Over the past two decades, the use of medication combined with psychotherapy or psychoanalysis has shifted from an infrequent occurrence to common practice. Concurrently, attitudes toward medication have changed from viewing this intervention as disruptive or as a last resort to a welcome aid in the psychotherapeutic or psychoanalytic process. However, this relatively rapid change has created difficulty in the integration of medication use into the psychotherapeutic setting. Psychotherapy and Medication is an exceptionally valuable and timely volume that provides psychoanalysts, psychotherapists, and other mental health professionals with information on how to work with medication theoretically, clinically, and technically in the context of a psychotherapeutic or psychoanalytic treatment. Important areas of discussion include evidence that a change in the use of medication has taken place, an examination of the factors that have led to this shift, as well as a review of the issues and questions about combining treatments. Psychotherapy and Medication also serves as a framework in how to best answer the many questions that have arisen as the willingness of analysts to use medication increases. Such significant questions include: How should analysts introduce patients to medication? What are the clinical advantages of combined treatment? What is the impact of medication discussions and prescribing on the analyst’s role and how is this best handled?

An in-depth look at a much misunderstood practice, offering a fresh viewpoint on how this science can be a universally effective route to our better selves.

Integrating Psychotherapy and Psychopharmacology: A Handbook for Clinicians is a practical guide for the growing number of mental-health practitioners searching for information on treatments that combine psychopharmacology, psychotherapy, and psychosocial rehabilitation. Research shows that combined approaches are among the most effective ways to treat an increasing number of psychiatric disorders. However, though these combined treatments are becoming the everyday practice of psychiatrists, psychologists, and other mental-health professionals, identifying the right treatment plan can be notoriously difficult, and clinicians are often left scrambling to answer questions about how to design and customize their treatment strategies. In Integrating Psychotherapy and Psychopharmacology, readers will find these questions fully addressed and the answers explained, and they’ll come away from the book with a toolbox full of strategies for helping their patients improve symptoms, achieve remission, and stay well using a combination of drug and psychological treatments.

Inevitably, every psychotherapist has some experience with severely disturbed patients. Consequently, they will turn with excitement to this important new book which is a stunning attempt by two knowledgeable, persevering psychotherapists to present their understanding and sound therapeutic approach to these difficult and challenging patients. The authors argue that the treatment of choice is clearly psychotherapy and that such treatment can be successful and as long lasting for schizophrenic patients as it is for neurotic patients, but the journey may be longer and it may take more time to traverse.The task of therapy is to untangle the past from the present to make the future conceivable. The volume provides a thorough historical overview of the theoretical and clinical approaches to the problem of schizophrenia, including the views of leading contemporary clinicians on the topic. In general, the major clinical controversies have been regarded as issues of whether to focus on past, present or future; reality or fantasy; affects; exploration or relationship; whether the therapist should be active or passive; and how to handle regression. The authors argue that these are the wrong issues. They say that the task of therapy is to untangle the past from the present to make the future conceivable. Reality and fantasy are intertwined and must both be dealt with. Affects are central to all therapy, and emphasis on anger, despair, loneliness, terror, and shame are all necessary, as is the clarification of affect, and the acceptance of positive affect. Activity versus passivity is again in the wrong question; the right one is what action is helpful, when it is helpful, and when is not doing anything helpful? Regression is inevitable; should one accept it fully or try to limit it? This has no general answer other than do what is necessary (i.e., unavoidable) or most helpful to a particular patient at a particular time.

TABLE OF CONTENTS: Part 1 Theory, Methodology, and Experimentation. 1 Some Historical and Conceptual Perspectives on Psychotherapy and Behavior Change. 2 Experiemental Designs in Psychotherapy Research. 3 The Application of Psychophysiological Methods to the Study of Psychotherapy and Behavior Modification. 4 Laboratory Interview Research as an Analogue to Treatment. 5 Social Psychological Approaches to Psychotherapy Research. 6 Clinical Innovation in Research and Practice. Part 2: Analysis of Client-Centered Psychoanalytic, Eclectic, and Related Therapies. 7 The Evaluation of Therapeutic Outcomes. 8 Research on Client Variables in Psychotherapy. 9 Research on Certain Therapist Interpersonal Skills in Relation to Process and Outcome. 10 Content Analysis Studies of Psychotherapy: 1954 through 1968. Quantitative Reseach on Psychoanalytic Therapy. 12 Placebo Effects in Medicine, Psychotherapy, and Psychanalysis. 13 Research on Psychotherapy with Children. 14 Psychotherapy and Ataraxic Drugs. Part 3: Analysis of Behavioral Therapies. 15 Counterconditioning and Related Methods. 16 The Operant Approach in Behavior Therapy. 17 Psychotherapy Based Upon Modeling Principles. 18 The Nature of Learning in Traditional and Behavioral Psychotherapy. Part 4: Therapeutic Approaches to the Home, Family, School, Group, Organization, and Community. 19 Behavioral Intervention Procedures in the Classroom and in the Home. 20 Evaluative Research and Community Mental Health. 21 Empirical Research in Group Psychotherapy. 22 The Effects of Human Relations Training. 23 Research on Educational and Vocational Counseling. Part 5: Evaluating the Training of Therapists. 24 Research on the Teaching and Learning of Psychotherapeutic Skills.

Appendix VIII: Master Drug Chart -- Resources -- Resources Websites -- Index

"The troubling increase in treatment resistance in psychiatry has many culprits: the rise of biomedical psychiatry and corresponding sidelining of psychodynamic and psychosocial factors; the increased emphasis on treating the symptoms rather than the person; and a greater focus on the electronic medical record rather than the patient, all of which point to a breakdown in the person-centered prescriber-patient relationship. Psychodynamic Psychopharmacology illuminates a new path forward. It examines the psychological and interpersonal mechanisms of pharmacological treatment resistance, integrating research on evidence-based prescribing processes with psychodynamic insights and skills to enhance treatment outcomes for patients who are difficult to treat. The first part of the book explores the evidence base that guides how, rather than simply what, to prescribe. It describes precisely what psychodynamic psychopharmacology is and why its emphasis on combining the often-neglected psychosocial aspects of medication with biomedical considerations provides a more optimized approach to addressing treatment resistance. Part II delves into the psychodynamics that contribute to pharmacological treatment resistance, both when patients' ambivalence about their illness, the medication itself, or their prescriber manifests in nonadherence and when medications support a negative identity or are used as replacements for healthy capacities. Readers will gain basic skills for addressing the psychological and interpersonal dynamics that underpin both scenarios and will be better positioned to ameliorate interferences with the healthy use of medications. The final section of the book offers detailed technical recommendations for addressing pharmacological treatment resistance. It tackles issues that include countertransference-driven irrational prescribing; primitive dynamics, such as splitting and projective identification; and the overlap between psychopharmacological treatment resistance and the dynamics of treatment nonadherence and nonresponse in integrated and collaborative medical care settings. By putting the individual patient back at the center of the therapeutic equation, psychodynamic psychopharmacology, as outlined in this book, offers a model that moves beyond compliance and emphasizes instead the alliance between patient and prescriber. In doing so, it empowers patients to become more active contributors in their own recovery"--