Clinical Reasoning and Decision-Making in Psychiatry

Mental health professionals routinely make treatment decisions without necessarily having an overarching perspective about optimal next steps. This important new book provides them with reader-friendly, pragmatic strategies to approach clinical problems as testable hypotheses. It discusses how to apply concepts based on decision analytic theory using risk-benefit analyses, contingency planning, measurement-based care, shared decision making, pharmacogenetics, disease staging, and machine learning. Readers will learn how these tools can help them craft optimal pharmacological and psychosocial interventions tailored to the needs of an individual patient. The book covers topics such as diagnostic ambiguity, interview technique, applying statistical concepts to individual patients, artificial intelligence, and managing high-risk, treatment-resistant, or demanding and difficult patients. Valuable clinical vignettes are featured throughout the book to illustrate common dilemmas and scenarios where the relative merits of competing treatment options invite a more iterative than definitive approach. For all healthcare professionals who prescribe psychotropic medications.

Preface; Foreword; 1. Making Sense of the Senseless: How to Gather and Organize Pertinent Information; 2. The Approach to Diagnostic Ambiguity; 3. What The Patient Isn't Telling You: When Seeing is Not Believing; 4. Shared Decision Making; 5. Deciding On Appropriate Treatment Modalities: Medication, Psychotherapy, Hospitalization and Other Levels of Care; 6. Measurement Based Care and Applying Statistical Concepts to the Individual Patient; 7. Hypothesis Testing and Crafting Patient-Specific Decision Trees; 8. Decision Points in Iterative Pharmacotherapy; 9. Hierarchical and Complex Pharmacotherapy Decision-Making; 10. Prioritizing the Components of Any Decision-Making Model.

Joseph Goldberg is Clinical Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai in New York.
Stephen M. Stahl is Adjunct Professor of Psychiatry at the University of California, San Diego, Clinical Professor of Psychiatry and Neuroscience at the University of California, Riverside, and Honorary Visiting Senior Fellow in Psychiatry at the University of Cambridge.