providers (PCPs), and mental health care
. See also Health care
availability of resources for,
140
complexities of diagnosis,
140
developmental considerations and,
141–142
education for,
139
future research on,
151
implications for treatment,
142–145
practical applications and strategies for,
145–151
reimbursement and,
140–141
role of in mental health care system,
138
time as constraint for,
139–140
Process-oriented clinical models, and adolescent psychopharmacology,
63–66
Pro Re Nata (PRN) intervention,
315–317
Prudence, and stance regarding treatment,
xxiv
“Psychiatric care visit,” and replacement of term “med check,”
17
Psychiatry
. See Child and adolescent psychiatry; Inpatient psychiatric setting; Integrated care models; Mental health care; Psychopharmacology; Psychotherapy; Telepsychiatry
Psychodynamic psychopharmacology
as approach to psychopharmacological interventions,
50–52
core concepts of,
53
definition of and description of approach,
46
development and,
47–49
goals of treatment,
56–57
implementation of,
52–56
Psychoeducation
. See also Education
behavior change and,
82–91
case example of,
79–81
clinical practices and strategies,
92–93
future research needs,
93–94
inpatient setting and,
179–181, 185
motivational interventions for adolescent psychopharmacology and,
75
primary care physicians and,
148
in resource-limited settings,
249
for transition-age youth,
227
Psychological analgesics, for management of painful topics,
6, 168
Psychological flexibility, in acceptance and commitment therapy,
66
Psychology, of pediatric psychopharmacology
definitions of terms,
3–4
developmental considerations and,
8–10
extramural influences affecting prescribing,
15–17
future research on,
18–19
meaning of medication,
6–8, 10–15
positive approach to pharmacotherapy for adolescents,
206207
recommendations on,
19–20
therapeutic alliance and,
4–6, 25–28
transition from split treatment to shared treatment,
17–18
Psychopharmacology
. See also Brief pharmacotherapy visit; Pediatric psychopharmacology; Pharmacotherapy; Polypharmacy; Psychodynamic psychopharmacology
definition of,
3–4
model components of curriculum in,
336337
Psychosis, and telepsychiatry,
205. See also Psychotic disorders
Psychosocial issues, for transition-age youth,
220–221
Psychotherapy
. See also Cognitive-behavioral therapy
integrated treatment and,
128
mental health care in LMICs and,
253
prescribing of medications via telepsychiatry and,
201–208
timing of prescriptions within ongoing,
7–8
Psychotic disorders,
52. See also Psychosis
Public policy, and mental health care in LMICs,
254
Questioning stance, and medication trials,
xxiv
Quinlan, D.,
164–165
Race
. See also African Americans; Asian Americans; Black, Indigenous and Persons of Color (BIPOC); Culture; Ethnicity
differences in medication use,
235–236
doctor-patient relationship and,
232, 234
implicit bias and,
233, 237
Randomization, and clinical trials,
270
Rauch, P. K.,
160
REACH Institute,
138
Reasoned action, theory of,
83
Recognition, and school psychopharmacotherapy consultation,
160–161
Recommendations
on psychology of psychopharmacology,
19–20
on split treatment model,
131, 132
for working alliance with school staff,
163
on Y-model for therapeutic alliance,
42–43
Referrals, by primary care providers,
142
Reflective listening, and therapeutic alliance,
34–35
“Regulate-Relate-Reason” framework, for psychodynamic psychopharmacology,
50
Rehabilitation Act of 1973,
165
Reimbursement, for mental health care by primary care providers,
140–141
Relapse, and nonadherence to psychopharmacology,
109
Release of information, and family involvement in care of transition-age youth,
224, 227
Remembering rituals,
9
Repurposing, of medications,
273
Research, on pediatric psychopharmacology
. See also Clinical trials; Placebo response
brief pharmacotherapy visit and,
114–115
inpatient hospitalization and,
189–191
mental health care by primary care physicians and,
151
psychoeducation and,
93–94
psychology of psychopharmacology and,
18–19
racial or cultural issues and,
239
therapeutic alliance and,
40–42
“therapeutic” in clinical trials,
269
Resilience, as goal of psychodynamic psychopharmacology,
56–57
Respect, and countertransference in integrated and split treatment models,
131–132
Response, and school psychopharmacotherapy consultation,
161
Restraints, and inpatient psychiatric units,
185, 188
Risk assessment, and balancing confidentiality and disclosure in adolescent psychopharmacology,
76
Rogers, C. R.,
123
Safety
clinical trials and,
278
inpatient units and,
178, 186–187
mental health care by primary care physicians and,
144, 149
Safety Planning Intervention,
186
Scaffolding, and therapeutic alliance,
37
Schools
. See also Collateral information; College; Education; Teachers
management of mood disorders in,
169, 172173
manifestations of psychiatric conditions in,
168–171
meaning of medication and,
14
midday doses of medications and,
9
psychopharmacotherapy within context of,
157–168
Screen for Child Anxiety Related Disorders (SCARED),
113
Selective serotonin reuptake inhibitors (SSRIs),
272, 296
Self-advocacy, and transition-age youth,
219–220
Self-efficacy
behavior change and,
84
motivational interventions for adolescent psychopharmacology,
75
Self-esteem, and therapeutic alliance,
6, 168
Self-regulation
development and,
48
primary care physicians and,
151
Semi-structured clinical interviews,
264
Senn, Milton,
143–144
Separation anxiety disorder,
288–289, 291–292
Serious mental illness, definition of,
45
Sertraline,
289
Settings
. See also Inpatient psychiatric setting; Schools; Telepsychiatry
mental health care by primary care physicians and,
145
placebo response and,
295–296
Shared decision making
brief pharmacotherapy visit and,
114
therapeutic relationship and,
324
transition-age youth and,
222
Shared treatment, transition from split treatment to,
17–18
Side effects, of medications
advice on language for describing,
xxvi
brief pharmacotherapy visit and,
111–114
cultural meaning of,
247–248
developmental considerations and,
8
psychoeducation and,
89–90
school settings and,
169
telepsychiatry and,
208
Silent World of Doctor and Patient, The (Katz 2002),
266
Skehan, B.,
222
Social anxiety disorder,
288–289, 299
Social learning theory,
83
Social media
. See also Internet
as source of information on medications,
15
support groups for parents and,
92
Social relationships, and school consultation,
160
Socioeconomic status
. See also Financial resources
medication adherence and,
233
psychoeducation and,
90
Splitting, as defense mechanism,
128–129, 326–327
Split treatment
communication and,
129, 130–131
developmental considerations and,
121–122
education in pediatric psychopharmacology and,
321, 326–327
implications for treatment,
122–130
psychology of psychopharmacology and transition to shared treatment,
17–18
resolving of conflict in,
132–133
respect and countertransference in,
131–132
Staffing, of inpatient psychiatric units,
185
Stages of change (SoC) model, and motivational interviewing,
64, 68, 71
Stance, of treatment
. See also Empathy
importance of in pediatric psychopharmacology,
xxiv–xxvi
motivational interviewing and,
64–65
Standardized symptom rating scales, and therapeutic alliance,
34
Stem-of-the-Y model
. See Y-model
Stigma
brief pharmacotherapy visit and,
109, 110, 111
inpatient psychiatric care and,
182, 184–191
as issue in pediatric psychopharmacology,
xxviii–xxix, 251
Stoplight Safety Plan (SSP),
186, 188190
Strong, S.R.,
123
Stubbe, D.E.,
327–328
Substance use
adolescent onset of,
63
in case example,
149
Suicide, and suicidal ideation antidepressants and risk of,
xxvii
increase in incidence of among adolescents,
177
safety issues in inpatient setting and,
186
Supervision and supervisors, and education in pediatric psychopharmacology,
327, 328, 337
Supply and demand failures, in LMICs,
253
Support groups, for parents,
90–91, 92
Supporting alliance, in school mental health programs,
161, 162, 164
Teachers
. See also Schools
education in pediatric psychopharmacology and,
328–329, 330
as gatekeepers for school mental health programs,
162
Telepsychiatry
COVID-19 pandemic and,
209–210
emergence of,
xxii, 198–199
future directions in,
208–209
implementation of,
199–201
preferred practices for,
203
psychotherapeutic aspects of prescribing via,
201–208
Tentative stance, and medication trials,
xxiv
Termination of care, therapeutic alliance and premature,
5. See also Discharge planning; Discontinuation
Tervalon, Melanie,
236
Therapeutic alliance
adherence and,
13
case examples of,
37–40
clinical trials and,
265, 279
common factors and,
36–37
developmental issues in,
25–28, 32, 179
education in pediatric psychopharmacology and,
324–325
engagement and trust in,
87–88
future research on,
40–42
genuineness and,
34
importance of,
27–28, 263
inpatient setting and,
179–181
integrated treatment and,
123–124
“med check” and,
16–17
mental health care in LMICs and,
251–252
mentalization and,
35–36
motivational interviewing and,
64
primary care physicians and,
143
psychology of psychopharmacology and,
4–6
recommendations on,
42–43
reflective listening and,
34–35
school-based psychopharmacology and,
166
split treatment and,
125–127
telepsychiatry and,
201–202
Y-model of,
xxi–xxii, 28–43
Therapeutic misconception, and clinical trials,
273–278
Therapeutic triangle,
125. See also Triadic alliance
Thinking, of children about medication,
8, 9, 170
Threat bias, and negative expectations,
295
Time
adherence and timing of medications,
14
children’s thoughts about timing of dosage,
9
as constraint for mental health care by primary care providers,
139–140
inpatient psychiatric admission and,
182–183
as key aspect of pediatric psychopharmacology,
xx–xxii
mental health care in LMICs and,
249–250
mental health care by primary care physicians and,
146
timing of prescription within ongoing psychotherapy,
7–8
timing of psychoeducation and,
88–89
Toys, in examination room,
145
“Transdiagnostic” therapy models, and adolescent psychopharmacology,
61, 63–64
Transference
clinical trials and,
266
integrated treatment and,
127–128
split treatment and,
128–130
transition-age youth and,
227
Transition-age youth (TAY)
. See also Adolescents
boundary and transference issues,
227
definition of,
215
family relationships and,
223–227
functional domains in treatment planning for,
218–221
information resources on,
228
psychiatric pharmacotherapy for,
221–223
vulnerabilities of and barriers to mental health care for,
216–218
Treatment
. See Combined treatment; Integrated treatment; Pediatric psychopharmacology; Split treatment model; Stance; Treatment planning
Treatment agreement, and adolescent psychopharmacology,
70–71
Treatment frame, and Y-model,
31
Treatment planning
in inpatient setting,
179–184
telepsychiatry and,
208
for transition-age youth,
218–221
Triadic alliance, and split treatment,
125–126, 328
Triangulation, and split treatment,
128–129
Tricyclic antidepressants (TCAs), and clinical trials,
264
Trust
psychodynamic psychopharmacology and,
52
stance regarding treatment and,
xxiv
therapeutic alliance and,
87–88
United Nations Convention on the Rights of Persons with Disabilities,
246
Valenstein, E.,
14
Valium,
120
Values, and motivational interventions for adolescents,
66, 67, 73–74
Venlafaxine,
296
Virtual frame, and telepsychiatry,
xxii
Virtual reality,
208. See also Telepsychiatry
Virtual tours, of patient homes during telepsychiatry,
202
Walsh, Mary,
49
Washington University (St. Louis),
103–104
Websites
. See also Internet
mental health care for transition-age youth,
228
parent support organizations and,
92
school-based mental health programs and,
165–166
Willingness, and stance regarding treatment,
xxiv
Winnicott, Donald W.,
xx, 12, 310–311
Withholding, and placebo effect,
xxvii
World Health Organization,
195, 247, 253, 254
Y-model, and therapeutic alliance,
xxi–xxii, 28–43
Zisook, S.,
321

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Go to Thinking About Prescribing
Thinking About Prescribing: The Psychology of Psychopharmacology with Diverse Youth and Families
Pages: 347 - 363

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Published in print: 18 January 2022
Published online: 5 December 2024
© American Psychiatric Association Publishing

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