Medication Adherence – Stigma

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Home – NEW Forums Module 7 – Overview of Pharmacotherapy Fall 2023 Medication Adherence – Stigma

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    • #11332

      One of my clients is off all his antipsychotic medications at this time. He is showing some minor positive symptoms and significant negative symptoms. But he also has a history of significant decompensation over time, usually resulting in certification, when he is off medications. He has very limited insight into how the medications help him, even though those around him are keenly aware. Part of the issue with him is that he has a sibling who also has a psychotic disorder, and his sibling’s symptoms are significantly more pronounced. So he is very quick to state that he does not agree with his diagnosis because clearly he couldn’t have the same diagnosis as his sibling. He thinks his psychosis is related to stress/pressure, etc. but that he does not have a psychiatric illness. I recognize that there is significant stigma around mental illness in general, and perhaps this is more pronounced when you have experienced that stigma first as a family member of someone with a psychotic disorder, and then later as someone experiencing psychosis, and certifications, yourself. So I try to strike a balance between providing psychoeducation around how psychosis can look different for different people, and that a family history is common for people with psychotic disorders, while at the same time working with the client’s explanatory model around stress/pressure exacerbating symptoms. I have pointed out that no matter what the underlying cause of the psychosis is, the medications do seem to help this client with their symptoms. And I have tried to get them to consider what symptoms would need to return in order for them to reconsider their decision to not take medications. In the meantime I continue to monitor their symptoms and meet with them regularly. We have build good rapport and he is agreeable to meet with me even though he does not feel he has a psychotic illness.

    • #11334

      My client too has stigma around medication and wants to be off meds. He thinks that he would not be able to get a job due to his medications. He thinks that his employer would know that there is something wrong with him and that he would get fired. So in order to break this stigma we had to do a lot of education around medications and how employers are not allowed to ask for medical records. He still is against taking medications and would cheek it sometimes but with lots of education has gotten better over time.

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