This way it makes it difficult for the CM to sign off all the medications at once for the residents when setting them up. case management service plans bizfluent, s m a r t behavior change outcome objectives, quick guide to By implementing this, the CM can do the final check of administering the medications. The resident will Conduct supportive psychotherapy for select patients who are currently going undergoing crises, going through transitions, or otherwise are appropriate for these services. When symptoms and function improve, visits every 3-6 months are recommended. For each, write down the medication name, prescribed dose, and prescribed frequency. Respect for, and communication with referring physicians, therapists, and caregivers to optimize treatment. %PDF-1.5 Management Approach and Treatment Options. ), Recognize and make therapeutic use of transference, Integrate biological and psychological aspects of a patient's history, Provide psychoeducation about psychiatric illness and the risks/benefits of commonly prescribed psychotropics, Understand how the meaning of a medication to a patient can have a significant impact on its efficacy and learn how to explore what medications mean to a patient, Use the placebo effect to more successfully prescribe medications, Demonstrate a basic understanding of diagnosis-specific psychotherapy and medication management, Have a basic understanding of medico-legal and psychotherapeutic issues in the context of one person prescribing medication and another person providing psychotherapy: confidentiality, informed consent, and collaboration, Use the concepts of transference and countertransference in prescribing medications in a therapeutic manner, Recognize the ways that prescribing mediation can enhance or hinder psychotherapy and ways that psychotherapy can enhance or hinder medication management, Identify the psychological aspects of non-adherence, Use structured cognitive-behavioral model including mood check, bridging to prior session, agenda setting, and review of homework, capsule summaries, and patient feedback, Use Dysfunctional Thought Records as a tool in therapy, Use Activity Scheduling as a tool in therapy, Identify common cognitive errors in thinking, Use behavioral techniques as a tool in therapy, Plan booster session's, follow-up, and self help sessions appropriately with patients when terminating active therapy, Assess regressive and adaptive shifts in ego functioning, Make interventions specifically in support of a patient's ego functions, including defensive operations, Deliberately take a non-interpretative stance in relation to a defensive operation in a patient, Recognize internal conflict and help a patient contain it without an emphasis on interpretation, Be directive: give advice set limits, and educate when appropriate with a patient. % Step 2 - Develop processes for using Medication Management Tools. As the nursing code of ethics states, nurses have the duty to protect the health and safety of those in their care (Winland-Brown, Lachman, O'Connor Swanson, 2015). the types of psychotherapy, and their indications, which are effective in managing the problems seen in a general psychiatry clinic. PGY-2 residents spend six months in the continuing care clinic. Knowledge of the types and indications for various neuropsychological tests and their interpretation. Techniques used in the evaluation and treatment of adults comorbid presentations of anxiety disorders and other major psychiatric disorders (mood, alcohol/substance abuse, and dependence, etc.). Changing ones own patterns or style of thinking could have a broad impact on how one manages their life. Provide tips for clinicians on strategies to overcome common barriers to medication filling and adherence. And Example Goals and Steps . A PCP can serve as another source of education, further stressing the importance of adherence and answering questions patients may have about their new regimen now that they have been on it for a few days. Residents will have a unique opportunity to gain an understanding of the concept of suffering and of compassion (suffering with). Initial and follow-up treatment (both pharmacologic and psychotherapeutic) of anxiety disorders, including strategies for choosing a new treatment based on the previous treatment history and presentation of the patient; Familiarity with the literature related to the effectiveness of these treatment approaches, including newly emerging evidence-based medical practices. 2016-04-26T17:08:21-07:00 %PDF-1.6 % Step 5 - Evaluate and refine. Residents will communicate with multidisciplinary treatment teams effectively and will incorporate feedback from them. ), Be able to explicate the differences in purpose and organization between a clinical and a medicolegal evaluation, including the different ethical responsibilities entailed, neurological illness and co-morbid psychiatric disorders, psychiatric disorders presenting with neurological symptoms, neurological disorders presenting with psychiatric symptoms, neuroanatomy and neurophysiology as they pertain to patient presentations, common neurologic disorders and their management, presentations of neuropsychiatric syndromes, the intersection of neurology and psychiatry, an understanding of the consultation process, and responsivity to consultation questions and requests, an understanding of the resources available to patients at the interface of neurology and psychiatry. These tools will also help to identify patient behaviors that may be putting patients at risk for an adverse drug event, such as overdosing, underdosing, or missing medications, or other important contextual factors limiting adherence. Regardless of the healthcare setting or demographic of patients, safe outcomes are the purpose of providing patient-centered care. You and your mental health provider will work together to define your long-term objectives from treatment. This clinic is run by Jon Grant, M.D. Identify the patient's goals and aspirations and relate these to treatment outcomes to increase treatment adherence. Ability to treat patients with TRMDs using the mode of treatment most suitable to the particular situation. Identify when countertransference issues or unfair patient demands are interfering with the resident's ability to provide appropriate clinical care. The Mental Health and Mental Disorders objectives also aim to . Atomoxetine (Strattera) is currently the only non-stimulant approved by the FDA for the treatment of ADHD in adults (FDA-Approved Non-Stimulant Medications for Adult ADHD). Word View a general overview on medication treatments for ADHD and how the medications work. Step 3 - Train team members and initiate implementation. When patients fail to get regular exercise, it could be an indication that ADHD is affecting their organizational skills. They are specific statements that have a set target that your teams need to reach. The clinic relies heavily on making use of other psychosocial rehabilitation services in the Chicagoland area. The follow-up appointment is vital for several reasons from a medication perspective. This multidisciplinary team meets weekly in case-based discussions and didactic sessions. Essential Functions and duties of position included: Provide Medication Therapy Management Review to patients (COA-Care for . I have also read about methods of administration which some literature provides evidence of 5Rs and others give as much as 10RS. As for private hospital we do practice cost saving and by recommending this system my organization would be able to achieve cost saving as well as incentives and improved efficiency in delivering high quality and safe care for our patients. Organizations should set a goal to ensure there is a follow-up plan in place for all patients and consider this an essential component of the discharge process. NIDA pursues this objective through research and development of non-opioid pain medications, abuse-deterrent formulations of existing medications, and user-friendly overdose reversal drug formulations (e.g., intranasal naloxone). stream interact with patients, their families, referral agencies and support staff in developing long term treatment plans. define target symptoms and then choose an appropriate intervention (e.g. To sign up for updates or to access your subscriberpreferences, please enter your email address below. Residents will develop and demonstrate a respectful attitude toward patients with addictive disorders. Program Goals & Objectives T0019_MAT 4-1-2016 4-1-2016 4-15-2016 Originated By: Approved By: Jonathan Ciampi David Kan, MD Purpose: This document outlines the program goals and objectives. Currently, two classes of FDA-approved medications are used for ADHD treatment: stimulant and non-stimulant. b.Ask the patient what the medication is for and document why the patient takes it. Be familiar with the various diagnostic conditions seen during childhood and adolescence including ADHD, Conduct Disorder, Anxiety Disorders, Substance Abuse Disorders, and Learning Disabilities, Understand the difference in symptomatology between children, adolescent, and adults, Understand the occurrence of commonalities in children and adolescents, Develop competency and appropriately prescribe and manage stimulant medication for ADHD including Ritalin, Dexedrine, and Adderal, Develop competency and appropriately prescribe and manage non-stimulant medication for ADHD including Wellbutrin, Clonidine, and Strattera, Develop competency and appropriately prescribe and manage SSRI medications for depression and anxiety, Be aware of the various structured diagnostic tests (CBCL, Conners, CDI, etc. It is a potent selective norepinephrine reuptake inhibitor. There is not enough research to conclude what type, intensity, or duration is best. There are other things that needs to be considered such as washing hands prior to administering, check the drug chart, the right patient, right drug, right route, right amount/dosage, the history or background record of the patient, allergy or intolerance}, the right education provided to the patient, documenting as given, documenting refusal and right evaluation. Oncology - Effective 2016. <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Through this activity I have learned that it is not always easy to take medications at the right times. Reasonable timeline: 6 months of therapy. Metacognitive therapy suggests stepping back from specific thoughts and instead understand ones own thinking style. At the follow up visit, consider the following: About 60% of adults experience improvements in quality of life and symptom reduction in response to treatment. Please note the Goals and Objectives listed here apply not only to the General Adult Clinics but also toallthe Adult Outpatient Subspecialty Clinics, though the latter may have additional specific Goals related to the subspecialty of each clinic. The idea remains that the dispersal of stable patients to MNAs in regards to medication administration allocates more time for RNs/LPNs to prioritize care for critical patients. Goals: . While methylphenidate and amphetamine have different mechanisms of action in the brain, they generally have a similar effect in terms of improvement of ADHD symptoms. Knowledge of the techniques and interview styles used in the evaluation of older adults with sensitivity to cognitive disorders what are common in this population. By using this system it eliminates mistakes or errors due to illegibility, dosage and frequency as this system would alert the prescribers for attention. Pharmacists are in a unique position to help. The initial phase (crash) of withdrawal syndrome occurs as the stimulant effects wear off. Geneva: World Health Organization; 2009. Interestingly, the utilization of computerized order entry does not prevent the prescriber from ordering an incorrect medication dose or the wrong drug (Lapane, Waring, Dube, & Schneider, 2011). Knowledge of side effects of the various treatments, and available treatment responses to them. Metacognitive therapy is as a type of therapy that involves changing how people think rather than what they are thinking about. Adherence with a regimen that includes an incorrectly prescribed medication, such as a mistake about the type of drug, dosage, refill frequency, can also cause great harm to a patient. The Anxiety Disorders Clinic provides consultation and treatment on treatment-refractory cases that are often referred from the Department, Hospital, and community. Recognize and tolerate one's uncertainties as a trainee in psychotherapy, Recognize, contain and make therapeutic use of countertransference, Maintain a therapeutic alliance in the face of transference distortions, using concepts of neutrality, abstinence, empathy, and support in an appropriate manner, Manage termination issues within the context of a psychodynamic psychotherapy, Understand and develop a therapeutic alliance with the patient, Recognize a variety of forms of therapeutic alliances including negativistic ones, Recognize and attempt to repair disturbances in the alliance, Listen to nonjudgmentally and with openness, Facilitate the patient talking openly and freely, Empathize with the patient's feeling states, Communicate appropriately with others treaters within the Department of Psychiatry, Communicate appropriately with the patient's permission with referring physicians, and others outside the Department of Psychiatry, Recognize and describe (to the supervisor) one's own affective response to the patient, Establish an educational alliance with the supervisor, Incorporate material discussed in supervision into the psychotherapy, Establish a therapeutic alliance with the patient, Identify the precipitating event (stressor) and the patient's reactions to, Identify history of the patient's usual coping mechanisms facilitate the patient's expression of emotions, Normalize the patient's emotional reactions to the event in the setting of crisis, when appropriate, Focus the therapy on the precipitating crisis, Actively listen to the patient to enhance understanding, Help the patient develop adaptive coping mechanisms and identify additional sources of support, Identify patient strengths and to reflect these back to the patient, Establish achievable therapeutic goals with the patient, Rapidly obtain collateral information where appropriate, Know community resources and be able to make timely and safe dispositions, Identify and effectively begin treatment with a suitable patient for psychodynamic psychotherapy, Link present to past as demonstrated by understanding the patient's present pattern of thought, feelings, action, and relationship in terms of his or her past personal experience, Identify and respond appropriately and flexibly to a variety of defenses in the clinical setting, Effectively confront, clarify and interpret previously preconscious and unconscious material in the therapeutic setting, Facilitate the discovery of latent meaning of clinical material (e.g. Pain Management and Palliative Care - Effective 2018 . 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