One of the difficulties that all psychiatrists encounter when they see patients for less than fifty minutes is how to be empathic while on the run. Nowadays the psychiatrist, often behind schedule, has but a Twenty Minute Hour to evaluate a patient's level of functioning and current symptoms and side effects; to judge their responsiveness to medication; to do some teaching about medication and/or disease management; and finally to complete the chart. Prime Time gives pointers from an experienced clinician on how to deal more effectively and efficiently within time constraints. It is designed to assist psychiatrists with medication and evaluation, and to allow for psychotherapy in addition to the requisite psychopharmacology. The primer provides a number of short cuts and clinical maneuvers in initiating and ending sessions that can help promote positive transference, assist effective flow of information, and aid in closing out the session without falling behind schedule.
Introduction. Part I: Ways to Make the Twenty Minute Hour Work for You. Beginnings -- Not a Moment to Spare. Measuring Symptoms. Setting the Contract. Decisions, Decisions. Psychoeducation/Teaching. Shortcuts: How to End on Time. Early and Later Pitfalls. Terminating Treatment. Part II: QUICK GRAB Answers for Specific Problems. Working with the Depressed Patient. Working with the Bipolar Patient. Working with the Anxious Patient. Working with the Traumatized Patient. Working with the Angry or Violent Patient. Working with the Somatizing Patient. Working with the Patient with Mild Schizophrenia. Working with the Questionably Psychotic Patient. Working with the Adolescent Patient. Working with the Elderly Patient. Working with the Borderline Personality Patient. Working with the Mildly Retarded Patient. Working with the Suicidal Patient. Working with the Pregnant Patient. Working with the Divorcing Patient. When Your Patient (or you) Are Being Stalked. When Tragedy Befalls You, or Your Patient. The Vulnerable Clinician. Part III: Useful References.