Dear Therapist:

Hi, I work with...[young men]...in the community and am often involved during crises as well.  I would like to know the panel’s opinion on having a doctor prescribe a fast-acting anti-anxiety medication such as Xanax or Klonopin for someone who is usually doing well but occasionally has severe bouts of anxiety? Some people have told me that just knowing they have that option, that the pills are there if they need them, can help them get through things. I would also like to know if you think it is helpful to use these medications when someone has gone through a serious trauma and needs that type of short-term relief. Thank you for your time and for sharing your knowledge. 

 

Response:

As a non-prescribing practitioner, I cannot speak directly to the efficacy or use of medication. Therefore, I will respond only briefly and generally about short-term treatment.

There are times—as with short-term trauma—when therapeutic intervention can consist of just a few sessions. Similarly, I have found—anecdotally—that medication use can be short-term as necessary.

I am being very clear about the fact that I do not advise anyone as to the use of medication since this is not my field. I certainly would not consider telling a trusted psychiatrist what I think they should prescribe, or how they should prescribe it.

You ask our opinion on “having a doctor prescribe…” If you’re referring to a competent psychiatrist, your input should not be a factor. If you are speaking of a doctor who is not competent, or who does not specialize in psychiatric conditions, this is not the doctor to be consulting in the first place. Any medical practitioner who prescribes medication based on the input of an unlicensed non-professional deserves to become an unlicensed non-professional.

I understand that in your capacity as adviser to those in crisis, you want to help in the best way possible, and that you want to have the information necessary to appropriately guide those who turn to you. This is admirable, and our community needs people like you who can help those of us who deal with troubling situations. As important as your advice and guidance is your reliance on any professionals involved. This includes dealing with professionals who are competent—and trusting in their expertise.

-Yehuda Lieberman, LCSW

  psychotherapist in private practice

  Woodmere, NY

  adjunct professor at Touro College

  Graduate School of Social Work

  author of Self-Esteem: A Primer

  www.ylcsw.com / 516-218-4200