At the Veteran Health Administration, there are veterans who have never sought psychiatric care during or even many years after their military service and when they are screened positive for depression on their Patient Health Questionnaire-9 (PHQ9) or finally come in requesting help for the PTSD, they remain fearful of any kind of psychotropic medication trials and opt for psychotherapy, thinking it is only one or the other treatment option. This session will look at the barriers associated with treatment resistance to medications and various ways team members in an integrated care system can address them appropriately to improve patient adherence and overall outcomes. Even though psychotropic medication use is the focus here, there should still be awareness of evidenced-based treatment for EACH individual without so-called “mindless prescribing”. Lastly, building trust, improving communication, and strengthening the clinician-patient relationship remain at the heart of both health psychology and psychodynamic psychopharmacology views on patient adherence.
Mintz, D. (2022). Psychodynamic Psychopharmacology: Caring for the Treatment-Resistant Patient. American Psychiatric Association Publishing.
DiMatteo, M. Robin, Leslie R. Martin, and Kelly B. Haskard-Zolnierek, Health Behavior Change and Treatment Adherence: Evidence-based Guildelines for Improving Healthcare; 2nd edition (New York, 2025; online edition, Oxford Academic, 22 May 2025)
Nieuwlaat R, Wilczynski N, Navarro T, et al. Interventions for enhancing medication adherence. Cochrane Database Syst Rev. 2014;2014(11):CD000011. Published 2014 Nov 20. Doi:10.1002/14651858.CD000011.pub4
Brown M. Books: Evidence-biased Antidepressant Prescription: Overmedicalisation, Flawed Research, and Conflicts of Interest: A Deep Dive into the Evidence. Br J Gen Pract. 2022 Feb 25;72(716):126.
Mintz D, Dotson S, Markowitz JC, Thase ME. The 16-Minute Hour: Combining Abbreviated Psychotherapy With Medication Visits. Part 3: Psychodynamic Therapy. J Psychiatr Pract. 2025;31(4):217-221. Published 2025 Jul 1