The Process of Medications to Augment CBT: Who? When? Why? How?

To medicate, or not to medicate, that is the question: Whether 'tis preferred in the mind to suffer The slings and arrows of continued impairment, Or to take Arms against a Sea of exposure challenges, And by opposing end them: to rise above the anxiety; say we end the heartache…

Parents often agonize as they consider the challenging decision to add medicine as an adjunct to their child’s behavioral treatment or not. While we have taken liberties with Shakespeare’s famous Hamlet soliloquy, it actually captures the palpable sense parents often have of being torn: will my child’s benefits of...Read more medicine be outweighed by what we as parents perceive as the disadvantages. The professional evidence in peer-reviewed journals is fairly consistent that combined pharmacotherapy and cognitive-behavioral therapy (CBT) leads to greater outcomes than either mono-therapy alone. To quote a recent thorough peer-reviewed analysis in the Journal of Clinical Child and Adolescent Psychology (Taylor et al., 2017): “… a combination of CBT and a selective serotonin reuptake inhibitor, not monotherapy, is likely key for achieving remission in severe anxiety.” It is also true that Ginsburg et al. (2018) provide a more sobering interpretation of the longer-term outcomes for child anxiety treatment. Yet cultural prejudices taint parental expectations and induce fear, reducing the likelihood of parents considering this option.

This presentation will guide non-prescribing behavioral clinicians through the process of considering adjunctive medication, including considerations of which patients, at what point in the treatment process and most importantly how to work with the parental ambivalence that will most assuredly arise in the vast majority of cases. Careful consideration will be given to the ethical and legal limits for psychologists when it comes to discussions of medications. Dr. Kurtz will share his now commonly accepted and oft cited algorithm (Kurtz, 2009) for suggesting which child patients under which conditions might be more suitable candidates for medication augmentation to CBT. The presentation will describe how parents can be good consumers and actively engaged in the titration process to increase their sense of agency.
Less...

Learning Objectives

• Describe 3 reasons to consider medication for a child who is already getting some behavioral therapy.
• State how long experts prefer for children to continue taking anti-anxiety medication,
• Discuss the safety and effectiveness of medicines in the largest and longest child RCTs for ADHD and anxiety, i.e., the MTA, PATS and CAMS studies.

Learning Levels

• Introductory
• Intermediate

Friday, January 10, 2020

12:00 PM EST - 01:00 PM EST