Prescribing Together : A Relational Guide to Psychopharmacology

What if, rather than acting only as dispensers of medication, mental health clinicians and primary care clinicians treating mental disorders were also collaborators with patients in the prescribing relationship? It’s a simple but profound shift in how to think about approaching psychopharmacology, and in Prescribing Together, Warren Kinghorn and Abraham Nussbaum argue that this sort of human-to-human relationship-building is critical to prescribing more effectively and to achieving health equity. While many other books have focused on what to prescribe for given conditions, this volume is more concerned with how to prescribe: how to talk to patients about medications, how to understand the cultural and social factors that affect how both clinicians and patients relate to medication, and how to build trust in the relationship. Each chapter offers a practical introduction to at least one key concept or skill, from cultural formation and structural competency to medication concordance and deprescribing. Profiles, rich in personal anecdotes, of a diverse group of accomplished clinicians serve as an engaging, real-life foundation for evidence-based strategies for building strong alliances in the context of 13 mental disorder categories, including: • Schizophrenia • Bipolar disorder • Major depressive disorder • Generalized anxiety disorder • Neurocognitive disorders • Borderline personality disorder In drawing a contrast between a dispenser and a collaborator model, Prescribing Together encourages clinicians not just to look at their patients, but to look with them at their lived experience, to understand their stories and interpersonal and social contexts—all with the aim of returning agency to patients and empowering them to set meaningful goals and to be active particpants in their own flourishing. Cover 1 Half Title 2 Title 4 Copyright 5 Contents 6 About the Authors 8 Acknowledgments 10 1 Introduction: From Dispensers to Collaborators 12 2 Relationship Matters 28 3 Prescribing Alliances 38 4 Peak Performance: Prescribing in the Context of Attention- Deficit/Hyperactivity Disorder 60 5 Visions and Voices: Prescribing in the Context of Schizophrenia and Other Psychotic Disorders 80 6 Stabilization Forces: Prescribing in the Context of Bipolar Disorder 102 7 Frayed Edges: Prescribing in the Context of Depressive and Anxiety Disorders 130 8 Unwelcome Strangers: Prescribing in the Context of Obsessive-Compulsive and Related Disorders 150 9 Building Peace: Prescribing in the Context of Trauma- and Stressor-Related Disorders 166 10 When the Body Speaks: Prescribing in the Context of Somatic Distress 184 11 Befriending the Body: Prescribing in the Context of Eating Disorders 202 12 Getting Clean: Prescribing in the Context of Substance Use Disorders 220 13 Knowing and Being Known: Prescribing in the Context of Neurocognitive Disorders 236 14 Strong Emotions: Prescribing in the Context of Borderline Personality Disorder 254 Epilogue: From Fixing to Attending 270 Appendix: Alliance Measures 274 Index 280 A 280 B 281 C 282 D 284 E 286 F 286 G 287 H 287 I 288 J 288 K 288 L 288 M 288 N 290 O 290 P 291 Q 292 R 293 S 293 T 295 U 296 V 296 W 296 Y 296 Z 296 Back Cover 298 "What if, rather than being dispensers of medication, mental health clinicians and primary care providers treating mental disorders were collaborators with patients in the prescribing relationship? To prescribe more effectively and achieve health equity, Warren Kinghorn and Abraham Nussbaum argue, it's necessary-and in Prescribing Together, they offer a roadmap for making it a reality. In these pages, readers will find practical introductions to key concepts, from cultural formation and structural competency to collaborative deprescribing, and profiles, enlivened by personal anecdotes, of a diverse group of accomplished clinicians that offer evidence-based strategies for building strong alliances in the context of 13 mental disorder categories, including generalized anxiety disorder, major depressive disorder, borderline personality disorder, and neurocognitive disorders. By focusing on how, rather than what, to prescribe, this book makes room for patients' lived experiences and interpersonal and social contexts, returning to them a sense of agency and empowering them to set meaningful goals and be active participants in their own flourishing"-- Provided by publisher