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Öèòàòà:
Íàéäåò ëè ñâîþ íèøó íà ïñèõîòåðàïåâòè÷åñêîé íèâå 27-ëåòíÿ ìîëîäàÿ æåíùèíà âðà÷ õîðîøåé êâàëèôèêàöèè, íåäàâíèé âûïóñêíèê ÂÓÇà? Âîçìîæíî äà, íî ñïåêòð åå êëèåíòîâ áóäåò âåñüìà óçîê. ÈÌÕÎ, êîíå÷íî. |
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Öèòàòà:
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#243
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Ìîæåò, ïðîñòî ëåíü
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Âîò ýòî âëåçëè äîêòîðà.
![]() Ìîãó ïîðåêîìåíäîâàòü î÷åíü òðóäíîãî è â òîæå âðåìÿ ïîíÿòíîãî àâòîðà "Áåéòñîí Ã. Ýêîëîãèÿ ðàçóìà. Èçáðàííûå ñòàòüè ïî àíòðîïîëîãèè, ïñèõèàòðèè è ýïèñòåìîëîãèè." Êíèãà èçäàâàëàñü â Ðîññèè. ññûëêó ïîñòàâèòü íå ìîãó, íî â òîé áèáëèîòåêå, êîòîðóþ ÿ ñòàâèë - êíèãà åñòü. Òàì âñåãî ëèøü 500 ñòðàíèö èíòåðåñíîãî òåêñòà. ![]()
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Ñ óâàæåíèåì Âëàäèìèð Ìèõàéëîâè÷ Ïîäêîëçèí |
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Êàê ïåðåäàåò «Ýõî Ìîñêâû», èññëåäîâàíèÿ âûÿâèëè çàêîíîìåðíîñòü: ëþäè, îáðàòèâøèåñÿ çà ïîìîùüþ ê ïñèõîàíàëèòèêó, íà 33% ðåæå ïîñåùàþò äðóãèõ âðà÷åé, íà 75% ðåæå ïîïàäàþò â áîëüíèöó, ïðîïóñêàþò ïî÷òè âïîëîâèíó ìåíüøå ðàáî÷èõ äíåé è ïðèíèìàþò íà òðåòü ìåíüøå ëåêàðñòâ. Ïðè÷åì ýòîò ýôôåêò ñîõðàíÿåòñÿ íà ïðîòÿæåíèè 2,5 ëåò ïîñëå çàâåðøåíèÿ êóðñà ïñèõîòåðàïèè. Óìåíèå ñïðàâëÿòüñÿ ñ æèòåéñêèìè áóðÿìè ïðåäîõðàíÿåò îðãàíèçì îò ïðåæäåâðåìåííîãî èçíîñà. Ìàëî òîãî: ñîãëàñíî ñòàòèñòèêå ÑØÀ, åäâà ëè íå ñàìàÿ áîëüøàÿ ïðîäîëæèòåëüíîñòü æèçíè îòëè÷àåò ïñèõîàíàëèòèêîâ, êîòîðûå, êàê èçâåñòíî, îáÿçàíû ðåãóëÿðíî ñàìè ïîäâåðãàòüñÿ ïñèõîàíàëèçó.
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#247
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Ìîæåò, ó êëèåíòîâ ïñèõîàíàëèòèêîâ ïðîñòî íå îñòà¸òñÿ äåíåã íà äðóãèõ âðà÷åé è ëåêàðñòâà? %-)
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#248
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Íà ðóáåæå òûñÿ÷åëåòèé â Ãàðâàðäå áûëè ïîäâåäåíû èòîãè íåîáû÷íîãî èññëåäîâàíèÿ: â òå÷åíèå ïî÷òè 70 ëåò ïÿòü ïîêîëåíèé ó÷åíûõ âåëè íàáëþäåíèÿ çà ãðóïïîé èç âîñüìèñîò ÷åëîâåê. Ñïåöèàëèñòû ïûòàëèñü ïîíÿòü, èç êàêèõ êîíêðåòíûõ ïîëîæèòåëüíûõ âåëè÷èí ñêëàäûâàþòñÿ ïîíÿòèÿ ñ÷àñòüå è ðàäîñòü æèçíè. Åùå äî íà÷àëà Âòîðîé ìèðîâîé âîéíû áûëè îòîáðàíû íåñêîëüêî ñîòåí øêîëüíèêîâ è ñòóäåíòîâ, ïñèõè÷åñêè è ôèçè÷åñêè çäîðîâûõ è íå ñêëîííûõ ê íàðóøåíèþ çàêîíà. Ñðåäè íèõ áûëè âûõîäöû èç îáåñïå÷åííûõ ñåìåé è îáèòàòåëè ãîðîäñêèõ òðóùîá, îäàðåííûå äåòè è ñêðîìíûå òðîå÷íèêè. Âñå îíè, êàê óìåëè, óñòðàèâàëè ñâîþ æèçíü, à êàæäûå íåñêîëüêî ëåò çàïîëíÿëè àíêåòû è ïðîõîäèëè ìåäèöèíñêîå îáñëåäîâàíèå. Ðåçóëüòàòû óíèêàëüíîãî îïûòà âûëèëèñü â ñòàâøóþ áåñòñåëëåðîì êíèãó ïîñëåäíåãî ðóêîâîäèòåëÿ ïðîåêòà äîêòîðà Äæîðäæà Âýéëàíòà. Ñðàâíèâàÿ æèçíü ñ ìèííûì ïîëåì, îí ïðåäëàãàåò ñòóïàòü ïî ñëåäàì òåõ, êòî óæå óñïåøíî ïðîøåë ïî íåìó, è ñ óäîâîëüñòâèåì äåëèòñÿ ÷óæèì îïûòîì ñ÷àñòëèâîé è äîëãîé æèçíè.
Èòàê, ïåðâûé çàêîí ñ÷àñòëèâîé æèçíè- Áîëåòü ìîæíî, íî íåëüçÿ ÷óâñòâîâàòü ñåáÿ áîëüíûì! Íàøà ñîáñòâåííàÿ îöåíêà ñâîåãî ôèçè÷åñêîãî ñîñòîÿíèÿ ãîðàçäî âàæíåå, ÷åì îáúåêòèâíûå ïîêàçàòåëè. Íèêàêèå ïëîõèå àíàëèçû, êàðäèî-, ýõî- è ïðî÷èå ãðàììû, ïåðåíåñåííûå èíñóëüòû, èíôàðêòû è èæå ñ íèìè íå âëàñòíû îìðà÷èòü ñòàðîñòü, ïîêóäà ÷åëîâåê âîñïðèíèìàåò èõ êàê äîðîæíûå ïðîèñøåñòâèÿ, íåèçáåæíûå â äëèòåëüíîì ïóòåøåñòâèè ïîëîìêè, à íå êàê îñíîâíîå ñîäåðæàíèå ìàðøðóòà. Îïòèìèñòû â áîëåå òÿæåëîì ñîñòîÿíèè âûãëÿäÿò è ÷óâñòâóþò ñåáÿ çíà÷èòåëüíî áîäðåå ðîâåñíèêîâ è äàæå áîëåå ìîëîäûõ ïåññèìèñòîâ. Âòîðîå ïðàâèëî- Ëþáîâü åñòü æèçíü â ñàìîì áóêâàëüíîì ñìûñëå Åñëè ê 50 ãîäàì âåðíûé ñïóòíèê æèçíè îáðåòåí – íåâàæíî, ñ ïåðâîé èëè ïÿòîé ïîïûòêè, – ýòî âåðíûé ïðèçíàê òîãî, ÷òî âû îòïðàçäíóåòå âîñüìèäåñÿòèëåòèå â ñâåòëîì óìå è äîáðîì çäðàâèè. Áîëåå òîãî: îêàçàëîñü, ÷òî ñòàáèëüíûé áðàê – ãîðàçäî áîëåå íàäåæíàÿ ïðèìåòà äîëãîëåòèÿ, ÷åì íèçêèé óðîâåíü õîëåñòåðèíà â òå æå 50. Äîêòîðà óâåðÿþò: äîëüøå è ñ÷àñòëèâåå æèâóò òå, êòî ëþáèò è ëþáèì, êòî óìååò âûñëóøàòü è ïîñî÷óâñòâîâàòü, êòî îòêðûò ëþäÿì è äîáðîæåëàòåëåí. Óìåíèå ïðîùàòü – îäèí èç ñàìûõ âåðíûõ êëþ÷åé ê ñ÷àñòëèâîìó äîëãîëåòèþ. À íàêîïëåííûå îáèäû – íà âñå ëè ìèðîçäàíèå âîîáùå èëè íà áëèæàéøåå îêðóæåíèå – ïîæèðàþò óì è òåëî, êàê ðàêîâûå êëåòêè, çàáèðàÿ ãîäû è óìåíèå èñïûòûâàòü ðàäîñòü. Ñâåòëûå ñòîðîíû æèçíè çàñëóæèâàþò áîëüøåãî âíèìàíèÿ, ÷åì òåìíûå. Êñòàòè, íåäàâíî ó÷åíûå îáíàðóæèëè, ÷òî ñâîéñòâåííûé íåêîòîðûì ïîæèëûì ëþäÿì âðàæäåáíûé íàñòðîé - ñàì ïî ñåáå ôàêòîð ðèñêà ðàçâèòèÿ êîðîíàðíîé íåäîñòàòî÷íîñòè, ïðè÷åì íåèçìåðèìî áîëüøèé, ÷åì âûñîêèé õîëåñòåðèí, èçáûòî÷íûé âåñ, ãèïåðòîíèÿ è êóðåíèå! À ÷òî æå äóøà? Èññëåäîâàíèÿ âûÿâèëè çàêîíîìåðíîñòü: ëþäè, îáðàòèâøèåñÿ çà ïîìîùüþ ê ïñèõîàíàëèòèêó, íà 33% ðåæå ïîñåùàþò äðóãèõ âðà÷åé, íà 75% ðåæå ïîïàäàþò â áîëüíèöó, ïðîïóñêàþò ïî÷òè âïîëîâèíó ìåíüøå ðàáî÷èõ äíåé è ïðèíèìàþò íà òðåòü ìåíüøå ëåêàðñòâ. Ïðè÷åì ýòîò ýôôåêò ñîõðàíÿåòñÿ íà ïðîòÿæåíèè 2,5 ëåò ïîñëå çàâåðøåíèÿ êóðñà ïñèõîòåðàïèè. Óìåíèå ñïðàâëÿòüñÿ ñ æèòåéñêèìè áóðÿìè ïðåäîõðàíÿåò îðãàíèçì îò ïðåæäåâðåìåííîãî èçíîñà. Ìàëî òîãî: ñîãëàñíî ñòàòèñòèêå ÑØÀ, åäâà ëè íå ñàìàÿ áîëüøàÿ ïðîäîëæèòåëüíîñòü æèçíè îòëè÷àåò ïñèõîàíàëèòèêîâ, êîòîðûå, êàê èçâåñòíî, îáÿçàíû ðåãóëÿðíî ñàìè ïîäâåðãàòüñÿ ïñèõîàíàëèçó. Åùå îäíî ïðàâèëî ñ÷àñòüÿ- Ó÷èòüñÿ íèêîãäà íå ïîçäíî è âñåãäà åñòü ÷åìó Ëþäè, ïîëó÷èâøèå õîòÿ áû íåïîëíîå âûñøåå îáðàçîâàíèå, æèâóò â ñðåäíåì íà 6 ëåò äîëüøå òåõ, êòî ïðåíåáðåã òàêîé âîçìîæíîñòüþ. Âèäèìî, ñåêðåò â òîì, ÷òî ó îáðàçîâàííûõ ëþäåé áîëåå øèðîêèå èíòåðåñû è âûñîêàÿ êóëüòóðà, áîëåå îòâåòñòâåííîå îòíîøåíèå ê ñâîåìó çäîðîâüþ. Âîçðàñò – íå îïðàâäàíèå íåæåëàíèÿ ó÷èòüñÿ. Íàîáîðîò: ïîæèëûå ëþäè èçáàâëåíû îò ñóìàñøåäøåãî òåìïà ðàáî÷èõ áóäíåé è îáÿçàííîñòåé ïåðåä äîìàøíèìè è ìîãóò â ïîëíîé ìåðå ïîëó÷èòü óäîâîëüñòâèå îò íîâûõ çíàíèé è íàâûêîâ. Ïñèõîëîãè çàìåòèëè, ÷òî ãîòîâíîñòü ê îñâîåíèþ íîâûõ ñôåð è çàíÿòèÿ òâîð÷åñòâîì ïðèáàâëÿþò ïåíñèîíåðàì ãîðàçäî áîëüøå áîäðîñòè è óâåðåííîñòè â ñåáå, ÷åì óñòîé÷èâîå ìàòåðèàëüíîå ïîëîæåíèå. Íå çðÿ ìóäðûå êèòàéöû ãîâîðÿò, ÷òî ëè÷íàÿ æèçíü íà÷èíàåòñÿ òîëüêî ïîñëå ïÿòèäåñÿòè. Ñàìîå âðåìÿ çàíÿòüñÿ ñîáîé! Áóäüòå çäîðîâû! (ñ) [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] |
#249
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Òèïè÷íàÿ ëîãè÷åñêàÿ îøèáêà. Õîðîøàÿ çàðïëàòà, ãèáêèé ãðàôèê ðàáîòû è ôàêòîð ìîðàëüíîãî óäîâëåòâîðåíèÿ îò ïîìîùè áëèæíèì - ÷òî åùå íàäî.
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#250
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Öèòàòà:
![]() DR. GEORGE VAILLANT Ä-ð Äæîðäæ Âýéëàíò ÿâëÿåòñÿ ïðîôåññîð ïñèõèàòðèè Ãàðâàðäñêîãî ìåäèöèíñêîãî ôàêóëüòåòà è ôàêóëüòåòà ïñèõèàòðèè, Áðàéõåì è Æåíñêîé áîëüíèöå. Ä-ð Äæîðäæ Âýéëàíò èñëëåäîâàòåëü â îáëàñòè ðàçâèòèÿ âçðîñëûõ è âîññòàíîâëåíèÿ ïðè øèçîôðåíèè, ãåðîèíîâîé íàðêîìàíèè, àëêîãîëèçì è ðàññòðîéñòâà ëè÷íîñòè. Ïîñëåäíèå 35 ëåò îí äèðåêîð ïðîåêòîâ ïî èçó÷åíèþ ðàçâèòèÿ âçðîñëûõ â Ãàðâàðäñêîì óíèâåðñèòåòå . Åãî îïóáëèêîâàííûå ðàáîòû âêëþ÷àþò â ñåáÿ: Adaptation to Life The Wisdom of The Ego The Natural History of Alcoholism-Revisited Aging Well A graduate of Harvard College and Harvard Medical School, Dr. Vaillant did his residency at the Massachusetts Mental Health Center and completed his psychoanalytic training at the Boston Psychoanalytic Institute. He has been a Fellow at the Center for the Advanced Study in the Behavioral Sciences, is a Fellow of the American College of Psychiatrists and has been an invited speaker and consultant for seminars and workshops throughout the world. A major focus of his work in the past has been individual adult development; more recently he has been interested in positive emotions and their relationship to community development. He is currently on the Steering Committee of Positive Psychology. Dr. Vaillant has received the Foundations Fund Prize for Research in Psychiatry from the American Psychiatric Association and the Jellinek Award for research in alcoholism. Most recently he received The Distinguished Service Award from the American Psychiatric Association. Åãî óïîìÿíóòàÿ âûøå êíèãà - [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] Îòçûâû íà êíèãó çàìå÷àòåëüíûå: [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] “George Vaillant is a poet, a visionary, and a scientist. This book is the culmination of a fifty-year project that revolutionized our view of human development and now may revolutionize our view of religion and spirituality.” —Martin E. P. Seligman, Ph.D., author of Authentic Happiness and Learned Optimism “At last—an explanation of spirituality from an evolutionary perspective that does justice to both. With his tremendous breadth of experience and personal wisdom, George Vaillant is the perfect spiritual and scientific guide.” —David Sloan Wilson, author of Darwin's Cathedral "More than a scientific defense of faith, George Vaillant's book is a moving account of his own intellectual quest, through science, for a spiritual view of human evolution and experience. Clearly a labor of love and a needed antidote to recent attacks on religion. An important book." —Melvin Konner, M.D., Ph.D., author of The Tangled Wing “Spiritual Evolution is a truly outstanding book, an exquisite weaving of science and spirituality focused on the positive emotions. The result is a wonderful synthesis of material leading to a compassionate and empowering conclusion about the future of humanity. A must-read for everyone who has considered the intersection between spirituality and the human person.” —Andrew Newberg, coauthor of Why God Won't Go Away: Brain Science and the Biology of Belief “In this inspirational and scientifically brilliant essay on human nature, Dr. Vaillant defends the love, hope, joy, compassion, awe, forgiveness, and faith that together form our naturally evolved spiritual essence—an essence enlivened by religion at its best, and distorted by religion at its worst. He draws on a lifetime of heralded literary, scientific, spiritual, and medical insight to write the one prescription that can dispel our shadows of confusion and help heal the world.” —Stephen G. Post, Ph.D., coauthor of Why Good Things Happen to Good People “With uncommon lucidity, balance, and scholarship, George Vaillant draws brilliantly from neurobiology, social science, human developmental psychology, and the wisdom of the great writers and thinkers to clarify and illuminate the positive emotions such as love, compassion, and altruism that elevate humankind and may yet save it.” —Irvin Yalom, M.D., author of Love’s Executioner |
#251
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Öèòàòà:
(1) Æèçíü ïñèõîàíàëèòèêà âåñüìà çàòðàòíà, òàê êàê òðåáóåò ïîñòîÿííîãî, ïî ñóòè "ïîæèçíåííîãî" äî-îáó÷åíèÿ è óñîâåðøåíñòâîâàíèÿ, ó÷àñòèÿ â ðàçëè÷íûõ ìåðîïðèÿòèÿõ, è íåñìîòðÿ íà êàçàëîñü áû íåïëîõèå ãîíîðàðû "áîãàòûõ ïñèõîàíàëèòèêîâ" çíà÷èòåëüíî ìåíüøå, ÷åì "áîãàòûõ âðà÷åé". Òî÷íåå ãîâîðÿ ÿ î òàêèõ íå ñëûøàë. (2) Ðàáîòà íå â òî âðåìÿ, êîãäà õî÷åòñÿ, à êîãäà ýòî óäîáíåå äëÿ êëèåíòîâ/ïàöèåíòîâ, çà÷àñòóþ â âå÷åðíèå ÷àñû è íåêîòîðîå "âûïàäàíèå" â ñâÿçè ñ ýòèì èç îáùåñòâåííîé è ñåìåéíîé æèçíè. (3) Ïñèõîòåðàïåâòó, ïñèõîàíàëèòèêó ÷àñòî ïðèõîäèòñÿ ñòàëêèâàòüñÿ ñ âåñüìà èíòåíñèâíûìè íåãàòèâíûìè ýìîöèÿìè è ïåðåæèâàíèÿìè îáðàùàþùèõñÿ ê íåìó çà ïîìîùüþ ëþäåé, "ïðîïóñêàòü èõ ÷åðåç ñåáÿ". "Îò õîðîøèõ ýìîöèé â ïñèõîòåðàïèþ ëþäè íå ïðèõîäÿò". |
#252
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Íó íå âïàäàéòå â ñàìîáè÷åâàíèå. Ãäå ïîçèòèâíûå ýìîöèè?
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#253
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Òÿæåëà æèçíü ïñèõîàíàëèòèêà â Ãðåéò Áðèòàíèè: [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] (àíãë. ÿç.)
È ïðîñòî ïñèõèàòðàì ñëîæíî: [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] (åùå áîëåå àíãë. ÿç.) |
#254
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Õîðîøèé áðèòàíñêèé þìîð. Êñòàòè, íàáëþäàÿ çà íåâîçìóòèìîñòüþ "ïñèõèàòðà" â ïåðâîì ðîëèêå, ÿ ïîäóìàë, ÷òî ìíå òåïåðü çíà÷èòåëüíî ïîíÿòíåå ñòàëî, ïî÷åìó æå ñòîëü ñèëüíî áðèòàíñêîå êðûëî ïñèõîàíàëèçà - Ìåëàíè Êëÿéí, Áèîí, Ôóêñ(Ôîóëêñ), Òàâèñòîêñêàÿ øêîëà...
À âòîðîé - ïðîñòî áëåñê! :-))) î÷åíü òîíêî è ïðîíèöàòåëüíî! |
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Schizophrenia: psychotherapy, psychological treatments, psychosocial treatments - EBM
GUIDELINE TITLE Schizophrenia
[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] B - Supportive individual and group psychotherapy in combination with medications can reduce relapses and enhance occupational and vocational functioning (Scott & Dixon, 1995). (Grade B, Level IIb) A - Cognitive Behavioural Therapy is beneficial in reducing the symptoms (especially the positive symptoms) of schizophrenia (Garety, Fowler, & Kuipers, 2000). (Grade A, Level Ia) A - Psychoeducation and family intervention can help reduce relapse rates. (Grade A, Level Ib) A - Social skills training improves social adjustment and coping skills, thereby reducing relapse rates (Benton & Schroeder, 1990; Corrigan, 1991). (Grade A, Level Ib) A - Vocational training is likely to benefit those who a) see competitive employment as a personal goal, b) have a history of prior competitive employment, c) have a minimal history of psychiatric hospitalization, and d) have been assessed to have good work skills (Lehman, 1995). (Grade A, Level Ib) PRACTICE GUIDELINE FOR THE Treatment of Patients With Schizophrenia AMERICAN PSYCHIATRIC ASSOCIATION STEERING COMMITTEE ON PRACTICE GUIDELINES [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] 2. Psychosocial treatments in the stable phase For most persons with schizophrenia in the stable phase, treatment programs that combinemedications with a range of psychosocial services are associated with improved outcomes.Knowledge and research regarding how best to combine treatments to optimize outcome arescarce. Nonetheless, provision of such packages of services likely reduces the need for crisis-oriented care hospitalizations and emergency department visits and enables greater recovery.A number of psychosocial treatments have demonstrated effectiveness. These treatments in-clude family interventions (31, 157, 158), supported employment (159–162), assertive commu-nity treatment (163–166), social skills training (167–169), and cognitive behaviorally oriented psychotherapy (158, 170). Individual psychodynamic psychotherapy and psychoanalysis for schizophrenia and severe mental illness Malmberg L, Fenton M [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] Main results No trials of a psychoanalytic approach were identified. Data are sparse for all comparisons involving a psychodynamic approach. There is no evidence of any positive effect of psychodynamic therapy and the possibility of adverse effects seems never to have been considered. The psychodynamic approach may be more acceptable to people than a more cognitive reality-adaptive therapy. Authors' conclusions Current data do not support the use of psychodynamic psychotherapy techniques for hospitalised people with schizophrenia. If psychoanalytic therapy is being used for people with schizophrenia there is an urgent need for trials. Core interventions in the treatment and management of schizophrenia in primary and secondary care Clinical Guideline 1December 2002 [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] 1.3.3 Early post-acute period Psychological treatments 1.3.3.4 Cognitive behavioural therapy (CBT) should be available as a treatment option for people with schizophrenia. A 1.3.3.5 Family interventions should be available to the families of people with schizophrenia who are living with or who are in close contact with the service user.A 1.3.3.6 Counselling and supportive psychotherapy are not recommended as discrete interventions in the routine care of people with schizophrenia where other psychological interventions of proven efficacy are indicated and available. However, service user preferences should be taken into account, especially if other more efficacious psychological treatments are not locally available. C 1.4 Promoting recovery 1.4.4 Psychological interventions Psychological treatments should be an indispensable part of the treatment options available for service users and their families in the effort to promote recovery. Those with the best evidence of effectiveness are cognitive behavioural therapy and family interventions. These should be used to prevent relapse, to reduce symptoms, increase insight and promote adherence to medication. Relapse prevention and symptom reduction: cognitive behavioural therapy and family interventions 1.4.4.1 Cognitive behavioural therapy should be available as a treatment option for people with schizophrenia. A 1.4.4.2 In particular, cognitive behavioural therapy should be offered to people with schizophrenia who are experiencing persisting psychotic symptoms.A 1.4.4.3 Cognitive behavioural therapy should be considered as a treatment option to assist in the development of insight.B 1.4.4.4 Cognitive behavioural therapy may be considered as a treatment option in the management of poor treatment adherence.C 1.4.4.5 Longer treatments with cognitive behavioural therapy are significantly more effective than shorter ones, which may improve depressive symptoms but are unlikely to improve psychotic symptoms. An adequate course of cognitive behavioural therapy to generate improvements in psychotic symptoms in these circumstances should be of more than 6 months' duration and include more than ten planned sessions. B 1.4.4.6 Family interventions should be available to the families of people with schizophrenia who are living with or who are in close contact with the service user. A 1.4.4.7 In particular, family interventions should be offered to the families of people with schizophrenia who have recently relapsed or who are considered at risk of relapse.A 1.4.4.8 Also in particular, family interventions should be offered to the families of people with schizophrenia who have persisting symptoms.A 1.4.4.9 When providing family interventions, the length of the family intervention programme should normally be longer than 6 months’ duration and include more than ten sessions of treatment.B 1.4.4.10 When providing family interventions, the service user should normally be included in the sessions, as doing so significantly improves the outcome. Sometimes, however, this is not practicable. B 1.4.4.11 When providing family interventions, service users and their carers may prefer single-family interventions rather than multi-family group interventions.A etc... |