Psychotherapy with

Yensen, R. DiLeo, F.B. Rhead, J.C. Riehards, W.A. Soskin, R.A. Turek, B. and Kurland, A.A. MDA-assisted psychotherapy with neurotic outpatients A pilot study. J Nerv Ment Dis 163 233-245, 1976. 

Richards, W. A., Rhead, J. C., DiLeo, F. B., Yensen, R., and Kurland, A. A. (1977) The peak experience variable in DPT-assisted psychotherapy with cancer patients. J. Psychedelic Drugs, 9 1-8. 

Our purpose with this book is to provide a background into the what, why, how, and when questions of psychotropic medications. Recognizing that this conversation cannot exist in a vacuum, we also review diagnostic issues, treatment goals, and ways to integrate psychotherapy with pharmacotherapy and then intersperse this information with clinical examples. It is this combination, the bio witli the psychosocial that optimizes care for so many of the people we treat. 

Traditional psychotherapy, with its emphasis on selfunderstanding, is directed at making patients more responsible for changing themselves and their behaviors. In con-... 

An attempt has been made to discuss the position of drug therapy of various types of mental disorders within a wider perspective, and especially to clarify the relationship between drug therapy and non-drug treatments. It was necessary to deal separately with the various classes of psychopharmaceuticals and the disorders treated with them, and for our purposes it was also sensible to refer as far as possible to controlled, i.e. comparative, studies. The drawback of this evidence-based approach is obvious comparative studies of therapeutic procedures almost necessarily favor one of the compared treatments because they can never be carried out with completely identical preconditions for all treatments (Elkin et studies comparing psychotherapy with pharmacotherapy were scrutinized and discovered to include studies that were not entirely blind, random, controlled or of high quality, leading to inaccurate conclusions. Thus, meta-analyses based on flawed studies are clearly inadequate for the establishment of treatment guidelines (Klein, 2000). On the other hand, the value of an admittedly incomplete summary such as presented here is that results obtained in different places by different authors with different preconditions can be critically compared and related one to the other. 

Klein, D.F. Flawed meta-analyses comparing psychotherapy with pharmacotherapy. Am. J. Psychiatry 157, 1204 1211, 2000. 

In another study, psychotherapy with and without drug therapy was compared with a no formal psychotherapy control group (421,422 and 423). No valid conclusions can be drawn from this study, however, because there was no adequate control group with respect to medication. Further, the majority of the psychotherapy group received medication and the control group was treated in an entirely different milieu, with many apparently transferred to a chronic facility. 

Gorham DR, Pokorny AD. Effects of a phenothiazine and/or group psychotherapy with schizophrenics. Dis NervSyst 1964 25 77-86. 

Rogers CR, Gendlin EG, KieslerDJ, etal., eds. The therapeutic relationship and its impact a study of psychotherapy with schizophrenics. Madison University of Wisconsin Press, 1967. 

Karon BP, Vandenbos GR. Experience, medication and the effectiveness of psychotherapy with schizophrenics. Br J Psychiatry 1970 116 427-428. 

Psychotherapy, with emphasis on the strength of the therapeutic alliance, has been used more often than drugs for such patients, with hypnotherapy specifically used as an intervention for multiple personality (dissociative identity) disorder ( 303, 304). In The Netherlands, individual psychotherapy and adjunctive anxiolytic or antidepressant medications are the most widely endorsed treatment modalities (305). 

Research is only beginning on how to combine psychotherapy with drugs. Although some of the earliest studies did not indicate any additive benefit of tricyclic antidepressants and interpersonal psychotherapy, recent studies are now demonstrat-... 

Gendlin, E. T. "Research in Psychotherapy with Schizophrenic Patients and the Nature of that Illness, " American Journal of Psychotherapy 20, 4-16,1966. 

In the January-March 1977 Journal of Psychedelic Drugs, five doctors on the Spring Grove team discussed their findings about "The Peak Experience Variable in DPT-Assisted Psychotherapy with Cancer Patients. They expressed the opinion that among the many altered states of psychedelic consciousness, peak experiences "are probably among the most difficult to... 

Nonetheless, this team concluded from its experiments with DPT "that peak experiences may constitute an intrinsic element of effective psychotherapy for some persons and that "rapid therapeutic progress in the course of short-term psychotherapy with cancer patients... is indicated by this study. In a comment also pertinent for anyone considering use of DPT, they observed that "when a peak experience does occur, its continuing relevance for daily living may be strongly dependent on the degree to which the associated insights are assimilated or transferred into the everyday self-concept and world view of the patient. ... 

Several issues are important in doing psychotherapy with someone with schizophrenia, where medication compliance is often an issue and where medication noncompliance is usually, eventually, associated with relapse. One goal is to recognize and take measures to minimize side effects. Several studies have shown that akinesia and akathisia are associated with medication noncompliance. Another issue is making the schizophrenic symptoms ego-dystonic to the patient. This may be a long process, involving repeatedly pointing out the ways in which the symptoms are dysfunctional in the patient s life. 

Rhead, J.C, et al. V)TJ. Psychedehc drug (DPT)-assisted psychotherapy with alcoholics A controlled study Journal of Psychedelic Drugs 287-300. 

Dobkin de Rios, M. and O, Rios Reategui 1967. Psychotherapy with ayahuasca (a harmine drink) in northern Peru Trans-cultural Psychiatric Research 4. 

Richards, WA. etal. 1977. The peak experience variable in DPT-assisted psychotherapy with cancer Journal of Psy-... 

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