Psychotherapy

In the first of a two-part Special Report, the evaluation and management of psychosis is explored across a range of disorders and clinical contexts.

The first generation of cognitive-behavioral therapy for psychosis, when added to standard care, has demonstrated efficacy in treating patients with delusions and hallucinations. Details in this article.

Information from studies on adolescents with psychosis and a review of the evidence about the risk of suicide and suicidal behavior in this patient population.

A patient’s spiritual “framework” can hold the key to therapeutic breakthroughs.

Rorschach, inkblots. . . what do you see here?

We avoid a basic aspect of human existence-namely, we are all a little lost and not knowing, and we had better accept this. In reminding our patients that the worst fate in life is not to suffer-but to suffer alone-we also remind ourselves.

For many patients with depression, full symptom remission remains elusive despite multiple trials of antidepressants. This article focuses on psychopharmacological and related interventions.

What if someone with “prescriptive privileges” looked at superficial symptoms only, and ordered antipsychotics without considering the bigger picture?

Here, tips for therapists to motivate and treat patients effectively with DBT.

Therapeutic farms that offer psychotherapy and psychopharmacology give patients an opportunity to learn about themselves.

The journey of switching specialties from anesthesia to psychiatry, from OR to office.

A therapeutic alliance can serve to build a trusting relationship between clinician and patient and increase the patient’s feelings of agency and autonomy.

For now, it is encouraging to know that psychiatrists remember that they, too, are physicians first who can tap into their medical training to provide comprehensive patient care.

About a year ago, I wrote the blog “Are Dogs Man's Best Therapist?” To my surprise, it turned out to be a very popular one. Since then, dogs continue to be in the news for their therapeutic effect, including being brought to Newtown right after the mass murder there.

Despite the high prevalence of depression among youths, there are empirically supported treatments that have been shown to reduce depressogenic symptoms, including the 3 therapies outlined in this article.

Dogs, indeed, may be man’s (and woman’s) best therapist at certain times and in certain situations, with important implications for mental health.

Knowing from the start how a personality is organized, especially as theorized by Karen Horney-appreciating the primary and repressed moves of the patient, inner dictates, claims, idealized image, and intrapsychic defensive maneuvers-makes the help we offer most likely to succeed.

For this psychiatrist, group therapy has proved to be an extraordinarily effective treatment for a range of mental disorders.

This article explores the use of functional analytic psychotherapy (FAP)-a behavioral, evidenced-based approach to psychotherapy that can add psychotherapeutic benefit to your existing brief approaches during medication checks.

Addressing the Underlying Causes of Treatment Resistance

For prescribing psychiatrists who want to offer treatment alternatives to patients who prefer to avoid medication, the evidence is clear that psychotherapy is an effective choice. Even in cases in which medication is accepted, the evidence suggests that psychotherapy may significantly improve patient outcomes.

A therapist forgets about a patient’s appointment. She becomes abnormally angry, unusually forgiving, atypically bored, or excessively voyeuristic. What is going on? The therapist’s countertransference is making itself known.

Psychotherapy outcomes and the mechanisms of change that are related to its effects have traditionally been investigated on the psychological and social levels, by measuring changes in symptoms, psychological abilities, personality, or social functioning.

Treatment resistance in bipolar disorder is clinically familiar but lacks a standard definition. Numerous evidence-based treatments exist for all phases of bipolar disorder, and these should be optimized and fully explored.

Here is a “pocket guide” for clinicians drawn from actual cases. With some modification, the list could become a patient information sheet or office policy.

Many psychiatrists, residents, and other mental health professionals believe that psychodynamic therapy lacks empirical support or that other psychotherapies are more effective.

Dramatology approaches human encounters, events, and scenes as dramatic enactments of characters in conflict and crisis.

The ancient role of conscience as a moral pilot is rejuvenated, and its neglected function as a spiritual daemon is refurbished for more psychologically minded modern readers.

There is currently a small but impressive evidence base that shows that psychological and interpersonal factors play a pivotal role in pharmacological treatment responsiveness.

Although several studies indicate that psychotherapy (alone or in combination with medications) can help psychiatric patients reach recovery faster and stay well longer, a declining number of office-based psychiatrists are providing psychotherapy to their patients.