|INTERVIEWING TIP OF THE MONTH
# 102 August 2008
A Family That Takes Meds Together Stays Together
TISA Description of the Problem: As we continue moving through the year 2008, we have a very special series of "Tips of the Month." In 2007 our TISA website was honored by having the following article, "My Favorite Tips from the Clinical Interviewing Tip of the Month Archive" published in the Psychiatric Clinics of North America (Shea, SC: Psychiatric Clinics of North America, June 2007,Vol 30:#2, 219-225). The clinical interviewing tips in this article all appeared on this website. During the first eight months of 2008 they will now be re-posted with some additional comments - exactly as they appeared in the journal. Congratulations to all of the contributors whose tips were chosen as the very best! Let us now look at our eighth and final tip from the article.
With young patients, the idea that they have "been singled out" as needing medications can be stigmatizing and hard to process in a healthy manner. The following insightful tip by Rory Sellmer, a fourth-year resident in psychiatry at the University of Calgary can prove to be creative and effective in diminishing this problem..
Tip: I encourage families to take their medications together to normalize the experience. This seems to work particularly well with young patients with psychosis. For example I might ask:
"What would it be like for you if you were to take your medications every night at the same time your Mom is taking her blood pressure medication?"
I also encourage the parents to make this a time to check in with symptoms.
TISA Follow-up: The art of learning and teaching clinical interviewing is always filled with delightful surprises and here is one of them from Dr. Sellmer. He first shared this tip with me when I was presenting in Calgary, and as soon as I heard it, I loved it. It is a delightful way to normalize taking medications, and it can be used frequently, for many parents are taking some type of medication. It helps the family members to view their illnesses as the problem, not themselves, emphasizing that the family is working together against the illnesses with which they are all coping. In addition, I think that it is useful to sometimes turn to the adolescent patient and say, "You know, it's also a great time for you to ask your Mom how things are going with her heart problems." This comment further cements the shared reality that "it is us against our illnesses, not us against each other."
Tip provided by:
Fourth-year resident in psychiatry
University of Calgary
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