Contact between psychotherapists and psychiatric residents who provide medication backup.

OBJECTIVE: Psychiatric residents frequently prescribe medication for patients who are in psychotherapy with another clinician. This study examined the extent and characteristics of communication between psychiatric residents and psychotherapists who treated patients in a university outpatient clinic. METHODS: Thirteen psychiatric residents who prescribed medications for 83 patients seen by other clinicians for therapy were surveyed about whether and how often during a five-month period they had contact with the therapist, who initiated the contact, and whether it took place with the patient's consent. Patients' charts were reviewed to determine if contacts were documented. RESULTS: The psychiatric residents indicated they had contact with the therapist in 44 of 83 cases (53 percent). Contact was initiated by the prescribing psychiatrist in 47.7 percent of the cases and by the therapist in 43.2 percent of the cases. The charts of only seven patients (8.4 percent) included written documentation of contact. CONCLUSIONS: Several steps are necessary to optimize communication between treating clinicians and documentation of such communication. They include initial contact to discuss the treatment contract and clarify each clinician's responsibilities, formal written consent from the patient, regular contacts between clinicians to discuss the patient's progress, and collaboration between clinicians on the patient's treatment plan.

Medication backup: attitudes and practices of psychiatrists and residents.

Twelve residents and 12 attending psychiatrists in the adult division of a university-based department of psychiatry responded to a 20-item questionnaire about medication backup, or the provision of psychotropic medications for a patient treated in psychotherapy by another clinician. The attending psychiatrists and residents did not differ significantly in their attitudes about and practices of medication backup. Results of this preliminary study indicated that about half of both groups saw between one and five patients a month for this purpose. All except one respondent believed that medication backup may have a detrimental effect on treatment.

Neurology training in psychiatry residency : self-assessment and standardized scores.

Keeping pace with advances in neurosciences is, in part, predicated upon an adequate knowledge of neurology obtained during the psychiatrist's residency training. Results from a questionnaire assessing resident abiliities in neurology and psychiatry were compared with Psychiatry Resident In-Training Examination (PRITE) scores. Self-confidence for treating neurological disorders declined with the progression of training; however, neurology PRITE scores improved significantly. Psychiatric PRITE scores and psychiatric self-confidence also improved over time. These findings have implications for current residency training criteria and education.