Psychotherapies for the Psychoses: Theoretical, Cultural and Clinical Integration

By John F.M. Gleeson; Eóin Killackey et al. | Go to book overview

Foreword

This new book springs out of the Fourteenth International Society for Psychotherapy in Schizophrenia (ISPS) Conference, held in Melbourne, Australia in September 2003. The theme of the conference was different perspectives in ‘understanding’ and ‘treating’ psychosis. Even the use of these two terms is arguably contentious and will no doubt land me in hot water!

The book represents a broad church with contributions from those with a cognitive-behavioural perspective, those adopting a more narrative approach and those operating from a psychodynamic approach. There are frequently tensions between proponents of these various approaches. The book attempts to bring together these different theoretical perspectives in a meaningful way. Material is examined from a theoretical perspective, a global perspective and an integrative perspective. The last specifically deals with integrating psychological interventions into ‘real life’ settings.

In the third section, the various approaches appear to take their beginnings from the patients themselves, recognizing the different needs of the firstepisode patient group and their unique characteristics including developmental phase. The importance of the treatment alliance and collaboration is pivotal to working with this patient group; if one cannot engage these individuals, obtain some shared understanding, then there can be no therapeutic progress. One of the lessons learned from psychodynamic approaches has been the primacy of the therapeutic alliance – something to my mind traditionally denied by behaviourists and given some but insufficient attention by the first generation of cognitivists. In psychotherapy the patient is an ‘active’ collaborator rather than being the recipient of action initiated by an external referent, the therapist. ‘Experience’, ‘Understanding’ and ‘Collaboration’ are key constructs.

It is pleasing to see that there is a major focus on families in this book. The family has traditionally been vilified, excoriated or neglected since the 1950s. There is a renewed focus on working with families to better understand their problems including their need for support and assistance in living with and ‘assisting’ the client. Equally importantly, there is a need to prevent

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