Psychotherapy advances

For years, psychiatric and drug abuse disorders were not even treated together. Now we know they commonly co-occur, which means for many years clients were getting only partial treatment. Even today we are still not sure how to treat these co-occurring conditions simultaneously in a consistently effective way with both psychotherapy and pharmacotherapy (see Chapter 5). The next century is likely to see many advances in both pharmacotherapy and psychotherapy to treat co-occurring conditions. There are effective methods to treat drug abuse and to treat other co-occurring psychiatric disorders. The next frontier in research is to learn how to combine these approaches in a way that can treat multiple disorders at once ... 

Despite the diagnostic challenges that remain in trying to understand the nature of MDD in children and adolescents, advances in its treatment has progressed considerably since the last edition of this textbook. Over this interval, selective serotonin reuptake inhibitors (SSRIs) have superseded TCAs as the treatment of first choice based both on efficacy and safety considerations. As in adults, specific psychotherapies (cognitive therapy, cognitive-behavioral therapy, and interpersonal therapy) may be as effective as antidepressant medication, at least in mild to moderate depression in children and adolescents ( 111, 112). Also, evidence indicates that depression in children and adolescents may be more influenced than is depression in adults by psychosocial variables such as peers and family, as well as other environmental factors (113). 

In this book we have focused treatment discussions on psychotropic medications. But bear in mind that however remarkable the advances in drug therapy may be, the traditional knowledge and skills of psychotherapy practice remain vitally important. In fact, research suggests that an ideal treatment often occurs when both psychotherapy and psychotropic medications are part of the treatment plan. In addition, services and interventions that enhance social support, such as group therapy, family psychoeducation, and Internet chat groups, are often critical to the success of the therapy. 

New discoveries in the neurosciences, refined technical advances in psychotherapy, and a large number of outcome studies in both pharmacotherapy and psychotherapy have made it abundantly clear People are complex. Mental health problems spring from many sources and reductionist, unidimentional models are simply inadequate to explain the wide array of mental and emotional problems people experience. Likewise, no single approach to treatment works for all problems. Certain disorders clearly respond better to certain interventions, whereas others require alternative approaches. 

Weist, M. D Christodulu, K. V. (2000). Expanded school mental health programs Advancing reform and closing the gap between research and practice. Journal of School Health, 70(5), 195-200. Weisz, J. R., Weiss, B. (1993). Effects of psychotherapy with children and adolescents. Newbury Park, CA Sage. 

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