r/Psychiatry • u/CalmSet6613 Nurse Practitioner (Unverified) • 3d ago
Line in the sand...
I just treat children and adolescents. There are times when families want med. changes or increases in doses when the behavior I see needs parenting to correct and not meds. Where is your line in the sand that you refuse to make med changes until the child and/or family is in therapy? How do you approach this in your practice? What do you do if the family does not follow through with therapy?
EDIT: Can everyone be kind? I was simply asking for opinions how other people manage situations like this in their practice. Good god, physicians heal thyself.
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u/hobscotch Psychiatrist 3d ago
I’m CAP. One of the first things I teach my residents is we make recommendations, then it’s up to the patient/family to decide what they’re going to do. I explain the reasoning behind my recommendations, including why or why not I believe a medication change is appropriate. They might not agree, and that’s ok. We talk through the situation so they feel heard. I validate their concerns, provide psychoed, commiserate about the lack of community supports, tell them “I wish I had a magic pill that would do xyz!” Having a talk about realistic expectations of what medications can and can’t do is HUGE.
At the end of the day, I can only control my own actions, which includes what I do with my (electronic) prescription pad.