The PULSE Model for Psychiatric Prescribing

doi:10.1017/9781108689229.004

Chapter 2 - The PULSE Model for Psychiatric Prescribing

from Section 1 - Practice and Principles

Published online by Cambridge University Press: 14 August 2026

John D. Cahill and

Keith Gallagher

Edited by

John D. Cahill and

Keith Gallagher

Show author details

John D. Cahill: Affiliation:
Yale School of Medicine, Connecticut
Keith Gallagher: Affiliation:
Yale University

Book contents

Get access

Summary

The PULSE model frames prescribing as a person-centered, integrated biopsychosocial and complex intervention. PULSE stands for the five skills domains: Partnership, Understanding, Life circumstances, Shared decision-making, and Expectations. Each of these five domains contains three key skills objectives; however, we discourage viewing these as an ordered checklist of tasks. It may be used for reflective practice in the clinic and as an educational tool in the classroom. This chapter describes each component in terms of fundamentals, aspirational performance, and common pitfalls.

Keywords

psychiatry prescribing alliance shared decision-making PULSE model

Information

Type: Chapter
Information: Prescribing Psychiatric Medications
The How, Why, and Why Not
, pp. 14 - 29
DOI: https://doi.org/10.1017/9781108689229.004 [Opens in a new window]
Publisher: Cambridge University Press
Print publication year: 2026

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Book purchase

Temporarily unavailable

Accessibility standard: Inaccessible, or known limited accessibility

Why this information is here

This section outlines the accessibility features of this content - including support for screen readers, full keyboard navigation and high-contrast display options. This may not be relevant for you.

Accessibility Information

The HTML of this chapter is known to have missing or limited accessibility features. We may be reviewing its accessibility for future improvement, but final compliance is not yet assured and may be subject to legal exceptions. If you have any questions, please contact accessibility@cambridge.org.

Content Navigation

Table of contents navigation
Allows you to navigate directly to chapters, sections, or non‐text items through a linked table of contents, reducing the need for extensive scrolling.

Index navigation
Provides an interactive index, letting you go straight to where a term or subject appears in the text without manual searching.

Reading Order & Textual Equivalents

Single logical reading order
You will encounter all content (including footnotes, captions, etc.) in a clear, sequential flow, making it easier to follow with assistive tools like screen readers.

Visual Accessibility

Use of colour is not sole means of conveying information
You will still understand key ideas or prompts without relying solely on colour, which is especially helpful if you have colour vision deficiencies.

Structural and Technical Features

ARIA roles provided
You gain clarity from ARIA (Accessible Rich Internet Applications) roles and attributes, as they help assistive technologies interpret how each part of the content functions.