As a Psychiatric Social Worker, and not a physician, I still spend a lot of time and energy discussing with my clients their medications, especially their psychotropic ones with them.
Knowing about the power of the placebo effect I am very cognizant and curious about what my clients think about their medications. Do they think they will help, are skeptical, or have mixed feelings? Will they be compliant and take them as prescribed or “forget” to take them or abuse them?
There is a fine line between medical and psychological effects of taking medications. Many of my clients expect medications to be a “silver bullet” and a “magical key” to ameliorate their symptoms and improve their experience of their quality of life.
Whether medications “work” has as much to do with psychological expectations as well as the pharmacological actions. Whose job is it to monitor the efficacy of the use of medications: the prescriber, the psychotherapist or both?
Throughout my career as a Psychiatric Social Worker I have increasingly found that it is my job if I want to help my clients improve their functioning. I find myself surprised at the lack of supervision by the prescriber on the psychological dynamics of prescribing medications. They don’t seem to have the time for it or an interest or competence in this aspect of their patients' treatment. They leave it up to the psychotherapist if the patient has one.
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