Antipsychotic drug-induced dysphoria

Abstract

In-patient psychotherapy Sm: We were interested to read Norton & Hinshelwood's (1996) account of the clinical need for in-patient psychotherapy units. However, we do not believe that in-patient psychotherapy units are the only, or indeed the best treatment for these patients. In-patient units are expensive to run, make heavy demands on staff round the clock, and remove patients from their normal environment and support networks. We run a therapeutic community as a day service, which is open for five days a week and caters for a similar patient population at a district level. Like the Henderson, the programme is one of milieu therapy with intensive group psychotherapy. There is no individual treatment. Like the Cassel, the analytic principles of â€oe¿ a culture of enquiry― and staffing and supervision to prevent splitting and other destructive defensive procedures are paramount. The advantages of having day patient treatment are financial, administrative and clinical. Treatment costs are approximately half of in-patient facilities, and the complexities of staffing the unit are much less. A considerable clinical advantage is the on-call system for out of hours run by the patients them selves, which is seen as an important part of the therapeutic process itself. For many patients it is also important that their previous social function ing continues during their admission, and this is particularly important for those who are parents.