There's a Med for That! Trauma Psychiatrists Discuss How to Think About Medications for Complex Trauma and Dissociative Disorder Patients
This webinar is tailored both to therapists and prescribers who treat patients suffering from complex posttraumatic stress disorder (c-PTSD) and dissociative disorders (DDs), including dissociative identity disorder (DID). We will review the current evidence base involving the use of pharmacotherapeutic interventions in c-PTSD and DDs and review "shock absorber" model for approaching medication management in working with these conditions. We will review potential uses of specific psychotropic medication classes in treatment. Pharmacologic considerations in managing problems with sleep, pain, addiction, and severe mood and psychotic disorders will be discussed . We will discuss trauma-specific approaches to taking a personal, psychiatric, medical, and medication history when medication management is being considered. Practical approaches to providing psychoeducation and setting reasonable expectations around medication effects will be reviewed. We will highlight psychodynamic processes that frequently impact the prescribing and monitoring of psychiatric medications (including the monitoring of side effects). Similarly, we will discuss strategies for addressing discrepant presentations, in which a patient with c-PTSD/DD presents in one manner to their therapist but in another to their prescriber (treatment splitting). We will discuss specific medication-related psychodynamics that may arise specifically in the treatment of patients with DID. We will discuss communication strategies that therapists can use to discuss medications effectively both with clients and with prescribers.
Potential to Distress
Yes - low potential
We will need to reference the reactions of patients who were abused using drugs, who later are prescribed medications/drugs as part of treatment. However, we will not be delving into historical details.
45 Minutes - Introductions and Clinical Vingnette
30 Minutes - Shock Absorber Model
15 Minutes - Recent Updates
30 Minutes - Sleep, Additions, Pain, and Comorbid Severe Mental Issues
60 Minutes - Art of Psychopharmacology
This presentation was originally presented as a live webinar in October 2022.
At the conclusion of this webinar participants will be able to:
- Describe the shock absorber model of psychotropic medications in the treatment of complex PTSD and dissociative disorders
- Identify three phobias to taking medications that patients with complex PTSD and DDs often report
- Identify three areas of a client's history that are essential to explore before recommending consultation for psychotropic medication management
- Describe two practical approaches to providing psychoeducation to traumatized clients who are considering starting a psychotropic medication
- Explain ways to collaborate constructively with psychiatrists in planning and monitoring a psychotropic mediation trial
Presenter: Benjamin Israel, MD
Presenter Bio: Dr. Benjamin Israel is delighted to be participating in the ISSTD’s online education series. Dr. Israel is a Clinical Assistant Professor at the University of Maryland School of Medicine, Department of Psychiatry. He works at a variety of clinical sites focused on consultation-liaison and emergency psychiatry. In July 2022, Dr. Israel opened a trauma-focused outpatient community psychiatry clinic within the University’s Division of Addictions Research and Treatment. Dr. Israel is the lead author of a forthcoming publication exploring trauma-responsive addictions treatment and clinic management. Dr. Israel teaches and supervises psychiatry and psychotherapy trainees at all levels. He also sees private psychotherapy patients, most of whom suffer with complex posttraumatic and dissociative syndromes. Dr. Israel has presented to professional audiences locally, nationally, and internationally on the diagnosis and treatment of complex posttraumatic syndromes. He has developed and led workshops on trauma tailored for medical providers who are not mental health or trauma specialists. Previously, Dr. Israel worked at the Trauma Disorders Program at Sheppard Pratt Hospital, where he functioned as a psychiatrist, psychotherapist, clinical supervisor, and Service Chief. Dr. Israel graduated from the University of Pittsburgh School of Medicine and completed residency training at the University of Maryland / Sheppard Pratt combined residency program in Baltimore. He is board certified in adult psychiatry. He lives in Baltimore, Maryland, with his wife and their two sons.
Presenter: Rich Loewenstein
Presenter Bio: Presenter Biography: Richard J. Loewenstein MD is Clinical Professor of Psychiatry at the University of Maryland School of Medicine, Baltimore, MD. He is the founder of, and from 1987-2020 was the Medical Director of, The Trauma Disorders Program at Sheppard Pratt, Baltimore, MD. He is rated by U.S. News and World Report as among America’s top 1 % of psychiatrists. Dr. Loewenstein did a research fellowship at the National Institute of Mental Health in Bethesda, MD. In the past he was a faculty member of the Departments of Psychiatry at Yale University, New Haven, CT; George Washington University, Washington, DC; and University of California, Los Angeles, CA. He is the author of approximately 100 papers and book chapters on dissociation, dissociative disorders, and trauma disorders, among others. He is the Section Editor, Dissociative Disorders, of the American Psychiatric Association (APA), DSM-5 Text Revision (DSM-5TR), to be published in Spring, 2022. He is co-editor of the 4th Revision (in preparation) of the International Society for the Study of Trauma and Dissociation (ISSTD) Guidelines for Treatment of Dissociative Identity Disorder in Adults. Since 2000, he has been an author of the Dissociative Disorders chapter in Kaplan & Sadock’s Comprehensive Textbook of Psychiatry. He is leading the revision of the Dissociative Disorders chapter for the upcoming (11th) edition of this textbook. He is distinguished life fellow of the APA and, among other awards, has received the Lifetime Achievement Award of the ISSTD.
- 3.00 APAThe International Society for the Study of Trauma and Dissociation is approved by the American Psychological Association to sponsor continuing education for psychologists. The International Society for the Study of Trauma and Dissociation maintains responsibility for this program and its content.
- 3.00 ASWB ACEThe International Society for the Study of Trauma and Dissociation (ISSTD), #1744, is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved as ACE providers. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. ISSTD maintains responsibility for this course. ACE provider approval period: 08/20/2021 – 08/20/2024. Social workers completing this course receive 3.00 continuing education credits.
- 3.00 ISSTD Certificate ProgramThis program is eligible for 3.00 credits in the ISSTD Certificate Program.
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