Psychiatric Treatment for Adolescents in the U.S. in the mid-/late-1970s
OK, this is actually for an assignment, but the point of the assignment is to conduct an initial psych assessment of the character. I swear that we are not graded on researching the history of psychiatry.
This assignment is based on the film Ordinary People, not the novel it's based on (which I've never read). According to Wikipedia, there appear to be some differences between the two (e.g., in the movie, Conrad Jarrett was hospitalized for 4 months--vs. 8 months in the book).
We know that Conrad underwent ECT while inpatient (it's mentioned during his interaction with his swim coach). But what other treatment would he receive?
1) Was cognitive and/or behavioral therapy sufficiently developed in the mid- to late-1970s for him to be exposed to it while inpatient, or would some flavor of psychodynamic therapy be the only likely option?
2) Psychopharmacology... If it was used at all with adolescents during that time, I assume we're talking some tricyclic antidepressant rather than a MAO inhibitor (given MAOis' drug and food interactions). I know that nowadays only fluoxetine, an SSRI, is FDA-approved for depression in children and adolescents, but for better or worse, other newer antidepressants (mainly SSRIs and SNRIs) are also used, but those didn't exist at the time. My guess is that psychiatrists nonetheless might've been creative with prescribing to adolescents. (On the other hand, Conrad's outpatient psychiatrist only appears to do psychotherapy with him in the movie.)
Research done: Honestly, I mostly looked up the various tricyclics in Wikipedia, but I didn't find enough about their history. When I Googled "use of tricyclic antidepressants in adolescents" (w/o the quotes), I found a bunch of stuff about their toxicity in pediatric populations. And I found out that they're used in children for bedwetting. (I didn't expect to find a whole lot, given that some newer antidepressants are safer in children--and again, only fluoxetine is FDA-approved. Or they're less unsafe if you will. I don't think they're that widely used today even in adults.)
This assignment is based on the film Ordinary People, not the novel it's based on (which I've never read). According to Wikipedia, there appear to be some differences between the two (e.g., in the movie, Conrad Jarrett was hospitalized for 4 months--vs. 8 months in the book).
We know that Conrad underwent ECT while inpatient (it's mentioned during his interaction with his swim coach). But what other treatment would he receive?
1) Was cognitive and/or behavioral therapy sufficiently developed in the mid- to late-1970s for him to be exposed to it while inpatient, or would some flavor of psychodynamic therapy be the only likely option?
2) Psychopharmacology... If it was used at all with adolescents during that time, I assume we're talking some tricyclic antidepressant rather than a MAO inhibitor (given MAOis' drug and food interactions). I know that nowadays only fluoxetine, an SSRI, is FDA-approved for depression in children and adolescents, but for better or worse, other newer antidepressants (mainly SSRIs and SNRIs) are also used, but those didn't exist at the time. My guess is that psychiatrists nonetheless might've been creative with prescribing to adolescents. (On the other hand, Conrad's outpatient psychiatrist only appears to do psychotherapy with him in the movie.)
Research done: Honestly, I mostly looked up the various tricyclics in Wikipedia, but I didn't find enough about their history. When I Googled "use of tricyclic antidepressants in adolescents" (w/o the quotes), I found a bunch of stuff about their toxicity in pediatric populations. And I found out that they're used in children for bedwetting. (I didn't expect to find a whole lot, given that some newer antidepressants are safer in children--and again, only fluoxetine is FDA-approved. Or they're less unsafe if you will. I don't think they're that widely used today even in adults.)