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Clementine Psychiatrist Lauren Ozbolt, MD, CEDS, FAPA is board certified in adolescent, adult and child psychiatry and oversees the psychiatric care and attending psychiatrists at Clementine. Dr. Ozbolt explains how she establishes a strong rapport with the adolescent and family in order to recommend the use of psychopharmacology.

After years of treating patients with eating disorders, I know the word “psychiatric medications” often sends chills down one’s spine.  Furthermore, the idea of using psychiatric medications in adolescents is frequently the stuff of parental nightmares. It is true that some adolescents have been scarred by memories of taking psychotropic medications without explanation or have felt “bullied” into taking medications.  I find that many teens are terrified of psychotropic medications and have false preconceived notions about how medications work.  As one young girl timidly told me, “I will be a zombie.” (Cue Walking Dead episode)

Thus upon meeting a new adolescent at Clementine, I typically don’t introduce the idea of taking psychotropic medications for the first few weeks of treatment (provided they are psychiatrically stable).  I find it is much more valuable at this stage of the game to establish rapport.  I really want to take the time to get to know the patient, focus on the nutritional aspects of treatment and try to gain a better understanding of the function of the patient’s eating disorder.

After seeing the adolescent daily for several sessions and establishing rapport, I then may make medication suggestions.  Psychotropic medications can be very helpful in the treatment of certain eating disorders targeting such symptoms as anxiety, depression, obsessive thoughts and food preoccupations.  I spend a great deal of time providing education about the medication, how it works in the body, risks, benefits and side effects.  I will often tell the adolescent what they will find if the “google” the medication and why or why not this may apply to them.  I never push a medications though, and often suggest that they take a few days to think about the medication and discuss it with their parents.  I similarly, give the parents the same extensive psychoeducation and rationale for my recommendation.  If the adolescent decides not to take psychiatric medications, again, I never push or try to convince her to take medication. I don’t believe in trying to convince people to take medication they don’t want to take—especially an adolescent who is in the separation-individuation stage of development where opposition is the rule.  Instead, I support the adolescent in their decision all the while, leaving the option for medication open.  I find this open approach coupled with a relationship that fosters trust and mutual respect sets a firm foundation for change.

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Melissa Spann, PhD, LMHC, CEDS-S

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.