Despite the increasing popularity of psychiatric meds as the go-to remedy for everything from seasonal depression to social anxiety, drugs are often not the best treatment alternative. That’s why, according to psychiatrist Steven Dubovsky, author of Psychotropic Drug Prescriber’s Survival Guide, a thorough, systematic approach to assessment is so important—and it starts with therapists.
Dubovsky believes that the decision to begin a drug trial should follow a process of scientific hypothesis testing. As he explains in this brief video clip with Networker Editor Rich Simon, he implements a certain algorithm to see why something isn’t working.
As Dubovsky explains, therapists should have a hypothesis about what might be causing a client’s suffering and investigate it until it’s either confirmed or disproved. If numerous hypotheses and all treatment options have been exhausted, then a therapist might consider psychiatric alternatives.
“Is the diagnosis right? Is this the right treatment? Have I missed something? Have I involved the family?,” Dubovsky says. “We should never say, ‘Well, we just need to do more of the same.'” This is true for both prescribers and therapists.
Richard Simon, PhD, founded Psychotherapy Networker and served as the editor for more than 40 years. He received every major magazine industry honor, including the National Magazine Award. Rich passed away November 2020, and we honor his memory and contributions to the field every day.
Steven Dubovsky, MD, is Professor and Chair of the Department of Psychiatry at the University at Buffalo, SUNY and Adjoint Professor of Psychiatry and Medicine at the University of Colorado.