PSYCHOPHARMACOLOGY AND TERMINATING Final Lecture

PLANS AND PROGRESS Psychopharmacology

Recommendations: You Try It Scenario: You have a student with ADHD in your classroom. You know that the best treatment might be a combination of medication and therapy. Questions:  What can you do with the child in the school-setting?  What can you discuss with the family about medication?  Practice how you would communicate with the family.

Collaboration: You Try It You have a child whose doctor has prescribed an anti-depressant.  What would you need to know about the child’s medical history.  What type of data might the doctor need?  Develop a progress monitoring tool to evaluate the student’s improvements (and side effects) in school.  Develop a communication tool (form letter, etc.) that you could use to provide data back to the doctor.

Terminating

Steps to Termination From the first day, you should be planning how you will know when the client is ready to terminate (how to evaluate progress). Set the goal as to what “done” means. Set small goals. Apprise the client when they have been successful. Start preparing the client ahead of time for termination. Termination can occur over multiple sessions; however, you should have a clear “end” to the treatment. Leave the client with the knowledge that you are there for them if their problems get bad again (or if new problems arise). Make sure they are aware of how to handle an emergency psychiatric situation.

Important Points: Termination Clients may have “rebound” immediately before or immediately after termination. It can be wise to schedule termination over a period of time (e.g., see me in 2 weeks, then 4 weeks, etc.). Terminating with children and parents can be helpful EVEN IF you were seeing the child in individual treatment. Termination often happens too early. New therapists frequently misjudge this. Sometimes tx stops because it is no longer helpful to the client (not because the client has met the goals). Sometimes tx ends with a referral to another therapist.

Self Termination Definition: the client stops coming to treatment or the client withdraws emotionally from treatment. Often clients will self-terminate when they no longer have the resources to continue tx:  Financial  Time  Energy  Transportation  Child Care If clients do not feel that they are making progress, they will self-terminate.

Terminating from the Start: You do it! Scenario: You have just started treatment with a family of a suicidal teenager.  What would you set as the main goal (operationally define the goal) of treatment?  What is the immediate needs / goals of this family? this child?  What would you do if the family stops coming to therapy (self- terminates)?

Terminating at the End: You Do It! Your impulsive nine-year-old client has met the goal that you originally set for him on the first day of treatment.  Are you done?  If no, what needs to be done to make that decision?  When/if you are ready, when would you start preparing the client for termination?  What might a final termination session look like?  What post-termination activities might be needed?