Goals and Objectives

Goals and Objectives: Continuing Care Clinic CCC (Schizophrenia)

To serve in the role as the primary psychiatrist, with attending backup, for 40 patients with chronic severe mental illness.
To define target symptoms and then choose an appropriate intervention (e.g. medication, supportive therapy, cognitive behavioral therapy, environmental intervention).
To interact with patients, their families, referral agencies and support staff in developing long term treatment plans.
To project a sense of optimism, and promote independence without unnecessarily placing patients at a risk of further disappointment.
Conduct supportive psychotherapy for select patients who are currently going undergoing crises, going through transitions, or otherwise are appropriate for these services.
Identify when countertransference issues or unfair patient demands are interfering with your ability to provide appropriate clinical care.
Identify patients who are unable or unwilling to make use of the clinic environment despite reasonable efforts on the teams’ part, and learn how to refer them to more appropriate settings.

Advantages and risks of typical and atypical antipsychotic medications. In particular to learn to identify and treat tardive dyskinesia in its earliest stages. To become familiar with means of preventing life-threatening complications of clozapine. To become aware of risk factors and clinical significance for the metabolic syndrome and the means of preventing it. To identify and treat extrapyramidal syndromes.
Learn about range of medication options for patients with severe mental illness, and what medications are likely to be most effective in diminishing particular symptoms. Learn to monitor for therapeutic efficacy and toxicity for each of these agents.
Learn to monitor and treat side effects of psychotropics, especially EPS, metabolic issues, neutropenia.
Learn to generate short and long term treatment plans for patients, how to communicate them to patients and families, and modify them based on patient feedback.
Understand what it is like to have a severe mental illlness, what are the barriers, internal and external, to recovery, and how psychiatrists and institutions can be of assistance
Learn to deal with difficult patients and family members without rupturing a therapeutic alliance. Identify your own vulnerabilities and sensitivities in this regard so that you cannot be ‘blind-sided’.

To project a sense of optimism, and promote independence without unnecessarily placing patients at a risk of further disappointment.
To show concern and compassion with being either patronizing or overly-involved.