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Holding Patients with Medication
Published in Paul Ian Steinberg, Psychoanalysis in Medicine, 2020
Attempts to use psychodynamic psychotherapy and psychoanalysis to treat severely disturbed individuals, including individuals with psychotic illness, are well documented (Arieti, 1955; Frosch, 1983; Marder, 2007; Searles, 1986; see also Chapter 4). These treatments make considerable demands on the patient to integrate a combination of secondary process and creative primary process thinking, which is challenging work for anyone (Dorpat & Miller, 1992). It is particularly difficult for these patients, with their limited capacity to recognize reality, to maintain an integrated sense of their identity and to contain their uncomfortable affects and impulses. A significant number of DTP patients appeared so stressed by the psychodynamic approach, or to suffer from symptoms so severe, that their ability to benefit from group therapy was compromised. A small dose of neuroleptic medication enabled them to function better in psychotherapy and to derive more benefit from it.
Treatment of Psychological Disorders
Published in Mohamed Ahmed Abd El-Hay, Understanding Psychology for Medicine and Nursing, 2019
Psychoanalytically-oriented and psychodynamic psychotherapy remains centered on the role of people’s internal drives and forces, but the duration of therapy is much briefer and less intensive (usually once or twice per week), and advice is given to the patient occasionally. Supporters of this type of therapy state that some of the insights and opportunity for change and growth available from long-term psychoanalysis can be achieved in a shorter time by introducing directive elements and a focus on particular topics. The patient and the therapist may sit opposite each other, face-to-face, or a couch is used. Examples of psychodynamic psychotherapies include interpersonal therapy (IPT), which is a structured, supportive approach that focuses on current rather than past problems. Treatment goals evolve from four main interpersonal problem areas: (1) grief; (2) interpersonal disputes; (3) role transitions; and (4) interpersonal deficits. IPT is usually a time-limited treatment, typically lasting 12–16 weeks, that encourages the patient to regain control of mood and functioning.
The Role of the Practice Counsellor in Substance Misuse Treatments
Published in Rosie Winyard, Andrew McBride, Substance Misuse in Primary Care, 2018
Psychodynamic psychotherapy has developed to become more focused these days on helping clients to understand conflicts in their feelings, desires and beliefs and how these affect their relationships with others. The interaction between the therapist and client provides a basis for greater self-awareness.
A Naturalistic Study of Time to Recovery in Adults with Treatment-refractory Disorders
Published in Psychiatry, 2021
J. Christopher Perry, J. Christopher Fowler
There is ample evidence that longer-term intensive treatment brings about significant improvement in symptoms and functioning. A high-quality meta-analysis of 23 studies (Leichsenring & Rabung, 2008) revealed that complex and often treatment-resistant patients receiving at least 50 weeks of psychodynamic psychotherapy showed better outcomes in overall effectiveness, target problems, and personality functioning than did patients after short-term psychotherapies. After long-term psychodynamic psychotherapy, patients with complex mental disorders were better off than 96% of the patients in the comparison groups. While delineating the current sample’s treatments is complex and beyond the current scope, the sample’s natural history included years of numerous treatment experiences, including residential and/or partial hospitalizations, psychotherapy, and/or medications (Perry et al., 2008). A subsequent report will examine the relationship of treatment to outcome.
Integrating psychotherapy and psychopharmacology: psychedelic-assisted psychotherapy and other combined treatments
Published in Expert Review of Clinical Pharmacology, 2020
Kyle T. Greenway, Nicolas Garel, Lisa Jerome, Allison A. Feduccia
One widely-referenced model for the common factors is the contextual model, which posits three primary mechanisms of action of psychotherapy: the real relationship, the creation of expectations through explanation of disorders and treatments, and the enactment of health promoting actions [84,85]. While these factors are shared between schools of psychotherapy, their implementation can vary dramatically in terms of how therapists and patients relate to each other, the explanatory frameworks (or therapeutic myths) that they employ, and the tasks that they undertake. For example, CBT partly strives to correct collaboratively identified maladaptive patterns of thought and to facilitate engagement in behavioral exposure and activation [90]. Psychodynamic psychotherapy, on the other hand, partly aims to change patients’ problematic patterns of relating to their selves and to others via developing insight about past relationships and their relationship with the therapist [90]. The contextual model also acknowledges that a strong therapeutic alliance is a necessity of all pathways, as is supported by research [85]. Exactly how – and how well – this alliance is established varies amongst techniques and individual therapists [85].
A worldwide survey on training provisions for psychiatric trainees in WPA member associations
Published in International Review of Psychiatry, 2020
Roger M. K. Ng, Marc H. M. Hermans, Edgard Belfort, Dinesh Bhugra
For training schemes with mandatory psychotherapy training, psychodynamic psychotherapy and cognitive-behavioural therapy are the two commonest types of psychotherapy being offered. Previous studies have found that psychodynamic therapy training was the predominant modality of training in the US (Sudak & Goldberg, 2012), and possibly in many countries of the HIC group. Given the demand on the duration and intensity of psychodynamic psychotherapy training, as well as on the availability of recognized psychodynamic trainers, it is not surprising that the LMIC group is less likely to have psychodynamic psychotherapy as a mandatory psychotherapy training modality. However, if any modality of psychotherapy is available in a member country or region, the duration of training is broadly equivalent in both income groups.