Psychotherapy

Minn Post did a feature story last week on Vail Place, an alternative mental health treatment center run on a community “clubhouse” model where the nearly 900 members and staff work side by side to run the center’s activities. Vail Place was founded in Hopkins, Minnesota in the early eighties by mental health activists and family members as a community for psychosocial rehabilitation. “The work isn’t therapy,” a member explains. “It’s growth. It’s ‘I cans’ rather than ‘I can'ts.’ And that’s important for mental health and survival.”

Writing on his critical psychiatry blog, Duncan Double critiques Joe Herbert’s piece on “Why can't we treat mental illness by fixing the brain?” in Aeon. While Herbert admits that there is a "mysterious and seemingly unfathomable gap" between psychology and neuroscience, which "bedevils not only psychiatry, but all attempts to understand the meaning of humanity,” he goes on to speculate that someday psychiatrists will be able to relate symptoms to brain activity.

The Boston Globe highlights a new book, “In the Mind Fields: Exploring the New Science of Neuropsychoanalysis,” by Casey Schwartz, which explores the importance on psychoanalysis in the age of neuroscience. The author explains that the psychoanalytic approach offers “an absolutely incomparable depth and attention to the specifics of each individual person and their reality. This is exactly what’s disappearing in neuroscience: the quirks, the particularities, the subtleties of the individual.”

Writing on his 1 Boring Old Man blog, Dr. Mickey Nardo reflects on the media frenzy around the RAISE study and asks why the prescription data has not been released. He adds skepticism about the political motives of the potentially overblown results, which he sees as a clear push for increased mental health funding.

Everyone in the world is either touched by their own mental health issues or have had a family member affected. What if they directed their buying power to an organization that would use the profits to fund exciting mental health & recovery projects both in the developing world and in their own countries; projects that would be ethical, non-coercive, personal recovery-based, and were aimed at creating recovery communities? What if they could buy products, crafts, services, art, music, books from people who had experienced mental health issues, enabling them to set up their own businesses or buy from social co-operatives that enabled distressed people to work and earn a living wage?

My opposition to psychiatric drugs is not just that they are harmful, dangerous, and destructive. That would be plenty motivation enough. And it is. But in addition, my profession, which I love and value, has been hijacked by the APA and Big Pharma. It is my goal to return psychiatry to its proper place - where good psychotherapy is understood to be the treatment for human suffering.

Yesterday, the New York Times reported that schizophrenia patients in an experimental treatment program (RAISE) who experienced better outcomes had been on lower doses of antipsychotics than normal. However, the article published in the American Journal of Psychiatry on Tuesday did not divulge any data on the varying antipsychotic drug doses in the different study groups.

The Society for International Psychology, Division 52 of the American Psychological Association, will host a webinar entitled “The Humanistic, Vigorous and Universal Approach of Rational Emotive Behavior Therapy.”

The American Psychological Association is hosting a two and half day interdisciplinary summit on November 3rd through 5th entitled Global Approaches to Integrated Care: Translating Science And Best Practices Into Patient-Centered Health Care Delivery. The summit features presentations and discussions on social determinants of health, demographics, culture and health disparities, and patients’ perspectives, among others. It can be livestreamed here.

Based on the Finnish Open Dialogue approach, the Parachute program is an alternative to current health care systems where a team of health care workers collaborate with families and those in distress to develop a path to recovery. The success of Parachute is now spurring the development of similar programs in the UK.

Results of a large government-funded study call into question current drug heavy approaches to treating people diagnosed with schizophrenia. The study, which the New York Times called “by far the most rigorous trial to date conducted in the United States,” found that patients who received smaller doses of antipsychotic drugs with individual talk therapy, family training, and support for employment and education had a greater reduction in symptoms as well as increases in quality of life, and participation in work and school than those receiving the current standard of care.

People diagnosed with severe depression show the same changes in brain scans when they respond to a placebo as they do when they take an actual antidepressant, according to a new study. Researchers also found that those whose symptoms were decreased by a placebo were more likely to report relief from antidepressant drugs.

While a great deal of the excitement about advances in psychological treatments comes from the potential for research in neuroscience to unlock the secrets of the brain, many mental health experts would like to temper this enthusiasm. A special issue of the Behavior Therapist released this month calls into question the predominant conception of mental illnesses as brain disorders.

To coincide with World Mental Health Day on October 10th, 2015, Verso Books, the largest independent and radical publishing house released a series of blogs on mental health and critical and antipsychiatry. The posts include pieces on R.D. Laing, colonialism, women’s oppression, delusions and art, “The Happiness Industry,” and social and institutional oppression.

While publication bias has been known to overestimate the efficacy of antidepressant treatments, a new study suggests that research on the use of psychotherapy in depression suffers from a similar bias.

The October edition of the Journal of World Psychiatry, the 3rd ranked journal of Psychiatry, will publish a reanalysis of antidepressant efficacy versus placebo in major depression. When the researchers, Arif Khan and Walter Brown, analyzed the data from the FDA archives for antidepressants approved between 1985 and 1997, “it was evident that the conventional wisdom of 70% response with antidepressants was at best an overestimate.” In fact, “the magnitude of symptom reduction was about 40% with antidepressants,” compared to “about 30% with placebo.”

On Wednesday, JAMA Psychiatry released a meta-analysis comparing the results of cognitive-behavioral therapy and antidepressant medication in severely depressed populations. Currently, many practice guidelines suggest that antidepressants be used over psychotherapy for major depressive disorder. The analysis, however, found that “patients with more severe depression were no more likely to require medications to improve than patients with less severe depression.”

Lynne Malcolm, for ABC’s All In the Mind program, interviews three psychoanalysts about how their field remains “relevant and useful in the contemporary therapeutic...

New research published in the August issue of Psychiatric Annals evaluates the results of randomized control trials on the use of various psychotropic drugs for patients diagnosed with borderline personality disorder (BPD). Despite the “American Psychiatric Association’s practice guidelines endorsement of SSRIs as first-line therapies for BPD,” the results of the meta-analysis reveal that pharmacotherapy in BPD is “not supported by the current literature,” and “should be avoided whenever possible.”

Seniors are twice as likely to receive psychotropic prescriptions than younger adults but are much less likely to receive mental health care from psychiatrists or to receive psychotherapy, according to a recent study published in the Journal of the American Geriatrics Society. "Our findings suggest that psychotropic medication use is widespread among older adults in outpatient care, at a far higher rate than among younger patients," the study’s lead author Dr. Maust said in a press release. “In many cases, especially for milder depression and anxiety, the safer treatment for older adults who are already taking multiple medications for other conditions might be more therapy-oriented, but very few older adults receive this sort of care."

The majority of children, adolescents and young adults prescribed antipsychotic medications have not been diagnosed with a mental disorder, according to a recent study published in JAMA Psychiatry.

-On the Oxford University Press blog, a professor of psychiatry and psychology weighs in on recent studies using therapy as a response to problematic psychosis symptoms.

An independent health research organization created to advise the Quebec government on best-evidence guidelines has called for psychotherapy to become the "front-line treatment choice in the mental-health system."

-An article in Canada's Globe and Mail makes the case for expanding public funding of mental health services beyond psychiatrists.

Psychiatrists are giving drugs to most people with emotionally unstable personality disorders outside of the best-practice clinical guidelines, and an accompanying editorial stated that the reason is because "therapy takes time."