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ForwardPsychodynamics of Pharmacologic Treatment-Resistance (3 of 4) - David L. Mintz, MD (Recorded)
Course 3 of 4 - The Art of Pharmacotherapy: Enhancing Outcomes by Integrating Patient-Centered, Psychodynamically-Informed Perspectives
Other Courses in this Series:
- Thinking About Prescribing: Psychodynamically-Informed, Patient-Centered Approaches to Pharmacotherapy (1 of 4)
- The Science of the Art of Psychopharmacology: An Introduction to the (Other) Evidence Base (2 of 4)
- Psychodynamic Psychopharmacology: Caring for the Treatment-Resistant Patient (4 of 4)
Pharmacologic treatment resistance remains a significant problem in psychiatry. Evidence-based approaches often stress (DSM) diagnostic clarity, focus on biological mechanisms of treatment resistance, while algorithms provide guidance about dose, duration and sequencing of biomedical treatments. Typically, these approaches give short shrift to psychological and interpersonal factors that contribute to treatment-resistance, despite a substantial evidence base suggesting that these factors play a role in treatment outcomes that may rival, or even dwarf, more biomedical factors.
In this presentation, we will consider common dynamics that contribute to pharmacologic treatment resistance. This includes ways that the patient’s ambivalence about medications, caregiving authority or health itself may result in treatment resistance to medications, and ways that patients may unconsciously turn medication to serve countertherapeutic ends, resulting in treatment resistance from medications and psychiatric chronification. Mechanisms by which prescribers may also contribute to treatment resistance will also be explored.
References:
Mintz, D. L., & Flynn, D. F. (2012). How (not what) to prescribe: nonpharmacologic aspects of psychopharmacology. Psychiatric Clinics, 35(1), 143-163.
Mintz, D (2022). Recovery from Childhood Psychiatric Treatment: Addressing the Meaning of Medications. Psychodynamic Psychiatry, 50(1), 131-148.
Mintz, D (2022). Psychodynamic Psychopharmacology: Caring for the Treatment-Resistant Patient, American Psychiatric Publishing, Washington DC.
If you enjoy this subject matter, you may be interested in our upcoming 2023 Virtual Fall Conference, Losing our Mind and Finding It: Re-Integrating Meaning in a Neurobiologically-Focused Era
Target Audience
______ Introductory __x__ Intermediate ______ Advanced
Learning Objectives
- Discuss the role of ambivalence in shaping pharmacologic treatment outcomes
- Explain some mechanisms by which medications, or the meanings of medications, might contribute to psychiatric chronification
- Diagnose common psychodynamics interfering with treatment response
- Approach treatment-resistant patients with greater empathy and understanding.
Education
- MD from University of Miami School of Medicine
- Residency through the Cambridge Hospital/Austen Riggs Center Combined Residency Program
- Fellowship in psychoanalytic studies at the Austen Riggs Center
David L. Mintz, MD, is a staff psychiatrist who joined the Austen Riggs Center in 1996. He presently serves as the director of psychiatric education, the associate director of training, and as a team leader. He also is principal investigator for the research initiative in Psychodynamic Psychopharmacology and author of the book Psychodynamic Psychopharmacology: Caring for the Treatment-Resistant Patient (2022, American Psychiatric Association Publishing). Dr. Mintz also coordinates the Elective in Psychodynamic Psychiatry at the Austen Riggs Center.
Professional Affiliations/Organizational Memberships
- American Psychiatric Association, former leader of the Psychotherapy Caucus
- American Academy of Psychoanalysis and Dynamic Psychiatry, Psychoanalytic Fellow and elected Trustee
Certifications/Appointments
- Editorial Board member of Psychodynamic Psychiatry
- Medical Student Education Committee member of the American Psychoanalytic Association
Awards/Recognitions
- Teichner Scholar at Cooper Medical School of Rowan University Psychiatry Residency Program
Research Interests
- Psychological aspects of taking and prescribing medications, psychodynamic aspects of medical education, professionalism, and clinical care of psychiatric patients with treatment-refractory conditions.
Austen Riggs Center Inc. adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Medical Education. All those at Austen Riggs Center involved in the planning of this activity, including the presenter(s) listed above, report they have no relevant financial relationships with an ineligible company*.
The views and opinions expressed in this presentation are those of the presenter(s) and do not necessarily represent the official policy or position of the Austen Riggs Center.
* An ineligible company is any entity whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
General CME/CE Information
Accommodations - The Austen Riggs Center follows all state and federal laws and regulations, including the Americans with Disabilities Act of 1990 (ADA). In accordance with the ADA, the Austen Riggs Center is committed to accessibility. If you need accommodations for your online course, please contact info@austenriggs.net.
Accreditation
(Physicians, Psychologists, Social Work and Nursing)
The Austen Riggs Center designates this live interactive webinar for a maximum of 1 AMA PRA Category1 Credit(s) ™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The Austen Riggs Center Inc. is accredited by the Massachusetts Medical Society to provide continuing medical education for physicians.
The Austen Riggs Center’s policy on disclosure, in keeping with requirements of the Massachusetts Medical Society, requires continuing education planners and speakers to disclose any relevant financial interest or other relationship with commercial entities that could pose a potential conflict of interest in the presentation of this educational activity. The Austen Riggs Center Continuing Medical Education Committee has established policies for identifying and resolving all conflicts of interest prior to this educational activity. The Austen Riggs Center accepts no commercial support of any kind to support our CME/CE activity.
The Austen Riggs Center Inc. also designates this live interactive webinar for 1 continuing education credit(s) (CE) for psychology.
Austen Riggs Center, Inc. is recognized by the New York State Education Department’s State Board for Psychology as an approved provider of continuing education for licensed psychologists #PSY-0115.
The Austen Riggs Center Inc. is approved by the American Psychological Association to sponsor continuing education for psychologists. The Austen Riggs Center maintains responsibility for the program and its content. For additional information about this program, please call the Erikson Institute Education Coordinator, at 413.931.5230.
Available Credit
- 1.00 AMA PRA Category 1 Credit™
ACCME - As a Jointly Accredited Organization, The Austen Riggs Center, Inc. designates this learning activity for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
- 1.00 APA
As a Jointly Accredited Organization, The Austen Riggs Center, Inc. designates this learning activity for 1.00 continuing education credit(s) (CE) for psychology. Continuing Education (CE) credits for psychologists are provided through the co-sponsorship of the American Psychological Association (APA) Office of Continuing Education in Psychology (CEP). The APA CEP Office maintains responsibility for the content of the programs.
Austen Riggs Center, Inc. is recognized by the New York State Education Department’s State Board for Psychology as an approved provider of continuing education for licensed psychologists #PSY-0115.
- 1.00 Contact Hours/ ParticipationA certificate of attendance for all Learners.