Shrink Rap: Three Psychiatrists Explain Their Work

Shrink Rap: Three Psychiatrists Explain Their Work

Shrink Rap: Three Psychiatrists Explain Their Work

Shrink Rap: Three Psychiatrists Explain Their Work

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Overview

Finally, a book that explains everything you ever wanted to know about psychiatry!

In Shrink Rap, three psychiatrists from different specialties provide frank answers to questions such as:

• What is psychotherapy, how does it work, and why don't all psychiatrists do it?
• When are medications helpful?
• What happens on a psychiatric unit?
• Can Prozac make people suicidal?
• Why do many doctors not like Xanax?
• Why do we have an insanity defense?
• Why do people confess to crimes they didn't commit?

Based on the authors' hugely popular blog and podcast series, this book is for patients and everyone else who is curious about how psychiatrists work. Using compelling patient vignettes, Shrink Rap explains how psychiatrists think about and address the problems they encounter, from the mundane (how much to charge) to the controversial (involuntary hospitalization). The authors face the field's shortcomings head-on, revealing what other doctors may not admit about practicing psychiatry.

Candid and humorous, Shrink Rap gives a closeup view of psychiatry, peering into technology, treatments, and the business of the field. If you've ever wondered how psychiatry really works, let the Shrink Rappers explain.


Product Details

ISBN-13: 9781421400129
Publisher: Johns Hopkins University Press
Publication date: 06/01/2011
Pages: 272
Product dimensions: 5.90(w) x 8.90(h) x 0.70(d)
Age Range: 18 Years

About the Author

Dinah Miller, MD, is a psychiatrist in Baltimore, where she is an assistant professor of psychiatry at Johns Hopkins School of Medicine.

Annette Hanson, MD, is an assistant professor of psychiatry at the University of Maryland School of Medicine and Johns Hopkins University School of Medicine. Drs. Miller and Hanson are coauthors of Shrink Rap: Three Psychiatrists Discuss Their Work.

Steven Roy Daviss, M.D., also on the faculty at the University of Maryland, is a hospital-based psychiatrist and medical informatician and is chair of the Department of Psychiatry at Baltimore Washington Medical Center. He is the co-creator of Shrink Rap, a blog by psychiatrists for psychiatrists, and My Three Shrinks, a podcast series about psychiatry.

Table of Contents

Introduction 1

A Note about Our "Patients" and Our "Doctors" 4

Chapter 1 Melissa and Oscar: Getting Help 5

What are the different types of mental health professionals?

What is a psychiatrist?

What is a forensic psychiatrist?

When a patient should see a psychiatrist rather than a primary care doctor

What is split treatment?

When a patient should see a psychiatrist for psychotherapy

When is split treatment better than care with only a psychiatrist?

Chapter 2 Josh: A Walk through the System 21

The psychiatric evaluation and the mental status exam

The importance of outside informants

What is a chemical imbalance?

How psychiatric diagnoses are determined

Involuntary commitment to a psychiatric unit

What are a patient's rights during hospitalization?

Chapter 3 The Brandt Family: Why People Seek Care 42

For psychiatric disorders

When life gets hard and stress causes symptoms

For psychiatric symptoms caused by medical illnesses

For maladaptive personality styles

For addictive or compulsive behaviors

For suicidal thoughts or behaviors

For insight and education

Chapter 4 Tara: Let's Talk 61

What is psychotherapy?

What are some different types of psychotherapy?

How psychiatrists learn to become psychotherapists

How are research studies conducted on psychotherapy as a treatment?

What people talk about in psychotherapy

What the psychiatrist does in psychotherapy

Privacy and confidentiality in the therapeutic relationship: on keeping secrets and minding HIPAA

Special exceptions: child custody subpoenas and the Patriot Act

Self-disclosure by the therapist

How long should treatment last?

Chapter 5 Josh Revisited: "Ask Your Doctor to Prescribe" 82

How psychiatric medications are (sort of) classified

How a doctor chooses a medication

Informed consent

Complementary and alternative treatments

How doctors dose medications

What happens when conventional treatments don't work?

Why psychiatrists don't like Xanax

Addictive medications in the treatment of the psychiatric patient

Chapter 6 Becca: When Things Go Wrong 99

Difficulties with communication and poor patient-doctor fit

Recovered memory therapy

Disorders induced by the psychiatrist

When psychotherapy is inappropriately used as the only treatment

Side effects and adverse reactions from medications

Black box warnings

Antidepressants and suicide in young people and how the FDA decides on black box warnings

Boundary violations

Therapists who exploit patients

Chapter 7 Eddie: A Child at Risk 122

Health care proxies, advance directives, and medical decision making for the dying patient

Informed consent and medical decisions for minors

Juvenile delinquency and the legal system

Custody evaluations: who gets the child?

Chapter 8 Eddie: The Prison Patient 135

Specialty mental health courts and compelled treatment

Interrogation and why criminals confess

Psychopaths versus sociopaths and whether they can be treated

The insanity defense

What becomes of the insanity acquittee?

Psychiatric care in jail and in prison

Civil commitment of sex offenders

Chapter 9 Mitchell: Hospital-based Psychiatry 158

What happens in the Emergency Department?

Finding a hospital bed for a psychiatric patient: insurance approval and bed availability

What happens during a psychiatric hospitalization?

Patient education, family involvement, and therapy

The agitated patient: restraint, seclusion, and forced medications

Shock treatments, or electroconvulsive therapy (ECT)

Bargaining for beds: insurance (again) and how psychiatric beds get allocated

Electronic health records

Day hospitals, or partial hospitalization programs

The consultation-liaison psychiatrist

Chapter 10 Sharon: The Business of Psychiatry 183

Psychiatrists and insurance networks: how it all works

The missed appointment: no-shows and late cancellations

Preventing lawsuits

Providing safe environments for violent patients

When the patient assaults the psychiatrist

Changes in the patients ability to pay for care

Influences of the pharmaceutical industry

Happy birthday! Gifts from patients

Chapter 11 Things We Argue About 201

Health care reform and how we allocate our treatments

What constitutes a psychiatric disorder: diagnostic criteria in the DSM age

Psychiatric disabilities and deciding who deserves special accommodation

Psychiatric disabilities in the workplace, from pilots to presidents

Medications with addictive potential

Medical marijuana for psychiatric disorders

Complementary and alternative treatments

The recovery model

Chapter 12 The Future of Psychiatry 221

More than just medicines and psychotherapy: VNS, DBS, and rTMS

Just beginning: genetics, brain structure and function, and neuroplasticity

Psychopharmacogenetics: scientific gains that will lead to treatments based on each patient's biology

Acknowledgments 227

Sources and Suggested Reading 231

About the Authors 239

Index 247

What People are Saying About This

From the Publisher

One of the most useful books I’ve read about mental illnesses—and as the father of a son with a severe mental disorder, I’ve read just about all of them. It demystifies our complicated medical and legal system, explaining everything from 'chemical imbalances' to involuntary commitment procedures to the most recent advances in brain mapping. If you have a mental disorder, love someone who has one, or are a doctor, therapist, social worker, lawyer, judge, or criminal justice professional, you need to read this book.
—Pete Earley, New York Times bestselling author of CRAZY: A Father’s Search through America’s Mental Health Madness

In the too-often confusing and fractured world of mental health services, Shrink Rap is a ready resource for patients and their families looking for more insight into the range of services available and how they are delivered.
—Keith Ablow, M.D., psychiatrist, Fox News contributor, and coauthor of The 7: Seven Wonders to Change Your Life

Keith Ablow

In the too-often confusing and fractured world of mental health services, Shrink Rap is a ready resource for patients and their families looking for more insight into the range of services available and how they are delivered.

Keith Ablow, M.D., psychiatrist, Fox News contributor, and coauthor of The 7: Seven Wonders to Change Your Life

Pete Earley

One of the most useful books I’ve read about mental illnesses—and as the father of a son with a severe mental disorder, I’ve read just about all of them. It demystifies our complicated medical and legal system, explaining everything from 'chemical imbalances' to involuntary commitment procedures to the most recent advances in brain mapping. If you have a mental disorder, love someone who has one, or are a doctor, therapist, social worker, lawyer, judge, or criminal justice professional, you need to read this book.

Pete Earley, New York Times bestselling author of CRAZY: A Father’s Search through America’s Mental Health Madness

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