An Integrated Treatment Algorithm for Pharmacotherapy and Psychotherapy

Abstract

The following steps were undertaken: (i) setting priorities for the commissioning of psychotherapy on the basis of the scientific literature including greater use of brief and focused forms of integrative therapy from a variety of psychotherapeutic schools; (ii) targeting interventions on the basis of objective criteria to ensure that patients were referred for the appropriate level and intensity of psychological intervention using the full range of available services within the NHS, the independent sector, and voluntary agencies; (iii) agreeing on an integrated treatment algorithm (ITA) for the use of the most cost-effective treatments while ensuring that a range of alternative interventions was available for patients for whom a first line therapy was not suitable. Such an ITA could be adapted to assist general practitioners in their management and referral decisions; (iv) sharing skills between specialist psychotherapy services and members of primary and mental health teams through training, supervision and consultation-liaison.

Childhood Trauma and Major Mental Illness – Integration of Psychopharmacology with Psychological Treatments

“…A substantial number of patients do not achieve a clinically meaningful benefit, despite multiple antidepressant trials and augmentation [10,11] while psychotherapy improves outcome when combined with medication, compared to medication alone [12]. The demand for psychotherapy services was found to exceed service provision by a factor of four [13] which need to be acknowledged and remedied.…”

Moving beyond the descriptive in psychotherapy research

“…5,9 There are also algorithms that can assist in the selection of the right treatment in terms of availability and the best fit between the client, therapist and psychotherapy. 10…”

Is there a missing-middle in Australian mental health care?

“…Equity of access to services is also included'. 7 However, a search of the Pubmed, Medline and PsycInfo databases searching for the specific term 'missing middle', only yielded 17 peer-reviewed papers on 3 September 2021, of which solely one defined the term 'missing-middle' in relation to mental health. 8 This was a paper by Petrie et al 8 who stated it was used by mental health practitioners to mean '…patients who were moderately unwell, but partly functioning, who did not meet criteria for crisis services and required ongoing treatment and therapy, which was often out of their financial means'.…”