ColgateX Medicating for Mental Health: Judicious Use of Psychiatric Drugs - PSYCRx Course Syllabus

Transcription

1 ColgateX Medicating for Mental Health: Judicious Use of Psychiatric Drugs - PSYCRx Course Syllabus Professor Scott Kraly Course Description The use of medications, herbaceuticals, or dietary supplements that aim to improve mental health is increasing globally. Although the increase in their usage acknowledges the legitimate utility of many of these pharmaceuticals and chemicals, their increased usage has outpaced scientific research evaluating the effectiveness and the safety of these chemical therapies for mental illness. In fact, the widespread, increasing use of drugs to treat diagnosed psychiatric disorders is due in part to (a) the prescribing of such drugs by professionals who lack training in psychiatry or in clinical psychology, (b) the prescribing of these drugs for children, adolescents, and the elderly despite a lack of scientific evidence that the drugs will be effective in those groups of people, and (c) the prescribing of these drugs in situations where a non-drug, behavioral therapy or psychotherapy may serve the better interests of the patient. Drugs used as psychiatric medications have their proper place, their strengths, and their limitations. Understanding when to use a psychiatric medication, having realistic expectations for what a medication can achieve toward relief of symptoms, and knowing how to weigh the benefits and risks of drug therapy can be difficult to accomplish. Choosing to use a psychiatric medication is a choice that should be made through an alliance between a responsible prescribing professional with expertise, and a patient who bears the burden of the problem to be treated. A collaborative effort of clinician and client increases the likelihood of successful use of a psychiatric medication a successful treatment that balances benefits and risks. But how is a patient or a client--especially someone who has little or no expertise in identifying the factors that either facilitate or diminish the successful use of a psychiatric medication able to act as an effective collaborator in developing a treatment program that includes psychiatric medication? The principal goal of this course is to offer the student information that is useful for facilitating the judicious use of medication for the treatment of psychological and behavioral disorders, such as depression, anxiety, schizophrenia, obesity, addiction, or ADHD. The course helps students to reach this goal in four ways: (a) Learn principles that facilitate making a judicious decision regarding the use of a psychiatric medication; (b) Gain a rudimentary understanding of the logic or evidence that supports these useful principles; (c) Learn strategies and techniques for using the internet to search for information helpful for making decisions related to the use of psychiatric medication; (d) Put what students have learned to the test by sharing their views with other students.

2 Altogether, the student should acquire a working knowledge important for gaining confidence that a psychiatric medication is being used wisely. Things that this course will not do include the following: (a) It will not provide specific advice regarding which drug is the best treatment to use for any psychiatric disorder; (b) It will not substitute in any way for a patient s need to consult with a physician, psychiatrist, or psychologist regarding the diagnosis or treatment of a psychological or behavioral problem; (c) It will not provide detailed information regarding specific psychiatric medications. Learning Outcomes The objectives of the course are to enable students: to appreciate the significance of the contemporary use of medications to treat diagnosed psychiatric disorders. to recognize the various factors that need to be considered in order to make judicious use of a psychiatric medication. to acquire realistic expectations for the ability of a psychiatric medication to improve symptoms of a diagnosed disorder. to understand how psychiatric medications are developed by the pharmaceutical industry. to understand how research on a drug s efficacy and relative safety can result in regulatory approval, resulting in the drug being marketed. to gain a basic understanding for how psychiatric medications alter the functioning of the brain. to appreciate how a psychiatric medication is likely to be most effective when used as part of a treatment program that includes psychotherapy, behavior therapy, or counseling. to begin to appreciate some of the problems for using psychiatric medications to treat children, adolescents, the elderly, and people of different cultures. Interacting with Course Content No background in psychology or neuroscience is required, but having taken a high school or introductory collegiate level course in psychology might enrich the student s experience in this course. The video presentations by Professor Kraly are delivered in a conversational style that minimizes the use of professional jargon, and includes helpful

3 definitions of potentially unfamiliar terms. The video presentations also include unscripted interviews/conversations with two clinical psychologists. The expected commitment of time for Medicating for Mental Health is between two (2) and (6) hours per week. Medicating for Mental Health is four (4) weeks long. Material for each week will be released on Wednesday of each section. Material will include video presentations, case study vignettes related to the Discussion Forum, a Resources for Further Learning unit, and assessment test questions. Recommended (but not required) readings will be posted weekly for students who wish to learn more about specific topics that are presented in the video presentations. Students will have the opportunity to submit questions to the Discussion Forum, and can engage with other students on the Twitter feed for the course. Exchanging Ideas There are several ways you can exchange ideas with other students in the course. Exchanging ideas is not a requirement for the course, but we encourage you to explore these several opportunities: Discussion Forum: This is a common way for exchanging ideas and engaging with other students in the course. There are two features of the Discussion Forum: A weekly Case Study Vignette will be used to provoke discussion related to issues raised in the video presentations for the week. In addition, students may make an entry into General Discussion regarding any issues raised in the video presentations, or provoked by a student doing optional recommended supplementary reading, or a student using the research tools offered in the Resources for Further Learning unit. Twitter: The Twitter feed for the course will provide the opportunity for PSYCRx students and staff to post brief comments related to course content. For example, there will be postings that draw your attention to current news stories that are related to topics in the course. The unique hashtag for the course #PSYCRx provides access to the course s Twitter feed. You are not required to participate in Twitter for this course. Resources for Further Learning Your participation in this course demonstrates a willingness to engage in self-education. The process of self-education can be bolstered by learning about and understanding the structures and characteristics of information resources, and the processes of information discovery and retrieval. The Resources for Further Learning section of each Week serves to help students to become more capable in discerning the relevance and veracity of information resources. This is particularly important in regard to health and medicine, as consequences for use or misuse of information can be critical to human life and wellbeing. Correctly assessing the authority and competence of information providers in the area of human health care is crucial for judging the quality and usefulness of information provided. Each Week, the Resources for Further Learning section will include:

4 Online information resources relevant to the week s material Explanation of the criteria used for selecting these resources Sample searches of these information resources General search concepts that you can use within this course and elsewhere You also can use these resources and techniques to enhance your contributions to the weekly Case Study discussion. Course Completion and Certification/Verification Requirements At the end of each week of the course, students will be asked to take a quiz on the material from that week. The questions on the assessments are based upon material available in the video presentations. Students should be able to perform well on the assessments without having done optional supplementary reading. Performance on these four assessments in addition to a final assessment test will be combined to determine overall performance in the course. To earn a certificate of completion, participants must have demonstrated successful completion of at least 80% of the course material as measured by the 5 assessments. This work must be completed prior to October 1, Students who choose to not participate in the course assessments are welcome to audit the course by engaging as much as possible. Course Outline and Schedule Week 1 The Proper Role of Psychiatric Medications (available August 26, 2015, 16:00 UTC) Module 1 Introduction Module 2 Does it make sense to medicate for psychiatric illness? Module 3 How are psychiatric medications discovered? Optional Supplementary Reading Resources for Further Learning--US government sources Case Study Vignette for Week 1 Assessment for Week 1 (due September 9, 2015) Week 2 The Brain s Response to Psychiatric Medications (available September 2, 2015, 16:00 UTC) Module 1 What do psychiatric medications do to the brain? Module 2 What can we realistically expect when medicating for mental illness? Optional Supplementary Reading Resources for Further Learning--non-US government and intergovernmental organization sources Case Study Vignette for Week 2 Assessment for Week 2 (due September 16, 2015)

5 Week 3 How Does One Know If a Psychiatric Medication Will Be Effective? (available September 9, 2015, 16:00 UTC) Module 1 What is the evidence that psychiatric medications are effective? Module 2 What factors determine whether a psychiatric medication will be available and effective? Optional Supplementary Reading Resources for Further Learning--commercial and business sources Case Study Vignette for Week 3 Assessment for Week 3 (due September 23, 2015) Week 4 Reasonable Expectations for Psychiatric Medications (available September 16, 2015, 16:00 UTC) Module 1 What special problems face children, adolescents, and the elderly being treated with psychiatric medications? Module 2 What does the immediate future hold for medicating for psychiatric illness? Optional Supplementary Reading Resources for Further Learning--non-profit, advocacy, and non-governmental sources Case Study Vignette for Week 4 Assessment for Week 4 (due September 30, 2015) Final Assessment (due September 30, 2015) All edx dates and times, including the release dates and times for this course, are listed in Universal Time Coordinated (UTC). US Eastern Daylight Time (EDT) is UTC minus 4 hours so our course weeks will publish at 12:00PM EDT on the listed day. Suggested Readings Please refer to the Supplementary Reading and the Resources for Further Learning menu items in the course site for supplementary course readings. Discussion Forum Guidelines One goal of this course is to provide you with the opportunity to interact with other students through the use of a discussion forum. Throughout this course you have the opportunity to connect to a global community. You are able to explore course topics and material with a variety of individuals with diverse backgrounds, experiences, and knowledge. Your active and thoughtful participation in the discussion forums will help you connect with and strengthen the course community, and provide you opportunities to strengthen

6 your understanding of course topics and materials. Your interactions with other course participants will likely impact your own thoughts, feelings, and perspectives. Guidelines Please consider the following guidelines when you create a post, response, or comment in a discussion forum: Get involved! Create posts, responses, and comments to ask and answer questions, or develop or introduce ideas. Be polite and respectful. Do not create a post, response, or comment that you would not make to anyone face to face. Create titles and posts that are concise but descriptive. Check the topics in the discussion forum before you post, you may be able to participate in a current discussion instead of creating a new post. As needed, include proper citations and references. Use proper spelling and grammar. Avoid using sarcasm or making jokes. These are easily misinterpreted. Do not use abbreviations or excessive punctuation, or write in all caps. Logistics For more information about navigating the discussion forums, check out the edx Course Discussion documentation linked here: 13.3 Explore Posts 13.4 Add, Edit, Delete a Post, Response, or Comment 13.5 Keep Up with New Activity 13.6 Provide Feedback on Contributions Discussion Forum Instructions There are two parts to the Discussion Forum: The Case Study Vignette, and the General Discussion. Important note. The Discussion Forum is intended to encourage students to consider information that informs the making of judicious decisions regarding the use of psychiatric medications generally. It is not intended to provide a source of advice specific to a personal clinical situation that any student in the course is facing. The opinions offered in the Discussion Forum are not to be taken as professional advice. The Forum is an opportunity to exchange opinions in a setting that attempts to model a discussion that might take place in a seminar course.

7 Case Study Vignette The case study vignette is intended to encourage you to consider many of the major issues raised in the video presentations for each Week, and then to apply what you have learned to the situation of the patient being presented in the case. Read the vignette for the Week twice. The first time, read it simply to get a feel for the situation for the patient, the clinician, and the patient s family. The second time, read it and form your opinions regarding the advice you think that this patient should receive, or the questions you think this patient should ask, from anyone the patient might consult for advice. As you do this, adopt one perspective of either a patient, a member of the patient s family, a prescribing physician, a psychotherapist, or a mental health caregiver (e.g., psychiatric nurse, social worker, etc.). Select one of these two tasks (below) and make an entry into one of the six categories in the Case Study portion of the Discussion Forum: 1. What would you decide to do if you were in the patient s situation? What or questions would you ask of the professionals you consulted? 2. What questions would you encourage the patient to ask of the professionals the patient consults? What would you encourage the patient to consider as he contemplates his situation? Select one of the two Tasks identified above. If you choose to make an entry in the Case Study Discussion Forum, select one of the six identified categories that best fits the role you have adopted: Patient; Physician (with drug prescribing responsibility); Psychotherapist (not able to prescribe medication); Family member; Friend of patient; Mental health caregiver. Feel free to speak as any responsible adult would, drawing upon what you have learned from the video presentations for the course (and from optional suggested readings or other reading you may yourself have discovered) or from personal experience to inform your advice or opinion. If you like, you can use the tools and resources introduced in Resources for Further Learning (listed under Courseware) in order to find information to support your Discussion Forum entries. Whether or not you make an entry in the Case Study Discussion Forum, feel free to engage in the conversations that are provoked by the entries made by other students in any or all of the six categories specified above. [Students are not required to participate in the Case Study Discussion Forum. But reviewing the video presentations (or your notes) and participating in the Case Study Discussion Forum conversations might provide a useful means of reviewing material prior to the Assessments for each week of the course.] General Discussion

8 In the event that you would like to initiate a conversation about an issue that does not fit the Case Study section of the Discussion Forum, please make an entry into the General Discussion category. Please keep in mind that the Discussion Forum is not a proper place to seek professional advice for a personal mental health issue, nor is it a proper place to expect to receive professional advice for a personal issue. Code of Conduct and Honor Code 1. PURPOSE A primary goal of Colgate University s edx initiative is to support learning by large numbers of course participants with varied and diverse backgrounds. As such, we are committed to providing a friendly, safe and welcoming environment for all, regardless of gender, sexual orientation, ability, ethnicity, socioeconomic status, and religion (or lack thereof). All course participants are expected to adhere to this Code of Conduct and the edx Terms of Service and Honor Code ( These documents outline our expectations for all those who participate in the course, as well as the consequences for unacceptable behavior. We invite all course participants to help us create safe and positive experiences for everyone. 2. OPEN EDUCATION CITIZENSHIP A supplemental goal of this Code of Conduct is to increase citizenship in the course community by encouraging participants to recognize and strengthen the relationships between our actions and their effects on our community. Communities mirror the societies in which they exist and positive action is essential to counteract the many forms of inequality and abuses of power that exist in society. If you see someone who is making an extra effort to ensure our community is welcoming and friendly, and who encourages all participants to contribute to the fullest extent, we want to know. 3. EXPECTED BEHAVIOR The following behaviors are expected and requested of all community members: Participate in an authentic and active way. In doing so, you contribute to the health and longevity of this community. Exercise consideration and respect in your speech and actions. Attempt collaboration before conflict. Refrain from demeaning, discriminatory, or harassing behavior and speech. Be mindful of your interactions and of your fellow participants. Alert course staff if you notice violations of this Code of Conduct or edx Terms of Service and Honor Code, even if they seem inconsequential.

9 4. UNACCEPTABLE BEHAVIOR Unacceptable behaviors include: intimidating, harassing, abusive, discriminatory, derogatory, or demeaning speech or actions by any participant in our community online or in one-on-one communications carried out in the context of community business. Harassment includes: harmful or prejudicial verbal or written comments related to gender, sexual orientation, race, religion, or disability; inappropriate use of nudity and / or sexual images; deliberate intimidation, stalking or following; harassing photography or recording; sustained disruption of staff or student course material; inappropriate contact, and unwelcome sexual attention. 5. CONSEQUENCES OF UNACCEPTABLE BEHAVIOR Unacceptable behavior from any course participant, including staff and those with decision-making authority, will not be tolerated. Anyone asked to stop unacceptable behavior is expected to comply immediately. If a course participant engages in unacceptable behavior, the course staff may take any action they deem appropriate, up to and including a permanent expulsion from the course, consistent with the edx Terms of Service and Honor Code. 6. IF YOU WITNESS OR ARE SUBJECT TO UNACCEPTABLE BEHAVIOR If you are subject to or witness unacceptable behavior, or have any other concerns, please notify the course staff as soon as possible. Please direct your concerns to psycrx.colgatex@colgate.edu. Our course staff will work with the participant engaging in the unacceptable behavior to either correct the situation or end their participation in the course. 7. ADDRESSING GRIEVANCES If you feel you have been falsely or unfairly accused of violating this Code of Conduct or the edx Terms of Service and Honor Code, you should notify course staff (psycrx.colgatex@colgate.edu) with a concise description of your grievance. 8. SCOPE We expect all course participants to abide by this Code of Conduct and the edx Terms of Service and Honor Code in all community venues online and in-person as well as in all one-on-one communications pertaining to community business. 9. LICENSE AND ATTRIBUTION This Code of Conduct is distributed under a Creative Commons Attribution-ShareAlike license and was modified from by David Wiley. Course Help/Support

10 EdX includes a Help tab on the left side of the course page to allow you to report a problem, ask a question, or make a suggestion to the edx Student Support team. This support applies to the general use of the edx platform and not this specific course. Questions about course lectures, materials, or tools should be posted in the Help/Support section of the course discussion forum. Our staff will respond to your questions through the discussion forums and may provide additional feedback in the Course Info under Course Updates & News. Please be aware that due to the number of participants enrolled in this course it is not possible for Professor Kraly or members of the Course Team to view or respond to every question or comment within the course. Our course development team works and lives in Hamilton NY US. As such, our hours of involvement will typically be Monday through Friday from 12:30 to 20:30 UTC [8:30AM to 4:30PM EDT]. However we will do our best to provide you with the support you need whenever possible.