Psychiatry & Psychotherapy Podcast Psychopharmacology Mediators With Dr. Goldberg
Mar 8, 2022
Joseph F. Goldberg, psychiatrist and clinician-researcher with 180+ publications and three books, discusses practical psychopharmacology and translating trials into real-world care. He covers tailoring treatments to patients, the role of adherence and life stressors as mediators, cognitive symptoms and off-label pharmacologic options, substance use complications and motivational interviewing, and practical testing like drug levels and pharmacogenetics.
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Forecast Non-Adherence And Collaborate
- Anticipate and address non-adherence proactively by forecasting it with patients and collaborating on barriers.
- Joseph F. Goldberg says tell patients most people struggle with meds and invite them to tell you early so you can troubleshoot together.
Therapeutic Alliance Amplifies Treatment Effect
- Maximize therapeutic alliance to boost placebo-like benefits that improve real-world outcomes beyond trial data.
- Goldberg notes trials minimize engagement to reduce placebo, but clinicians should use psychotherapeutic skills to enhance response.
Stress Response Shows True Treatment Benefit
- Assess resilience by observing how patients handle stress after starting treatment as the true test of recovery.
- Goldberg compares this to a cardiac stress test: provoked stress reveals if treatment built resilience.
