Treating psychiatric patients in your homeopathic practice - Healing with Homeopathy

Townsend Letter for Doctors and Patients,  Dec, 2003  by Robert Ullman,  Judyth Reichenberg-Ullman

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Using homeopathic medicine as primary treatment for psychiatric patients raises a number of considerations for the practicing homeopath. Because there is no specialty training available in homeopathic psychiatry, it is important to assess one's own background, knowledge, interest level and availability before taking on the care of patients with primarily psychiatric diagnoses. The following considerations are useful in deciding whether treating these patients is likely to be worth it and successful.

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1. Your experience level in homeopathy and psychiatric care

If you don't have much experience with this type of patient, or are new to homeopathic practice, please spend time sitting in, studying cases, or attending the seminars of homeopaths for whom psychiatric cases make up a fairly large portion of their practice. If you are not having success, ask for consultation on challenging cases from more experienced prescribers. When necessary, refer to other homeopaths, or for conventional psychiatric care or hospitalization.

2. Time consuming and demanding patients

These patients may call you a lot and have crises that you will need to manage. Try to encourage the patient to also seek out other support as well, such as therapists, support groups, crisis services and psychiatric hospitals in their community.

3. Irrational thinking and behavior

Do not expect psychiatric patients to necessarily make logical or rational decisions or to use common sense. They may do things that are unexpected, foolish, illegal or counter-productive to the health and well being of themselves and others.

4. Difficulty with case taking

Schizophrenic patients or patients with dementia may not be accurate historians and can give you a delusional, false or inaccurate picture of their life and symptoms. Anxious patients may exaggerate symptoms in order to motivate you to take therapeutic action, when waiting is the better course of action. Depressed patients are often withdrawn and uncommunicative, making case taking difficult or impossible. Obsessive patients may pay inordinate attention to irrelevant behaviors and details. Some patients may be manipulative or play games with you.

5. Poor follow-through

Psychiatric patients (as with regular patients) may miss appointments, arrive late or give up treatment too soon. They may need additional appointment reminders and encouragement to stick with treatment.

6. Problems with relatives

Relatives may be very helpful by providing an outside observation of the patient's life and symptoms, but may also have strong opinions about what the patient should be doing, what medications they should be taking, what doctors they should be seeing, and whether your treatment is successful. Relatives could blame you or seek compensation if the patient commits suicide, creates damage or hurts someone while under your care.

7. Financial problems

Psychiatric patients may not have employment or income, and may spend their money carelessly. They may not always pay for the treatment they receive, or follow through to collect insurance reimbursement. Social Security or Medicaid may be their only source of healthcare funding.

8. Physical danger

Occasionally, psychiatric patients seeking homeopathic treatment may pose a danger to themselves or others, including you and other healthcare practitioners. These patients require evaluation and possible hospitalization. Be aware, and avoid unsafe situations with potentially dangerous patients.

9. Legal problems

The patients themselves may have legal problems that tie up their time and resources, and perhaps can result in financial stress, psychiatric hospitalization or even incarceration. With regard to your own legal risk, it may be unwise to take on psychiatric patients without sufficient malpractice insurance.

10. Medications

These patients are often already taking conventional medications, which must be considered when prescribing homeopathically. Most psychiatric medications are not a barrier to homeopathic treatment, but they alter symptoms or cause considerable side effects, both of which can confuse the homeopathic picture or make it difficult to understand the full extent of the homeopathic medicine.

11. Antidoting

Psychiatric patients may not be compliant or cognizant of what must be avoided in order to avoid compromising their homeopathic treatment.

12. Coordination with other psychiatric caregivers

Where possible it is useful to consult with or obtain reports from the patient's other caregivers, and to inform them and share information whenever it seems useful to do so.

13. Odds of success with homeopathic treatment

If you have a well-taken and complete case, a properly chosen remedy and good follow-up, the odds of success can be high depending on various factors. These include diagnosis, medications, compliance, clarity of symptoms, and how well they match with a homeopathic medicine. There are many potential pitfalls, however. Just having the right homeopathic medicine without correct management and follow through is not sufficient for success.