I have a presentation coming up soon at the Vatican at a conference about equitable health care. I am presenting about social justice, kids, and psychiatric drugs so I have been researching, with my colleague Jacqueline Spark’s help, the latest information. I found some pretty disturbing stuff regarding the differential prescription rates of poor kids. A study of 11,700 children under age 18 covered by Medicaid found that the number of children newly treated with antipsychotics increased from 1,482 in 2001 to 3,110 in 2005 (Mathak, West, Martin, Helm, & Henderson, 2010). In other words, a staggering 26% of kids in this sample were taking antipsychotics. Another study found that children covered by Medicaid were prescribed antipsychotics at a rate four times higher than children with private insurance, and were more likely to receive antipsychotics for unapproved uses (Crystal, Olfson, Huang, & Gerard, 2010), or in other words, for reasons of control, not treatment. A study of foster care children found that 57% received three or more drugs (Zito et al., 2008), six times the national average in spite of the fact that no research supports more than one drug for kids. Finally, the use of antipsychotics with privately insured children, aged 2 through 5, has doubled between 1999 and 2007 (Ofson, Crystal, Huang, & Gerhard, 2010). About 1.5% of all privately insured children between the ages of 2 and 5, or one in 70, received some type of psychiatric drug in 2007 despite the fact that there is little to no evidence in this age group.

When you consider the research of antipsychotics with kids (the TEOSS study found that only 12% of kids benefited from antipsychotics and that serious adverse events were all but guaranteed), this is quite a distressing situation. My presentation and the resulting paper will call for a higher standard of prescriptive care. Where children are concerned, the stakes are higher. They are, essentially, involuntary patients—most do not have a voice to say no to treatments or devise their own, and depend on adults to safeguard their wellbeing (Sparks & Duncan, 2008). Moreover, poor children often have fewer adults watching over them and are vulnerable to dangerous drugs used as interventions of control rather than therapy, and therefore require more care to ensure equitable treatment. The evidence demands that the trend of rising prescriptions and lower psychosocial intervention be stopped and a higher standard of care implemented: 1) psychosocial intervention should be considered first–families and youth should have a voice in decisions about their care, especially the disenfranchised; 2) no off label prescribing; 3) no polypharmacy; 4) immediate separation of the pharmaceutical company influence from science and practice; and 5) monitoring treatment response with consumer rated measures. My presentation will call for a higher standard of care for our most vulnerable and precious commodity, our children, that invites unity among all concerned health professionals. It is time to no longer accept prescriptive practices that do not follow the evidence and increasingly put clients at perilous risk for serious health consequences, dependence, and disability. Read more about psychiatric drugs here and watch a video here.

On another note, we have applied for evidence based treatment status with SAMHSA thanks to the Norway Feedback Trial (congrats to Morten Anker on his Ph.D., just conferred this week) and the two RCTs by Jeff Reese. I’ll keep you posted.

Finally, don’t forget the free webinar this month about my book, On Becoming a Better Therapist: November 23rd at 6:00 PM Central. Register now!

I am doing a free webinar about CDOI. Here is a teaser:

And here is info about the webinar:

“Dr. Barry Duncan – What in the heck is CDOI? Client Directed, Outcome Informed Ideas and Practices”

You might hear folks say CDOI this or CDOI that, and wonder, what in the heck is CDOI?! Client directed, outcome informed services contain no fixed techniques or causal theories regarding the concerns that bring people to treatment. Any interaction can be client-directed and outcome-informed when the consumer’s voice is privileged, social justice is embraced, recovery is expected, and helpers purposefully form partnerships to: (1) enhance the factors across theories that account for success—especially the heart and soul of change; (2) use client’s ideas and preferences (theories) to guide choice of technique and model; and (3) inform the work with reliable and valid measures of the consumer’s experience of the alliance and outcome. This webinar covers the waterfront, from recovery to the common factors to the ORS and SRS—an all in one place description of this thing we call CDOI.

Date: Tuesday, December 22, 2009

Time: 12:00 PM – 1:00 PM CDT

Register now by clicking the link below:

https://www2.gotomeeting.com/register/326593746  

BTW, check out the new resources added to the handouts page: CDOI Fact Sheet, Youth Outcome Management, and Evidence Based Practice Talking Points: http://heartandsoulofchange.com/resources/handouts/

And I wanted to let you know about all the publicity the Norway Feedback Study has received after a press release was sent out by the University of Rhode Island—a co-investigator of the study was Dr. Jacqueline Sparks, faculty in the Department of Human Development and Family Studies.

5 Questions with Dr. Sparks http://www.pbn.com/detail.html?sub_id=46289

New Therapy Technique Reduces Divorce Rates http://ow.ly/162i0O

Professor finds strong link between counseling approach and relationship success: http://www.medicalnewstoday.com/articles/171024.php  

Finally, the Norway Feedback Study also made the Clinician Digest by Garry Cooper in the November edition of the Psychotherapy Networker. Check it out:

http://www.psychotherapynetworker.org/magazine/currentissue/689-clinicians-digest?start=3

I hope you join me for the free webinar.