The Organization of the Treatment Recommendation Phase in Routine Psychiatric Visits

The article examines the organization of the treatment recommendation phase in psychiatric consultations for individuals with chronic and serious psychiatric conditions. Recommending treatment in chronic psychiatric care is a complex course of action that involves building a case for a treatment recommendation, eliciting an acceptance of the proposal, checking medical records, and detailing an implementation plan. This organization allows the participants to manage the complexities of making and implementing treatment decisions in this setting, such as anticipated resistance to treatment proposals, problems with adherence to a medication regimen, and the intricacy of dealing with multiple related medications whose dosages and effects need to be carefully balanced and monitored. We show that the psychiatrist orients to getting clients’ full, informed consent to the proposed medication regimen rather than a simple acquiescence and, in doing so, balances the institutional authority to prescribe, monitor, and enforce psychotropic medications with an orientation to client involvement. The data are in American English.