Goals & Objectives: Refractory Mood Disorders Clinic

The Treatment-Refractory Mood Disorders Clinic provides consultation and treatment for referred patients.

At the end of this rotation, residents will display the following:

Patient Care:

  1. Ability to complete in depth assessments to determine the diagnosis of Treatment Refractory Mood Disorders (TRMDs).
  2. Ability to treat patients with TRMDs using the mode of treatment most suitable to the particular situation
  3. Ability to educate patients and families regarding TRMDs.
  4. Ability to collaborate effectively with family and referring professionals.
  5. Ability to complete psychopharmacolgic assessments of TRMD patients and to follow-up these patients

Medical Knowledge:

  1. Knowledge of the techniques used in the evaluation of adults with treatment resistant mood disorders (TRMDs), including evaluation of previous pharmacologic, somatic, and psychotherapeutic treatments.
  2. Knowledge of the various treatments used in TRMDs, strategies for choosing new treatment based on the previous treatment history and presentation of the patient.  Familiarity with the literature related to their effectiveness, including newly emerging evidence.
  3. Knowledge of interactions between drugs used in mood disorders treatment, as well as interactions with drugs used for common medical disorders. Knowledge of side effects of the various treatments, and available treatment responses to them.
  4. Knowledge of the various psychotherapeutic components of supportive psychotherapy with treatment resistant mood disorders patients, including teaching the patient self-observation, dealing with suicidal impulses, and recognition of mood swings and their impact on judgment and impulsivity.

Interpersonal and Communication Skills:

  1. Ability to form an alliance with patients with TRMDs and their families, in order to collect information, establish a diagnosis, provide education and implement a treatment plan. 


  1. Respect for the patients and the family's' stress during evaluation and treatment
  2. Willingness to seek supervision for all treatments, especially those which engender strong countertransference responses
  3. Respect for the members of the treatment team and their differing roles