Towards a more humanistic psychiatry: Development of need‐adapted treatment of schizophrenia group psychoses

Alanen, Yrjö O.

doi:10.1080/17522430902795667

Cited by 81 publications

(31 citation statements)

References 31 publications

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“…These drugs, which benefit only between a third to two-thirds of recipients (in terms of relapse prevention or symptom reduction), have serious health risks (Ross & Read, 2004;Mosher et al, 2004), including increased mortality risk (Weinmann et al, 2009), for all recipients, leading to high levels of 'non-compliance'. Meanwhile a range of psychological interventions that address the psycho-social causes and the maladaptive mechanisms identified above, have been found to be effective, at least for some patients, and are free from health risks for all (Gleeson et al, 2008;Read et al, 2004c;Alanen, 2009;Morrison, 2009). Meanwhile a range of psychological interventions that address the psycho-social causes and the maladaptive mechanisms identified above, have been found to be effective, at least for some patients, and are free from health risks for all (Gleeson et al, 2008;Read et al, 2004c;Alanen, 2009;Morrison, 2009).…”

Section: Treatmentmentioning

confidence: 99%

Time to abandon the bio-bio-bio model of psychosis: Exploring the epigenetic and psychological mechanisms by which adverse life events lead to psychotic symptoms

Read¹,

Bentall²,

Fosse³

2009

Epidemiol Psychiatr Sci

146

121

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Link to this article: http://journals.cambridge.org/abstract_S1121189X00000257How to cite this article: John Read, Richard P. Bentall and Roar Fosse (2009). Time to abandon the bio-bio-bio model of psychosis: Exploring the epigenetic and psychological mechanisms by which adverse life events lead to psychotic symptoms.Abstract. Mental health services and research have been dominated for several decades by a rather simplistic, reductionistic focus on biological phenomena, with minimal consideration of the social context within which genes and brains inevitably operate. This 'medical model' ideology, enthusiastically supported by the pharmaceutical industry, has been particularly powerful in the field of psychosis, where it has led to unjustified and damaging pessimism about recovery. The failure to find robust evidence of a genetic predisposition for psychosis in general, or 'schizophrenia' in particular, can be understood in terms of recently developed knowledge about how epigenetic processes turn gene transcription on and off through mechanisms that are highly influenced by the individual's socio-environmental experiences. To understand the emerging evidence of the relationship between adverse childhood events and subsequent psychosis, it is necessary to integrate these epigenetic processes, especially those involving the stress regulating functions of the HPA axis, with research about the psychological mechanisms by which specific types of childhood trauma can lead to specific types of psychotic experiences. The implications, for research, mental health services and primary prevention, are profound.Declaration of Interest: None of the authors have any conflicts of interest in relation to this paper.KEY WORDS: sexual abuse in childhood, psychosis, mechanism of psychiatric symptoms.

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Section: Treatmentmentioning

confidence: 99%

Time to abandon the bio-bio-bio model of psychosis: Exploring the epigenetic and psychological mechanisms by which adverse life events lead to psychotic symptoms

Read¹,

Bentall²,

Fosse³

2009

Epidemiol Psychiatr Sci

146

121

View full text Add to dashboard Cite

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“…The Boston study (Gunderson et al, 1984) found that introspective therapies do not obtain better results than supportive ones and McGlashan (1994) proposed integration of supportive strategies in the dynamic approaches. Support and insight factors do not exclude each other and the focus of the therapies should adapt to the patients' needs (Alanen, 2009) and to the possibilities of the therapists and care devices (García Cabeza, 2008).…”

Section: Discussionmentioning

confidence: 99%

Therapeutic factors and insight in group therapy for outpatients diagnosed with schizophrenia

García-Cabeza

Chávez

2009

Psychosis

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Aims:This study aimed to discover the most important group therapeutic factors in group psychotherapy with patients diagnosed with "schizophrenia", according to Yalom's Q-sort questionnaire, and to determine if these factors were related to insight. Method: Seventeen patients diagnosed with schizophrenia who came to weekly outpatient group therapy were evaluated. In addition to a sociodemographic questionnaire, a psychopathology scale (BPRS), the global assessment of functioning scale (GAF), insight scales (SAI-E and Camarillo) and the Yalom Qsort questionnaire were administered. Results: The patients self-rated "instillation of hope" as the most valuable therapeutic factor and identification as the least.The insight level of the patients was positively correlated with the self-rated "self-understanding" value within the group therapy factors.A reciprocal relationship was found between insight and the group therapeutic factor of self-understanding. As the patients acquired better clinical insight, they gave greater importance to self-understanding as a group therapy factor. Conclusion: This greater acknowledgement of the value of self-knowledge increased their possibilities of acquiring even better clinical insight.

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“…In the wake of the failure of the theory of the “schizophrenogenic mother,” and the pain that its caused, the biomedical model has a “moral stance” (Luhrmann, , p. 139). Focusing on the dysfunction of the individual allows one to avoid encountering “deep rooted problems” (Alanen, , p. 159) such as poverty, war, childhood trauma, social inequality, violence and failures of justice systems. Furthermore, bio‐psychiatry has an intricate relationship with neoliberalism where the focus on the individual at once justifies neoliberal policy and supports the expansion of related industries (Moncrief, ).…”

Section: Community Treatment Orders and The Scapegoating Mechanismmentioning

confidence: 99%

The social utility of community treatment orders: Applying Girard’s mimetic theory to community‐based mandated mental health care

Jäger

Perron

2019

Nursing Philosophy

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Serious mental illness (SMI) has long posed a dilemma to society. The use of community treatment orders (CTOs), a legal means by which to deliver mandated psychiatric treatment to individuals while they live in the community, is a contemporary technique for managing SMI. CTOs (or a similar legal mechanism) are used in every province in Canada and in many jurisdictions around the world in the care and management of clients with severe and persistent mental illness (most frequently schizophrenia) who have a history of treatment non‐compliance and subsequent relapse. Although there is ongoing controversy around CTOs, their use continues to be on the rise. René Girard's mimetic theory, in which he posits the social utility of the scapegoat mechanism, may shed some light on how established cultural patterns contribute to contemporary responses to SMI: how culture depends on the reproduction of certain narratives, and how these act to shape the identity of those involved. The CTO specifically can be seen to act as a scapegoating mechanism, wherein, by singling out and controlling individuals who appear to threaten social order, social order is restored. This paper reviews Girard's theory, looks at how it has been applied to SMI, and then considers how it may illuminate the social role of the CTO. This examination may provide mental health nurses with insight into the constructed identities of their patients, as well as the role of mental health care within broader cultural narratives.

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Towards a more humanistic psychiatry: Development of need‐adapted treatment of schizophrenia group psychoses

Cited by 81 publications

References 31 publications

Time to abandon the bio-bio-bio model of psychosis: Exploring the epigenetic and psychological mechanisms by which adverse life events lead to psychotic symptoms

Time to abandon the bio-bio-bio model of psychosis: Exploring the epigenetic and psychological mechanisms by which adverse life events lead to psychotic symptoms

Therapeutic factors and insight in group therapy for outpatients diagnosed with schizophrenia

The social utility of community treatment orders: Applying Girard’s mimetic theory to community‐based mandated mental health care

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