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Background: Body dysmorphic disorder (BDD) is a severe and undertreated condition. Although cognitive-behavioral therapy (CBT) is the first-line psychosocial treatment for this common disorder, how the intervention works is insufficiently understood. Specific pathways have been hypothesized, but only one small study has examined the precise nature of treatment effects of CBT, and no prior study has examined the effects of supportive psychotherapy (SPT). Methods: This study re-examined a large trial (n = 120) comparing CBT to SPT for BDD. Network intervention analyses were used to explore symptom-level data across time. We computed mixed graphical models at multiple time points to examine relative differences in direct and indirect effects of the two interventions. Results: In the resulting networks, CBT and SPT appeared to differentially target certain symptoms. The largest differences included CBT increasing efforts to disengage from and restructure unhelpful thoughts and resist BDD rituals, while SPT was directly related to improvement in BDD-related insight. Additionally, the time course of differences aligned with the intended targets of CBT; cognitive effects emerged first and behavioral effects second, paralleling cognitive restructuring in earlier sessions and the emphasis on exposure and ritual prevention in later sessions. Differences in favor of CBT were most consistent for behavioral targets. Conclusions: CBT and SPT primarily affected different symptoms. To improve patient care, the field needs a better understanding of how and when BDD treatments and treatment components succeed. Considering patient experiences at the symptom level and over time can aid in refining or reorganizing treatments to better fit patient needs. [ABSTRACT FROM AUTHOR]

Background: Habits are behavioral routines that are automatic and frequent, relatively independent of any desired outcome, and have potent antecedent cues. Among individuals with anorexia nervosa (AN), behaviors that promote the starved state appear habitual, and this is the foundation of a recent neurobiological model of AN. In this proof-of-concept study, we tested the habit model of AN by examining the impact of an intervention focused on antecedent cues for eating disorder routines. Methods: The primary intervention target was habit strength; we also measured clinical impact via eating disorder psychopathology and actual eating. Twenty-two hospitalized patients with AN were randomly assigned to 12 sessions of either Supportive Psychotherapy or a behavioral intervention aimed at cues for maladaptive behavioral routines, Regulating Emotions and Changing Habits (REaCH). Results: Covarying for baseline, REaCH was associated with a significantly lower Self-Report Habit Index (SRHI) score and significantly lower Eating Disorder Examination-Questionnaire (EDE-Q) global score at the end-of-treatment. The end-of-treatment effect size for SRHI was d = 1.28, for EDE-Q was d = 0.81, and for caloric intake was d = 1.16. Conclusions: REaCH changed habit strength of maladaptive routines more than an active control therapy, and targeting habit strength yielded improvement in clinically meaningful measures. These findings support a habit-based model of AN, and suggest habit strength as a mechanism-based target for intervention. [ABSTRACT FROM AUTHOR]

Background: Evidence for the efficacy of cognitive-behavioural therapy for schizophrenia is promising but evidence for clinical effectiveness is limited.Aims: To test the effectiveness of cognitive-behavioural therapy delivered by clinical nurse specialists in routine practice.Method: Of 274 referrals, 66 were allocated randomly to 9 months of treatment as usual (TAU), cognitive-behavioural therapy plus TAU (CBT) or supportive psychotherapy plus TAU (SPT) and followed up for 3 months.Results: Treatment effects were modest but the CBT condition gave significantly greater improvement in overall symptom severity than the SPT or TAU conditions combined (F (1,53)=4.14; P=0.05). Both the CBT and SPT conditions combined gave significantly greater improvement in severity of delusions than did the TAU condition (F (1,53)=4.83; P=0.03). Clinically significant improvements were achieved by 7/21 in the CBT condition (33%), 3/19 in the SPT condition (16%) and 2/17 in the TAU condition (12%).Conclusions: Cognitive-behavioural therapy delivered by clinical nurse specialists is a helpful adjunct to routine care for some people with chronic psychosis. [ABSTRACT FROM AUTHOR]

Background: The attempt to define psychotherapeutic skills appropriate for psychiatrists has aroused an interest in supportive psychotherapy, a previously undervalued and underdeveloped member of the psychotherapeutic family. This has been coupled with an increasing recognition of the importance of support within formal psychotherapies, especially when working with highly disturbed patients.Method: A review of supportive psychotherapy (ST) was performed, based on a Medline literature search.Results: It is argued that, from the perspective of attachment theory, support is an integral part of al psychotherapies. ST is also a specific mode of treatment suitable for some patients suffering from psychotic illnesses and borderline personality disorder. ST is an eclectic treatment drawing on many theoretical approaches. A common theme based on a narrative co-constructionist perspective, the search for positive meaning, is identified.Conclusions: Supportive psychotherapy is an essential component of good psychiatric practice. Further research is needed to define its benefits and limitations. [ABSTRACT FROM AUTHOR]

Supportive psychotherapy is much practiced, but little described. An account is given of an approach that combines supportive and dynamic elements, is suitable for 'difficult' patients, and may be cost-effective. Two illustrative causes are presented. [ABSTRACT FROM AUTHOR]

The article differentiates dynamic psychotherapy (DP) with supportive psychotherapy (SP). According to the author, DP is once-a-week psychotherapy, while SP, in terms of frequency and regularity, is less fixed and more closely related to needs. According to the author, SP is relatively infrequent which could be once a month or less. DP, the author adds, focuses on identified problems in the client and of having agreed realistic goals for therapy. On the other hand, SP is concerned with symptoms which could be chronic and readily identifiable.

Practicing psychiatrists' views about the treatment of schizophrenia were investigated as part of a Quality Assurance Project. A questionnaire which asked for treatment recommendations for each of four case descriptions of patients with schizophrenia was mailed to a one-in-six random sample of Australian psychiatrists; 90% responded. Psychiatrists almost uniformly advocated the use of antipsychotic drugs and usually recommended concurrent supportive psychotherapy or family/social intervention procedures. The recommendations varied systematically, according to the initial history obtained and to the initial response to treatment. [ABSTRACT FROM AUTHOR]

Aim To conduct a three-arm partial randomised controlled trail to evaluate the effectiveness of expedited regular supportive psychotherapy and assertive case management for patients presenting with suicidal ideation or self-harm to the emergency department (ED). Hypothesis We expect expedited regular supportive psychotherapy plus assertive case management will reduce the suicidality and/or suicidal behaviour in patients by at least 20% at 4 weeks compared to patients receiving only assertive case management or routine care and these differences will be sustained at 6 months. Methods This will be a longitudinal, prospective, three-arm controlled single-rater-blinded partial randomized clinical trial with a recruitment period of 12 months and an observation period of 6 months for each participant. Patients in the intervention group will receive regular face-to-face or over the phone brief supportive psychotherapy during weekdays following presentation to the ED with suicidal ideation or self-harm until patients are actively enrolled in regular community mental health services with active case management by the therapist. Patients in the control and the assertive outreach arms will each receive the usual follow-up services offered routinely to regular patients and assertive outreach patients respectively who present to the ED with suicidal ideation or self-harm. Results Recruitment will commence in February 2016 and we expect the results of the study to be available by September 2017. Conclusion If our hypothesis is proved correct, our intervention will be a new model for caring for patients with self-harm and suicidal ideation and is expected to reduce suicide rates. [ABSTRACT FROM AUTHOR]

The author comments on the article about supportive psychotherapy by Jeremy Holmes. She notes that Holmes describes the difficulties in defining supportive therapy but failed to explain its confusing interpretations. She cites Holmes' argument that supportive psychotherapy offers secure attachment that could help to anchor the therapeutic relationship and allow gains to be made. The author points out that Holmes' article failed to provide a comprehensive examination of the literature and adequate level of critical evaluation.

A letter to the editor is presented in response to an article about supportive psychotherapy.

A letter to the editor is presented in response to an article about supportive psychotherapy.

Families universally agree that Anorexia Nervosa takes over almost every aspect of their lives, becoming the central organizing principle of the family''s life. Over the last years focus for family interventions has been the Multiple Family Day Treatment approach (MFDT), which has a strong focus on helping families to maximize their strengths and resources, in order to help their patient member to recover. An important goal of MFDT is to help break the interconnections that have developed between the symptom and family interactions, and help overcome the sense of being unable to move and communicate freely about the problems. When families come together they witness each other, revealing their narratives about developed rules, roles, rituals and myths. The differences in the way that individual families have coped, allows for the possibility to look for alternative ways of managing the problem within the family. The authors describe their first experience with MFDT, which occurred in a Portuguese hospital with 17 families of anorectic patients. The shared experience of what it is like for families to live with anorexia quickly helps to create group cohesion and a supportive atmosphere in which difficulties can be tackled. Hearing how other families have overcome problems helps families to broaden their own time frame and consider trying new things. The MFDT has attracted considerable interest has an innovative and effective treatment, and feedback received from families has been very positive emphasizing in particular the collaborative nature of the treatment. [Copyright &y& Elsevier]

A letter to the editor is presented in response to the article about supportive psychotherapy in the February 1988 is presented.

A letter to the editor is presented in response to an article about supportive psychotherapy.

A letter to the editor is presented in response to an article about supportive psychotherapy.