Accentuate the Positive: Strengths-Based Therapy for Adolescents.

PURPOSE: The field of psychiatry has conventionally employed a medical model in which mental health disorders are diagnosed and treated. However, the evidence is amassing that using a strengths-based approach that promotes wellness by engaging the patient's assets and interests may work in synergy with the medical model to promote recovery. This harmonizes with the patient-centered care model that has been promoted by the Institute of Medicine. METHODS: The article uses a clinical case to highlight the attributes of a strength-based model in the psychiatric treatment of adolescents. RESULTS: Outcome metrics from a number of studies have demonstrated enhanced youth and parent satisfaction and decreased use of hospital level of care with the implementation of strengths-based therapeutic modalities. IMPLICATIONS: Incorporating strengths-based interventions into conventional psychiatric practice provides a multi-faceted treatment approach that promotes recovery in children and adolescents with psychiatric disorders.

How to manage conflicts of interest with industry?

The use of medications has risen steadily in psychiatry. Perhaps in response, during the past few years there has been increasing scrutiny of alleged unethical behaviours by medical researchers, educators, and practitioners secondary to influence by the pharmaceutical industry. Research is quite consistent that gifts and generous financial arrangements can dampen skepticism, sometimes unconsciously, and thereby persuade recipients to advocate for or prescribe medications that are more expensive, but no more effective, than alternatives. Interestingly, this research-backed premise that physicians can be lured by gifts remains often disbelieved by recipients. Adding to such inducements to prescribe new, expensive medications are pressures from patients due to the increasing ubiquity of direct-to-consumer advertising. Criticism from patient advocate groups, government agencies, and the press has sparked debate within the profession. Many medical journals, academic medical centre research and educational endeavours, and medical organizations are reviewing policies to eliminate, or better manage, their conflicts of interest with industry. The basic ethical standard is that although pharmaceutical companies' primary concern is for its shareholders, physicians' primary concern must be for their patients.

An experiment in graduate medical education: combined residency training in pediatrics, psychiatry, and child and adolescent psychiatry.

As an experiment in graduate medical education, a 5-year curriculum in pediatrics, psychiatry, and child and adolescent psychiatry was developed and evaluated over a 10-year period. The evaluation results suggested that the program's goal to create a cadre of specialists was achieved in terms of recruitment, performance during training, fostering of clinical reasoning ability, board certification rates, and postgraduate activities. As a result, the American Boards of Pediatrics and of Psychiatry and Neurology decided to make the combined training track permanent, and the numbers of training sites and residents have since been expanded.