Wednesday, 23.08.2017

American Society of Clinical Psychopharmacology
Model Psychopharmacology Curriculum

Introduction
Ira Glick

 

Introduction
On behalf of many pioneers in psychopharmacology, I am pleased to write this introduction for the archiving of the American Society of Clinical Psychopharmacology’s Model Psychopharmacology Curriculum. The aim of this archival record is to provide a historical look into the teaching and practice of clinical psychopharmacology, primarily in the United States, in the years from the 1950s through 2016. In short, this is a history of the development of the field of psychopharmacology.

As such, we hereby archive early editions of the psychopharmacology curriculum originally designed for teachers, residency training directors and chairs of psychiatry. The aim is to examine the “how, what, and why” of the psychopharmacology program and curriculum. The secondary aim is to examine what was being taught to psychiatric residents at a particular time as the field developed. In 1950s–1970s, the field was almost primarily focused on a psychodynamic, psychoanalytic, psychotherapy compared to an almost exclusively psychopharmacologic focus in actual clinical practice at present.

By way of background, I will provide a brief 1) history of the project, 2) current curriculum content and pedagogy, and 3) present status and future directions. 

 

History of the Project

Little did we know, in 1982, that a small request for “teaching content” focused on the new field of psychopharmacology, would lead to a project extending over the next 40 years. Dick Shader, Carl Salzman, Dave Janowsky and myself, operating as a small ACNP committee focused on education, assembled what we thought should be a “common core set of lectures” for residency programs.

We created a hard copy version of the lectures, sent it out for free to all ACNP members – some of whom taught and a few were department chairs – most were academic researchers.

The result was a resounding silence – as it mostly sat on people’s desk “gathering dust.”

It occurred to us (belatedly), that we ought to let psychiatry departments know that there was now something called “clinical psychopharmacology” to be taught to psychiatric residents that might help patients. DUH! As such, mostly by word-of-mouth, teachers came to us asking for a copy. Interestingly, one of the foreign ACNP members translated it into Japanese in 1986.

Coincidentally, in the 1990s, as the ACNP focused on “basic and translational neuroscience” with less focus on clinical issues – the American Society of Clinical Psychopharmacology (ASCP) as an organization spun off. As a by-product of this move, the project was reborn and a first edition under ASCP auspices was published in 1999. It is now in its 9th edition, being revised and updated every 2 years. The late Nick Ward and Bruce Lydiard have been instrumental in providing material for the early versions, which will be archived here.

 

Current Status

The curriculum has evolved to provide everything we could think of for a psychopharmacology training program. It has everything a training director would want or need to set up a program – including the “what, how, why, and how to evaluate learning.” It has now over 90 lectures by experts in their field and over 5000 slides. It has moved from hard copy to PowerPoint to electronic versions on the web.

As experts in a particular disorder have defined “specific psychopharmacological medications for specific disorders,” we have expanded our roster of lectures and “expert” lecturers/teachers nationally – there are too many to be listed here. We have also expanded “related topics” – like ethics, legal aspects, working with industry, etc.

The ASCP Board has been steadfast in their support and we have received no industry support for this effort.

 

Summary and Conclusion

By way of highlighting how psychopharmacology practice has changed, we recognize that much clinical work is being done by non-psychiatrists and non-MDs. Accordingly, we have re-designed and tailored the curriculum for teachers of 1) medical students (future non-psychiatric psychopharmacology prescribers), and 2) for primary care/family physicians. Richard Balon (Medical Student Curriculum), Sid Zisook (Residency Curriculum), and Dan Orr (Primary Care Curriculum) have been central to these efforts. They have produced three editions for medical students and two for primary care physicians.

As the field has become more specialized, we have developed special sections on child/adolescent psychopharmacology organized by Vishal Madaan, geriatric psychopharmacology by James Ellison, and a series of lectures on substance use/abuse put together by Professor Charles O’Brien at University of Pennsylvania. We have added lectures on the “art” of psychopharmacology as well as how to combine medication and psychotherapy and a paper on how to actually conduct quality psychopharmacology visits over the lifetime of patients.

We have adapted the curriculum to different cultural settings and the resident version has been distributed to third world countries by the World Psychiatric Association.

The aim remains – “to improve teaching and to improve clinical psychopharmacology practice.”

 

Ira Glick

September 15, 2016