TREATMENT DEVELOPMENT IN PSYCHODYNAMIC INTERPERSONAL PSYCHOTHERAPY (HOBSON'S ‘CONVERSATIONAL MODEL’) FOR CHRONIC TREATMENT RESISTANT SCHIZOPHRENIA: TWO SINGLE CASE STUDIES

Abstract

Two cases are presented from a project to develop psychodynamicinterpersonal (PI) therapy (Hobson's`Conversational Model') with long-term severe schizophrenia treated in a locked setting. We present two cases from a treatment development project including a description of the model and its use in this setting with some (anonymized) details of the therapy. The ward milieu can act as a container for disturbed dynamics during psychotherapy, but the lack of progress prior to the psychotherapy suggests that there is also the potential for the ward to reinforce or even replicate the disturbance in the patient's internal world. These complex interactions are considered in the light of the methodology for future studies. Preliminary outcome data and a description of the positive changes observed are included, but with a note of caution about the difficulty of interpreting outcome findings from single case studies in a complex treatment setting.

Lessons from psychotherapy research for psychological interventions for people with schizophrenia

“…However, successful family interventions incorporating psychodynamic principles or techniques have been carried out in both Scandinavia and the US (e.g. Levene, Newman, & Jefferies, 1989Tuori et al, 1998), and reports have begun to appear in British psychotherapy literature reporting on successful exploratory use of psychodynamicinterpersonal interventions with people with schizophrenia (Davenport, Hobson, & Margison, 2000).…”

Therapeutic communities

“…Another example where therapeutic community principles have been modified and adapted for those with severe mental illness is Davenport's work in Salford in a secure setting with patients with poorresponse schizophrenia (Davenport, 1997(Davenport, , 2000. Particular attention is given to potentially harmful interactions between the dynamics of the psychosis itself, early experiences of abuse and the psychology of the institution.…”

Personal reflections of mental health nurses training to use Hobson's Conversational Model (psychodynamic‐interpersonal) of psychotherapy

“…1999). Of potential value with people with schizophrenia (Davenport et al . 2000), and people with early Alzheimer’ disease (Brierley et al .…”

“… Firstly, everyone was adamant that they were enthusiastic about continuing to use the model in their own practice and wanting to participate in future developments associated with the model. Group members wanted to disseminate the model as a way of working with people with non‐psychotic enduring mental health problems. We also plan to begin using the model with people with psychotic disorders as there is an emerging literature in this area (Davenport et al . 2000).…”

“…We also plan to begin using the model with people with psychotic disorders as there is an emerging literature in this area (Davenport et al . 2000).…”