Patient ambivalence in treatment and medication non-adherence are common challenges in mental health settings. Poor therapeutic alliance with care providers is frequently cited as a reason for lack of engagement in mental health treatment. This often stems from experiences of patients feeling that they are not able to collaborate in their own treatment. One solution for this is to implement patient-centered interventions, such as shared decision making and motivational interviewing. Clinicians responsible for medication management may not always provide care consistent with patient-centered practices due to lack of experience or comfort. This session will help psychiatric pharmacists identify factors that contribute to treatment ambivalence and medication non-adherence and recommend strategies to address these issues.
Consider making this session part of your BPS Continuing Professional Development plan! Please refer to the BPS Psychiatric Pharmacy Content Outline to see how this activity may align.
Target Audience
If you are a pharmacist, nurse practitioner, or other health care professional involved in the comprehensive medication management of individuals living with mental health and/or substance use disorders, we invite you to participate in this online course.
Course Requirements
To receive ACPE credit for this session, you must:
- Register for this course.
- Review the full content of the activity and reflect upon its teachings.
- Complete the evaluation at the end of the activity.
- Provide the necessary details in your profile to ensure correct reporting by AAPP to CPE Monitor.
Faculty Information
View biographical information
Russell E. Spieth, MEd, PhD
Vice President of Adult Behavioral Health and Licensed Clinical Psychologist
The Centers
Cleveland, OH
Russell E. Spieth, PhD is the Vice President of Adult Behavioral Health at The Centers in Cleveland, Ohio. He was previously the Managing Director of Campus Mental Health and Consultant/Trainer at Northeast Ohio Medical University. He is an Ohio licensed psychologist. He received his PhD in Counseling Psychology from the University of Akron, MEd in Counseling Psychology from Columbia University, and BS in Psychology from Florida State University. He has more than 25 years' experience providing clinical services to persons with co-occurring mental and substance use disorders and has trained clinicians in motivational interviewing for over 20 years. Dr. Spieth provides psychological services at Royalton Psychological Associates on a part-time basis.
Learning Objectives
- Identify factors that contribute to ambivalence to mental health treatment, medication non-adherence, and misalignment between patient and provider goals.
- Compare interventions that address mental health treatment ambivalence and/or medication adherence.
- Recommend strategies to address ambivalence to mental health treatment and non-adherence based on patient-specific factors.
Continuing Education Credit and Disclosures
Activity Dates: 04/08/2024 - 04/08/2027
ACPE Contact Hours: 1
ACPE Number: 0284-0000-24-022-H99-P (Application)
Nursing Credit Reminder: Note that ACPE credit is accepted for ANCC Certification Renewal and AANPCB advanced practice provider content. For specific questions related to your organization's acceptance of ACPE continuing education units, please contact your organization directly.
The American Association of Psychiatric Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
AAPP owns the copyright, is licensed or has received permissions for use of, or is otherwise permitted to use copyrighted materials within any CPE activity. Authors and speakers are required to obtain necessary copyright permissions for content in CPE activities. AAPP complies with copyright laws and regulations.
View planning committee disclosures
2024 Program Committee and Recertification Editorial Board
| Elayne D. Ansara, PharmD, BCPP, BCPS Mental Health Clinical Pharmacist Practitioner VISN23 Clinical Resource Hub Indianapolis, IN Non-Financial Interests: The Board of Pharmaceutical Specialties (Psychiatric Pharmacy Specialty Council) |
| Bridget Bradley, PharmD, BCPP Clinical Pharmacist Oregon Health & Science University Beaverton, OR External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: ACCP PSAP May 2021, Neurology and Psychiatry Book Educational Grants, Research Grants or Contracts: NACDS Community Pharmacy Residency Grant |
| Katie L. Brase, MA Program Specialist American Association of Psychiatric Pharmacists Lincoln, NE No Relevant Financial Relationships to Disclose |
| Dana Chiulli, PharmD, BCPP Clinical Pharmacist Practitioner - Mental Health VISN 06 Mental Health Clinical Resource Hub Flower Mound, TX No Relevant Financial Relationships to Disclose |
| Marissa Cullen, PharmD, BCPP Clinical Pharmacist UPMC Western Psychiatric Hospital Pittsburgh, PA No Relevant Financial Relationships to Disclose |
 Beth DeJongh, PharmD, BCPS, BCPP |
| Chelsea N. Di Polito, PharmD, BCPP Assistant Director, Pharmacy Administration - Clinical Services University of Maryland School of Pharmacy Baltimore, MD No Relevant Financial Relationships to Disclose |
| Alisha D. Donat, PharmD, BCPP Clinical Pharmacy Specialist - Mental Health South Texas Veterans Health Care System San Antonio , TX No Relevant Financial Relationships to Disclose |
| Bennett J. Doughty, PharmD, BCPP, BCPS Clinical Assistant Professor Binghamton University School of Pharmacy and Pharmaceutical Sciences Binghamton, NY External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: PsychU- Speaker's Bureau |
| Traci M. Dutton, PharmD, BCPP, BCPS Clinical Pharmacy Specialist - Mental Health; Program Director - PGY2 Psychiatric Pharmacy Residency VA Tennessee Valley Healthcare System Murfreesboro, TN Employment: Tennessee Valley VA Healthcare System, Clinical Pharmacy Specialist - Mental Health, Member of VA PBM Educational Advisory Committee which oversees Board Certification Study Groups |
 Megan J. Ehret, PharmD, MS, BCPP |
| Kimberly Ehrhard, PharmD, BCPP Clinical Pharmacist, Psychiatry The University of Kansas Health System Kansas City , KS No Relevant Financial Relationships to Disclose |
 Robert J. Haight, PharmD, BCPP |
| Abigail Hampton, PharmD, BCPP Clinical Pharmacy Practitioner- mental health Kansas City Veterans Affairs Kansas City, MO No Relevant Financial Relationships to Disclose |
| Suzanne C. Harris, PharmD, BCPP Associate Professor/Director of Well-being and Resilience/Clinical Pharmacist Practitioner UNC Eshelman School of Pharmacy Chapel Hill, NC No Relevant Financial Relationships to Disclose |
| Jordan Haygood, PharmD, BCPP Clinical Pharmacy Specialist - Psychiatry Medical University of South Carolina Charleston, SC No Relevant Financial Relationships to Disclose |
| Courtney A. Iuppa, PharmD, BCPP Clinical Pharmacy Manager & Residency Program Director Center for Behavioral Medicine Kansas City, MO No Relevant Financial Relationships to Disclose |
| Archana R. Jhawar, PharmD, BCPP Clinical Pharmacist Jesse Brown VAMC/ UIC College of Pharmacy Chicago, IL No Relevant Financial Relationships to Disclose |
| Kayla D. Johnson, PharmD, BCPP, BCPS Clinical Pharmacist Specialist Vanderbilt University Medical Center Thompsons Station, TN External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: Pharmacy Times Continuing Education Speaker |
| Dongmi Kim, PharmD, BCPP, BCPS Assistant Clinical Professor Fairleigh Dickinson University School of Pharmacy Florham Park, NJ No Relevant Financial Relationships to Disclose |
| Jamie C. Kneebusch, PharmD, BCPP, BCPS Assistant Clinical Faculty UC San Diego, Skaggs School of Pharmacy La Jolla, CA No Relevant Financial Relationships to Disclose |
| Erin D. Knox, PharmD, BCPP Director of Experiential Education UCI School of Pharmacy & Pharmaceutical Sciences Irvine, CA Non-Financial Interests: Santa Ana Community College, Pharmacy Technology Program, Advisory Committee |
| Lauren E. Leiby, PharmD, BCPP Behavioral Health Patient Care Pharmacist Nationwide Childrens Hospital Columbus, OH No Relevant Financial Relationships to Disclose |
| Linda D. Logan, PharmD, BCACP, BCPP, BCPS Public Service Associate University of Georgia Athens, GA Educational Grants, Research Grants or Contracts: HRSA Graduate Psychology Education Grant, UGA Mental Health Seed Grants for MHFA and Virtual Dementia Tour, UGA College Pharmacy Ansel Fund |
| Megan Maroney, PharmD, BCPP Clinical Associate Professor Ernest Mario School of Pharmacy at Rutgers, the State University of New Jersey Long Branch, NJ External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: Pharmacy Times - speaker and medical writing honoraria, Otsuka Pharmaceuticals - Excel Speakers Bureau (former, through March 2022), Novus Medical Education - consultant/medical writing, Boehringer Ingelheim - advisory board, Sunovion Pharmaceuticals – consultant/advisory board, Biogen and Sage Therapeutics - advisory board |
| Monica Mathys, PharmD, BCGP, BCPP Professor Texas Tech University School of Pharmacy Dallas, TX Non-Financial Interests: AAPP Foundation Board member |
| Maren McGurran, PharmD, BCPP, BCPS Clinical Pharmacist, Psychiatry Northwest Missouri Psychiatric Rehabilitation Center MO No Relevant Financial Relationships to Disclose |
| Lindsey N. Miller, PharmD, BCPP Clinical Pharmacist and Associate Professor Lipscomb University and Vanderbilt Psychiatric Hospital Nashville, TN External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: Social Security Administration- Board of Adjudication: Presentations on various disease states Financial Interests: Pharmacy Times Panel Discussant- Payer Forum Sponsored by Alkermes (January 2020), Pharmacy Times- CE Presentation Sponsored by Otsuka (August 2019) |
| Breanna L. Moody, PharmD, BCPP Clinical Pharmacy Specialist - Mental Health Clinic Lexington VA Health Care System Lexington, KY Non-Financial Interests: BPS - BCPP Item Writer for 2022 cycle |
| Brianne Mosley, PharmD, BCPP, BCPS Psychiatric Clinical Pharmacist McLean Hospital Belmont, MA No Relevant Financial Relationships to Disclose |
| Jessica L. Mulhollan, PharmD, BCPP Clinical Pharmacy Specialist, Substance Use Disorders and Mental Health Clinical Pharmacy Supervisor Louis Stokes Cleveland VA Medical Center Cleveland, OH No Relevant Financial Relationships to Disclose |
| Kristen Neumeister, PharmD, BCPP Clinical Pharmacist North Texas State Hospital Fort Worth, TX No Relevant Financial Relationships to Disclose |
| Megan O'Connell, PharmD, BCPP Clinical Pharmacy Specialist - Psychiatry and Neurology Michigan Medicine Ann Arbor, MI No Relevant Financial Relationships to Disclose |
| Melissa C. Palmer, PharmD, BCPP, BCPS Clinical Pharmacy Specialist - Mental Health Alaska VA Healthcare System Anchorage, AK No Relevant Financial Relationships to Disclose |
| Haley Pals, PharmD, BCPP Substance Use Disorder/Psychiatric Clinical Pharmacist Tomah VA Medical Center Tomah, WI No Relevant Financial Relationships to Disclose |
| Brittany L. Parmentier, PharmD, MPH, BCPS, BCPP Clinical Pharmacy Specialist in Psychiatry The Harris Center for Mental Health and IDD Houston, TX No Relevant Financial Relationships to Disclose |
| Jake R. Peters, PharmD, BCPP, BCPS Assistant Professor of Pharmacy Practice/Clinical Pharmacy Specialist - Psychiatry Butler University College of Pharmacy/Indiana University Health Indianapolis, IN No Relevant Financial Relationships to Disclose |
| Sarah J. Popish, PharmD, BCPP VA PBM Academic Detailing Services, Program Manager Department of Veterans Affairs Sarasota, FL No Relevant Financial Relationships to Disclose |
| Devon A. Sherwood, PharmD, BCPP Associate Professor of Pharmacy Practice University of New England Portland, ME External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: New Hampshire MCAP (Mental Health Care Access in Pediatrics) - Subject Matter Expert – Psychiatric Pharmacy / Psychopharmacology Consultative Services Educational Grants, Research Grants or Contracts: SAMHSA funded grant - Collaborative SBIRT Training for Maine’s Future Health Professions Leaders |
| Rosana Steavenson, PharmD, BCPP, BCPS Program Manager, Mental Health Clinical Pharmacy Programs; Mental Health Clinical Pharmacy Specialist South Texas Veterans Health Care System San Antonio, TX No Relevant Financial Relationships to Disclose |
| Abby Stocks, PharmD, BCPP Inpatient Behavioral Health Pharmacist Inova Fairfax Medical Campus Falls Church, VA Educational Grants, Research Grants or Contracts: College of Psychiatric and Neurologic Pharmacists "Defining the Future" research grant |
| Nina Vadiei, PharmD, BCPP Clinical Associate Professor University of Texas at Austin San Antonio, TX No Relevant Financial Relationships to Disclose |
| Heidi J. Wehring, PharmD, BCPP Adjunct Associate Professor of Psychiatry Maryland Psychiatric Research Center, University of Maryland School of Medicine Baltimore, MD No Relevant Financial Relationships to Disclose |
 Kara R. Wong, PharmD, BCPP |
All relevant relationships have been mitigated.
View disclaimer and disclosure of off-label use
Off-Label Use: This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA (see faculty information). The opinions expressed in the educational activity do not necessarily represent the views of AAPP and any educational partners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Disclaimer: Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
View fair balance and integrity statement
It is the policy of AAPP to ensure independence, balance, objectivity, scientific rigor, and integrity in continuing education activities. Those involved in the development of this continuing education activity have made all reasonable efforts to ensure that information contained herein is accurate in accordance with the latest available scientific knowledge at the time of accreditation of this continuing education activity. Information regarding drugs (e.g., their administration, dosages, contraindications, adverse reactions, interactions, special warnings, and precautions) and drug delivery systems is subject to change, however, and the reader is advised to check the manufacturer’s package insert for information concerning recommended dosage and potential problems or cautions prior to dispensing or administering the drug or using the drug delivery systems.
Fair balance is achieved through ongoing and thorough review of all materials produced by faculty, and all educational and advertising materials produced by supporting organizations, prior to educational offerings. Approval of credit for this continuing education activity does not imply endorsement by AAPP for any product or manufacturer identified.
View nursing education availability
ACPE approved contact hours are accepted for ANCC Certification Renewal: At least 50% (37.5 hours) of your 75 continuing education hours must be formally approved continuing education hours. Formally approved continuing education hours meet one or more of the criteria listed below:
- Continuing nursing education (CNE) approved for nursing contact hours by an accredited provider or approver of nursing continuing education
- Continuing medical education (CME) approved for CME hours
- Sponsored by organizations, agencies, or educational institutions accredited or approved by the American Nurses Credentialing Center (ANCC) or the Accreditation Council for Continuing Medical Education (ACCME) or the Accreditation Council for Pharmacy Education (ACPE) or the Commission on Dietetic Registration
All relevant relationships have been mitigated.