Kaplan & Sadock’s Pocket Handbook of Clinical Psychiatry

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Individual couples therapy Each partner is in therapy. It may be concurrent, which means it is with the same therapist. It may also be collaborative, which is when each partner sees a different therapist. Conjoint therapy Conjoint therapy is the most common treatment method in couples therapy, and either one or two therapists treat the partners in joint sessions. Four-way session In a four-way session, each partner is seen by a different therapist in regular joint sessions and all four persons participate. A variation developed by William Masters and Virginia Johnson is used for the rapid treatment of sexually dysfunc tional couples. Group psychotherapy Group psychotherapy consists of three to four couples and two therapists. They explore sexual attitudes and have an opportunity to gain new information from their peer groups. Each receives specific feedback about their behavior, either negative or positive. Combined therapy Combined therapy refers to all or any of the preceding techniques used concur rently or in combination. Dialectical Behavior Therapy Dialectical behavior therapy (DBT) is a form of therapy that has been used suc cessfully in patients with borderline personality disorder and parasuicidal behav ior. It is eclectic, drawing on methods from supportive, cognitive, and behavioral therapies. Some elements are derived from Franz Alexander’s view of therapy as a corrective emotional experience and also from certain Eastern philosophical schools (eg, Zen). Patients are seen weekly, with the goal of improving interper sonal skills and decreasing self-destructive behavior by means of techniques in volving advice, use of metaphor, storytelling, confrontation, among many others. Patients with borderline personality disorder especially are helped to deal with the ambivalent feelings that are characteristic of the disorder. Combined Therapy Combined therapy involves the concurrent use of psychotropic drugs and psy chotherapy. It is extremely widespread and has become the standard of care. In this therapeutic approach, psychotherapy is augmented by the use of phar macologic agents. The term pharmacotherapy-oriented psychotherapy is used by some practitioners to refer to the combined approach. Whenever more than one clinician is involved in treatment, there should be regular exchanges of in formation. When a patient is in psychotherapy with someone other than the cli nician prescribing medication, it is important to recognize treatment bias and to avoid contentious turf battles that put the patient in the middle of such conflict.

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