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  • Guidance for Psychological Therapists - Enabling conversations with clients taking or withdrawing from prescribed psychiatric drugs

Guidance for Psychological Therapists - Enabling conversations with clients taking or withdrawing from prescribed psychiatric drugs

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Psychiatric drugs such as antidepressants and antipsychotics are more prescribed today than at any other time in our profession’s history. Around a quarter of the UK adult population was prescribed a psychiatric drug last year, with around 16% being prescribed antidepressants (2016–17). The steep rise in prescriptions means that most therapists now work with clients who have either taken or are taking psychiatric drugs. To date, the lack of summarised evidence, information and training for therapists who work with clients experiencing withdrawal effects constitutes a growing problem for therapists whatever their modality or work setting. 

This guidance seeks to provide such support in two distinct ways: firstly, it aims to support therapists in deepening their knowledge and reflection on working with the said client group. Secondly, it invites therapists to familiarise themselves with core issues relating to the role of psychiatric drugs in therapy.

While this guidance is written for therapists, much that is included may be of professional interest to those working in allied helping professions (e.g. nursing; occupational therapy; social work; and those in relevant caring and medical roles).

Section 1: Dr James Davies, Professor Rosemary Rizq & Dr Anne Guy
1. Introduction
1.1 What are the aims of this guidance?
1.2 Who is this guidance for?
1.3 The medical model and the emerging crisis
1.4 Glossary
1.5 Scope
1.6 How to use the guidance

Section 2: Professor Joanna Moncrieff & Dr Tom Stockmann
2. Introduction for therapists on how psychiatric drugs work
2.1 The place of prescribed drugs in Mental Health Services
2.2 How do psychiatric drugs work?

Section 3: Professor Rosemary Rizq, with Professor Tim Bond, Dr Anne Guy, Dr David Murphy, Paul Sams, Professor Marcantonio Spada & Georgina Whitney
3. Implications for therapeutic practice
3.1 The biomedical paradigm and its relationship to different therapeutic modalities
3.2 Key issues for therapists to consider when working with clients who are taking or withdrawing from prescribed psychiatric drugs
3.3 Practice-related guidance for therapists

Section 4: Professor Joanna Moncrieff & Dr Tom Stockmann
4. What psychiatric drugs do by class
4.1 Interpreting the evidence on psychiatric drugs
4.2 Antidepressants
4.3 Benzodiazepines and related drugs
4.4 Antipsychotics
4.5 Lithium and other drugs referred to as mood stabilisers
4.6 Stimulants
4.7 Combined psychotherapeutic and psychopharmacological intervention in depression
4.8 Conclusion: Understanding psychiatric medication

Section 5: Professor John Read & Dr James Davies, with Luke Montagu & Professor Marcantonio Spada
5. What do we know about withdrawal?
5.1 A general introduction to dependence and withdrawal
5.2 Evidence on the likelihood, range of possible experiences, duration and severity of withdrawal per drug class
5.3 Overall impacts of withdrawal on individuals
5.4 The withdrawal process and terminology

Section 6: Dr Anne Guy, with Dr James Davies, Daniel C. Kolubinski, Luke Montagu & Baylissa Frederick
6. The role of the therapist in assisting withdrawal from psychiatric drugs – what do we know about what is helpful?
6.1 The combined wisdom approach
6.2 Psychiatrist led multidisciplinary models
6.3 How are UK therapists already working with withdrawal?
6.4 Conclusion 

Section 7: Dr Anne Guy (Ed.)
7. Patient voices – examples of withdrawal experiences from real life

All-Party Parliamentary Group for Prescribed Drug Dependence

This guidance was facilitated by the All-Party Parliamentary Group for Prescribed Drug Dependence by bringing together the main professional bodies representing psychological therapists in the UK with key academics and professionals. The aim of the guidance is to support therapists in deepening their knowledge and reflection on working with clients prescribed psychiatric drugs.

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All-Party Parliamentary Group for Prescribed Drug Dependence