Posted by fachad on February 19, 2003, at 13:33:01
In reply to My psychiatrist decided to let me suffer, posted by Caleb462 on February 18, 2003, at 23:52:35
There is lots of this stuff all over the place, I suggest you do a search in google, but here is a nice document:
http://www.abainternational.org/sub/membersvcs/journals-pubs/rtrrebt/index.asp
The whole document is posted at the above link, here are a few excerpts that seem appropriate to your situation. Point 6 is copied in full, as it specifically addresses your concern.
Key Points:
1. An Individual Has a Right to a Therapeutic Environment
2. An Individual Has a Right to Services Whose Overriding Goal is Personal Welfare
3. An Individual Has a Right to Treatment by a Competent Behavior Analyst
4. An Individual Has a Right to Programs That Teach Functional Skills
5. An Individual Has a Right to Behavioral Assessment and Ongoing Evaluation
6. An Individual Has a Right to the Most Effective Treatment Procedures Available
An individual is entitled to effective and scientifically validated treatment. In turn, behavior analysts have an obligation to use only those techniques that have been demonstrated by researchers to be effective, to acquaint consumers and the public with the advantages and disadvantages of these techniques, and to search continuously for the most optimal means of changing behavior.
Consistent with the philosophy of least restrictive yet effective treatment, exposure of an individual to restrictive procedures is unacceptable unless it can be shown that such procedures are necessary to produce safe and clinically significant behavior change. It is equally unacceptable to expose an individual to a nonrestrictive intervention (or a series of such interventions) if assessment results or available research indicate that other procedures would be more effective. Indeed, a slow-acting but nonrestrictive procedures could be considered highly restrictive if prolonged treatment increases risk, significantly inhibits or prevents participation in needed training programs, delays entry into a more optimal social or living environment, or leads to adaptation and the eventual and the eventual use of a more restrictive procedure. Thus, in some cases, a client's right to effective treatment may dictate the immediate use of quicker-acting, but temporarily more restrictive procedures.
A procedure's overall level of restrictiveness is a combined function of its absolute level of restrictiveness, the amount of time required to produce a clinically acceptable outcome, and the consequences associated with delayed intervention. Furthermore, selection of a specific treatment technique is not based on personal conviction. Techniques are not considered as either "good" or "bad" according to whether they involve the use of antecedent rather than consequent stimuli or reinforcement rather than punishment. For example, positive reinforcement, as well as punishment, can produce a number of indirect effects, some of which are undesirable.
In summary, decisions related to treatment selection are based on information obtained during assessment about the behavior, the risk it poses, and its controlling variables; on a careful consideration of the available treatment options, including their relative effectiveness, risks, restrictiveness, and potential side effects; and on examination of the overall context in which treatment will be applied.
> After a two-month trial on Risperdal, and a raised dose of Effexor, with no decrease in my anxiety level, I decided I needed to be put on a benzo. Klonopin, to be specific. I wasn't going to say this outright, I was hoping I'd be able to slide it in at some point during the appt. The oppurtunity never came, so I just said "I've been reading a lot about Klonopin, and was thinking maybe it would be a good drug for my anxiety."
>
> His response: "Klonopin is an addictive drug. I don't like to prescribe to benzos to anyone, especially not to someone like you, who has used substances in the past."
>
> I had figured this guy to be a reasonable, open-minded doctor, but apparently not. I have been on Zoloft, Paxil, Celexa, and now Effexor XR and Risperdal. My diagnosis is GAD/OCD/Depression/Mild Social Phobia. The depression is mostly under control, and I'm able to manage the OCD fairly well, but I'm as anxious as I've ever been, if not more. But is he interested in giving me the most effective treatment? No, instead he wants me to take more Risperdal and is giving me a freaking anti-histamine to take "as needed" for anxiety. Blah, whatever, I need a new doc (again).
poster:fachad
thread:201736
URL: http://www.dr-bob.org/babble/20030219/msgs/201870.html