Trans4mind Home Page
~ Making the Human Heart Visible ~

Looking for a better life?

Our online, interactive video workshops present the most effective methods of personal development, combined with personal support from expert life coaches.

Serious Problems in Psychotherapy Require Serious Medicine

By Steven A. Frankel, M.D.

As a psychotherapy patient, do you wonder whether the work you and your therapist are doing will succeed and produce lasting results? You may like, even admire, your psychotherapist, but how do you know that as a result of his or her work you will achieve the goals for which you came to treatment?

Patients frequently remain in the dark about whether treatment is actually succeeding. The solution to this dilemma is a treatment considerably broader in scope than conventional psychological and psychiatric therapy. This treatment embodies proven techniques for accurately assessing the nature and severity of a psychological problem and for monitoring treatment progress. In using these methods, therapist and patient work collaboratively to track progress, continually providing feedback to each other.

In conducting this innovative method of treatment, the therapist assumes the kind of clinical responsibility that is typical of a physician. He or she takes responsibility for addressing the full range of the patient's presenting and underlying problems, and coordinating his or her treatment, always assimilating the feedback the patient provides.

Take my patient Cori (not her real name). She had been treated by multiple psychotherapists and psychopharmacologists. Cori was bright and empathic, but had a history of failed relationships, depression, and withdrawal when situations soured. Following the loss of a job, Cori was forced to seek support from her aging parents.

All previous attempts at treating Cori had been disappointing. The medications prescribed by Cori's psychiatrists and psychopharmacologists all created additional problems through their side effects. Psychotherapy was unsatisfactory, too. In part, what caused these failures was the inability of professionals to work closely together. Those who were medically oriented also neglected to take full account of Cori's feelings of disappointment and helplessness, while they focused on her physiology. Cori fired her last therapist after two years because she had not progressed. That was when Cori first came to me.

Cori's case was indeed challenging. She needed a full medication review and overhaul, a more functional support system, vocational retraining, and goal-oriented psychotherapy addressing not only her depression, but also practical problems interfering with her daily life. No single issue had overriding priority, and none could be resolved with conventional psychotherapy alone.

What Cori required was a new kind of approach to her treatment, one distinguished by reliable diagnostic assessment, clear-cut goals, monitoring of progress, and above all, coordination between professionals. This is the approach I use when practicing collaborative psychology. As therapist-coordinator of Cori's case, I orchestrate and monitor the entire operation, collaborating with all the other clinicians and consultants involved, and the key people in her support system. But, this brief description of my experience with Cori doesn't capture the essence of the treatment. Cori was a complex human being and this new treatment had to be characterized by profound respect for her and her thinking. Cori needed to be a fully collaborating partner in her treatment. A patient, but not just a patient.

In its comprehensiveness and use of psychological assessment, this is a novel approach to psychotherapy. When patients have a combination of symptoms, such as depression, difficulties involving family, children, relationships, or employment, and at times one or more medical conditions, the issues tend to overlap and may be hard to sort out. To find solutions to these complex problems, the therapist must closely collaborate with the patient and all the other professionals involved.

At the beginning of collaborative psychology treatment there is a clinical evaluation. This step is followed as soon as possible by psychological or neuropsychological testing. Based on these two assessments and the data they provide, the therapist-coordinator prepares a preliminary treatment plan. At this point the patient and therapist together determine the type of treatment they are agreeing to undertake. Then each clinical strategy proposed in the treatment plan is evaluated for efficacy during a trial period. Verbal or written reports, successively modifying the treatment plan, are created in response to changes and progress in treatment.

You may be asking yourself at this point why go to this much trouble and expense?

Consider for a moment the world of medicine. Would you fault a physician who is meticulous about collecting data, obtains needed consultations, regularly informs patients about findings, and revises his or her treatment plan according to whether or not progress is occurring? Of course not.

Using this collaborative psychology method, clinician and patient can determine exactly what kinds of problems need to be treated and become aware of changes in the patient's status as they occur. As the patient or his or her circumstances change, the treatment plan can be modified, so it remains maximally effective. A second clinical and data-based opinion from the psychologist who administers the assessment tests is always part of the process. This person remains available throughout treatment and even past its termination. Making the clinical process even stronger are the regular progress reports the patient receives from and discusses with the clinician.

The extra cost and time required for this comprehensive treatment approach are more than justified by its built in focus on the patient's progressively demonstrated needs and progress. The testing and self-discipline this procedure requires of the clinician assures against misdiagnosis or over-treatment. The likelihood of engaging in formulaic, unproductive treatment, such as often occurs when a therapist reflexively sees a psychotherapy patient once per week for many months or even years, is much reduced. Collaboration with spouses or family members is also encouraged when it is likely improve the treatment outcome.

And, once again, the benefits of such a process? More focused and efficient treatment that leads to substantial results. Cori is now working at a job she enjoys, her family is actively supporting her recovery, she hasn't abused any substances for several years, and is doing a marvelous job of mothering her two boys. Those are results!

Steven A. Frankel, M.D. is the author of four books describing collaborative psychology, including his most recent book Evidence from Within: A Paradigm for Clinical Practice. He has been a practicing psychiatrist for over thirty years. A graduate of Yale University Medical School, Dr. Frankel is board certified in both general and child psychiatry. He is an Associate Clinical Professor at the University of California Medical School and founder and director of the Center for Collaborative Psychology in Kentfield, CA. Learn more about how you, your family, or your patients can work with Dr. Frankel at Steven A. Frankel, M.D..

More personal development articles at the Counterpoint Article Library

From our extensive site, you'll find good info on many topics using this search:

Looking for a better life?

Our online, interactive video workshops present the most effective methods of personal development, combined with personal support from expert life coaches.

A great way to support your Trans4mind Training is to use these popular and effective hypnosis downloads...

  • The Next Level ~ Designed to radically boost your performance in any field. It's based on a technique used by top athletes and other successful people to help them make a big stride forward.
  • Create Your Own Reality ~ Use the power of your unconscious mind to transform your life.
  • Deeper Self Respect ~ Use hypnosis to connect with your true inner worth.
  • Detach From Fear ~ Tune out nervousness and anxiety with hypnosis.
  • Generalized Anxiety Treatment ~ Use hypnosis as a generalized anxiety disorder treatment and you can feel calm today.
  • Improving Concentration and Focus ~ Learn how to discipline, direct and command your mind to improve your performance.
  • Exercise Motivation ~ Give you powerful keys to getting back on track with your exercise - and staying there.
  • Overcoming Shyness ~ Provides an invisible security blanket allowing you to develop social ease and overcome shyness.
  • Quick Confidence Booster ~ An audio hypnosis session that's specifically designed to get you (quickly!) back on track.
  • Stop Negative Thoughts ~ Learn powerful hypnotic techniques to stop negative thoughts before they start.
  • Overcoming Procrastination ~ Let hypnosis help you get on with what you need to do, when you need to do it. Let nothing hold you back.
  • Think Thin ~ Use hypnosis to re-train your brain and lose weight naturally... that's how to get and stay slim.
  • Fall Asleep Fast ~ Relearn how to fall asleep fast and enjoy a good night's sleep.
Search on an issue that interests or concerns you...
 
Copyright © 1997-2016 Trans4mind Ltd