“Dr. Debbie Granick’s The 20 Minute Therapist is a significant contribution to Psychiatric-Mental Health Nurse Practitioner (PMHNP) practice. In this essential guide, Dr. Granick brings much-needed clarity to the art and science of integrating various psychotherapy approaches into medication management sessions. Grounded in the realities of clinical practice, she seamlessly covers everything from billing and documentation to how to select the evidence-based modality for the specific client problem. Her practical Say This/Not That tables offer explicit therapeutic communication skills paired with clear clinical rationale while keeping the therapeutic relationship front and center. This timely book is an indispensable resource for students, faculty, and practicing PMHNPs seeking to move beyond the silo of prescribing and towards expertise as therapists.”

— Kathleen Wheeler, PhD, PMHNP-BC, APRN, FAAN
Author of Psychotherapy for the Advanced Practice Psychiatric Nurse: A How-To Guide for Evidence-Based Practice, 4th edition

Coming from Carlat Publishing

Why combine medication and therapy?

For years, clinicians debated whether medication or therapy works better. The more useful question is whether patients do better with both, and the research says they do.

• Better outcomes: a meta-analysis of more than 11,000 adults with depression found combined treatment roughly 25%–27% more effective than medication or psychotherapy alone (Cuijpers et al., 2020).
• Fewer dropouts and relapses: STAR*D showed remission falling and dropout rising with each new medication trial. Adding therapy reduces the risk of depressive relapse compared with medication management alone.
• Lasting skills: medications target sleep, appetite, and energy. Therapy teaches patients new ways to think, cope, and connect.

And the economics finally work. When you spend at least 16 minutes on distinct psychotherapy, separate from medication management, you can bill an add-on psychotherapy code. That’s the “20 minutes” in the title: brief, billable therapy that fits inside the follow-up visit you already have. You no longer have to choose between good care and a sustainable practice.

What’s inside

The 20 Minute Therapist is built for the clinic, not the bookshelf. Its 26 chapters are organized in three parts, with 33 quick-reference tables you can use between patients.

Part I: Basics of Integrated Treatment. Why combined care works, how to bill add-on psychotherapy ethically and effectively, how to document integrated visits, and how to introduce therapy to patients who are ambivalent or unfamiliar with it.

Part II: Therapeutic Approaches. Core skills, supportive psychotherapy, psychoeducation, motivational interviewing, CBT, IPT, DBT, brief psychodynamic therapy, ACT, internal family systems, and eclectic therapy. Each is adapted for time-limited visits, with realistic dialogue and sample documentation.

Part III: Real-World Applications. Anxiety, depression, bipolar disorder, PTSD, substance use, insomnia, adult ADHD, suicidal ideation, and schizophrenia, plus strategies for patient resistance, alliance ruptures, time pressure, and caring for yourself.

Along the way you’ll find:

• “Say This / Not That” tables for every modality, with word-for-word language for the patient in front of you
• “Write This / Not That” documentation guides that save time, protect privacy, and support reimbursement
• Billing tools, including sample CPT reimbursement and a 10-patient-day revenue comparison
• Quick-reference cards by condition to keep the right technique within reach
• A self-assessment tool to help you decide where to start

About the author

Debbie Granick, DNP, PMHNP, LCSW, MPH, brings more than 25 years of experience as both a clinical social worker and a psychiatric nurse practitioner. She practices at Common Ground Psychiatry in North Carolina and teaches through Debbie Granick, PLLC. She created The 20-Minute Therapist™ training platform, which has helped hundreds of prescribers build confidence with therapy. Colleagues know her for a dynamic, straight-shooting, humor-filled teaching style, and that voice comes through on every page.