On Psychodynamic Meanings of Psychiatric Treatment: Discussion of “From Dyad to Triad”

Sandberg, Lawrence B.

doi:10.1080/10481885.2018.1459392

Cited by 1 publication

(1 citation statement)

References 14 publications

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“…That even the same author can hold these contrasting views highlights the ambiguity of attitude towards medication use alongside psychotherapy. Medication prescription has also been suggested to create a third person within the usual dyad of a psychotherapeutic relationship, which can lead to the prescriber being a subject of transference and potentially exposed to unconsciously driven influences (Sandberg, 2018). Haigh and Pearce (2017) provide a comprehensive review of medication use within TCs, highlighting for some TCs, the aim is to stop all psychotropic medication within three months of starting treatment, with a view to promoting agency.…”

Section: Introductionmentioning

confidence: 99%

A pill for every ill?

Hopping¹,

Ivanova

Howe³

2020

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Purpose National guidelines in the UK for emotionally unstable personality disorder and antisocial personality disorder (PD) do not recommend treatment with medication, suggesting instead psychotherapy. There is little evidence that medication has benefit from the literature. Despite this, many patients with PDs are prescribed medications. This study aims to quantify medication prescriptions within the therapeutic community for those with PD and assess if treatment led to changes in prescription. Design/methodology/approach An audit tool was designed in Microsoft Excel; 30 most recent patients discharged from the authors’ service since November 2018 were identified. Their discharge summaries were scrutinised for changes in medication comparing the beginning of treatment to the end. These were then analysed in terms of changes in class of medication and dose as well as total number of medications prescribed. Findings In total, 31 patients’ notes were scrutinised. Then, 25 patients were prescribed psychiatric medication at the start of their treatment, 24 had medications changed falling to 17 at the end of treatment. Antidepressants were the most commonly prescribed medications. By class, antidepressant prescriptions fell by 35 per cent, antipsychotics by 43 per cent, anxiolytics by 40 per cent. The prescription of mood stabilisers and Z drugs remained the same. Originality/value The assessment of medication changes during psychotherapeutic treatment within a therapeutic community is unique in the literature. Understanding and hypothesising the dynamics involved within this process has also received little attention in research. This study highlights the potential from which further research into this neglected but pertinent area could be conducted.

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Section: Introductionmentioning

confidence: 99%