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Combining drug therapy and psychotherapy

combining drug therapy and psychotherapy

-By Timothy Lyons

The debate between biological and psychological origins of pathological disorders had culminated in a schism in psychology around the 1960’s. This rift was between camps that proposed to treat mental disorders with psychotherapy and those that consider psychopharmacology the first line of attack. It would have been diffcult combining drug therapy and psychotherapy (Preston, O’Neal, & Talaga, 2013).

As biological research progressed, the study and design of both medications and therapeutic techniques began to focus upon mental disorders with greater accuracy. The scientific study of therapeutic modalities to target specific pathologies enhanced their efficacy. The design of medication through predicted interactions based on pharmacokinetics, metabolism and even through cultural perceptions has assisted in better decisions in drug therapy and in combining drug therapy and psychotherapy. (Olson, 2015; Preston, O’Neal, & Talaga, 2013). With the study of new medications and methods, unpleasant side effects are reduced and treatment by pharmacologic means as an adjunct to therapy is improving (Preston, O’Neal, & Talaga, 2013).

Discussion

The impact of pharmacology on the science of psychological treatment has been at the center of controversy since the debate between psychotherapy and biological treatment began. At one time it was highly unlikely that therapists would be combining drug therapy and psychotherapy. It has even been posited that drug companies have pushed for new disorders to come about as a way to enrich themselves (Drugwatch.com, 2012). The study of psychopharmacology threads its way through this type of specious reasoning. Now more than ever, there is science behind treatment combining drug therapy and psychotherapy when necessary, which points toward this combination as being the most effective means to reduce pathological issues with mental disorders (Preston, O’Neal, & Talaga, 2013).

Study in behaviorism

Studies in behaviorism with the use of internal events to discriminate medication side effects is one way that science uses combining drug therapy and psychotherapy and a combination of biological and psychological factors to determine medication efficacy, potency and gain valuable data on receptor selectivity.(Kangas & Maguire, 2016) . The (Pampallona, Bollini, Tibaldi, Kupelnick, & Munizza, 2004) study supports the use of medications and therapy by combining pharmacological interventions backed by psychotherapy to improve medication compliance. This study showed that persons who received methods combining drug therapy and psychotherapy had a statistically significant improvement rate over those that received just the pharmaceutical intervention.

Study with victims of violence

Some journal studies have looked at the relationship between history, background, culture and even access to services. The (Howell & Miller-Graf, 2016) article specifically looks at the relationship between victims of violence, their socioeconomic or cultural setting and innovation of advanced technologies combined with pharmacology. In this way the settings of delivery are seen as a way in which to combine treatments. This is also a manner in which treatment modalities can be considered, especially when combining drug therapy and psychotherapy. The situation that one lives in can also be one that influences treatment.

Study in routes of administration 

The Journal article (Blancke, Dworak, Rodvold, Halvorsen, & Gidal, 2015) takes into consideration routes of administration for pharmacotherapy. In this study an intranasal administration of a medication that reduces seizures was tested against intravenous methods. The article points out that currently the only FDA approved administration of this medication for seizures is rectally.  This is a great example of science looking at ways in which dugs can be improved just by the way in which they are delivered. This study also may point to another means of effective administration besides those pointed out as parenteral in (Olson, 2015). In this type of study we can see ways that science is helping to improve compliance, delivery and effects. This appears to be the type of science that can assist in decisions regarding combining drug therapy and psychotherapy in treatment of psychobiological disorders.

Combining drug therapy and psychotherapy

The school of thought that biological disorders should only be treated with pharmacology has gone by the way side. In this same way, the psychological disorder treated through psychotherapy is not the only way to treat a disorder. If we have two tools that can combine together so that the sum of their parts is a greater whole, then as therapists we would be remiss in our duties if we did not consider this for every client. There are many considerations when looking at treatment to rule out or in, techniques to treat individuals. With knowledge of pharmacology, while understanding of the role of perception, culture and even side effects of medication, practitioners can provide improved therapeutic modalities and medical treatments.

References

Blancke, L. L., Dworak, H. A., Rodvold, K. A., Halvorsen, M. B., & Gidal, B. E. (2015). Pharmacokinetics, pharmacodynamics, and safety of USL261, a midazolam formulation optimized for intranasal delivery, in a randomized study with healthy volunteers. Epilepsia (Series 4), 56(11), 1723-1731.

Drugwatch.com. (2012, January 22). Pharmaceutical Companies and Disease Mongering. Retrieved November 2, 2016, from https://www.drugwatch.com/2012/01/22/disease-mongering-and-drug-marketing/

Howell, K. H., & Miller-Graf, L. E. (2016). Clinical considerations when intervening with individuals exposed to violence. Psychology of Violence, 6(3), 478-483. doi:10.1037/vio0000057

Kangas, B. D., & Maguire, D. R. (2016). Drug Discrimination and the Analysis of Private Events. Behavior Analysis: Research and Practice, Online Publication. doi:10.1037/bar0000032

Olson, J. (2015). Clnical Pharmacology Made Ridiculously Simple (4 ed.). Miami, FL: Medmaster, Inc.

Olufs, E. L., Vallely, R. J., Hembree, K. C., & Evans, J. H. (2016). Brief educational “curbside consultation”: Impact on attention-deficit/hyperactivity disorder referrals in an integrated healthcare setting. Families, Systems & Health: the Journal of Collaborative Family Healthcare, 34(3), 221-228. doi:10.1037/fsh0000210

Pampallona, S., Bollini, P., Tibaldi, G., Kupelnick, B., & Munizza, C. (2004). Combined pharmacotherapy and psychological treatment for depression. Archives of General Psychiatry, 61, 714-719. Retrieved from http://dx.doi.org/10.1001/archpsyc.61.7.714

Preston, J. D., O’Neal, J. H., & Talaga, M. C. (2013). Handbook of Clinical Pharmacology for Therapists (7 ed.). Oakland, CA: New Harbinger Publications.

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