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Medical Family Therapy in Psychiatry

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Clinical Methods in Medical Family Therapy

Part of the book series: Focused Issues in Family Therapy ((FIFT))

Abstract

The term “Psychiatry,” named first in 1808 by physician Johann Christian Reil, is derived from two Greek words: psyche (soul) and iatros (healer) (Marneros, 2008). Over the years, psychiatry has remained a specialty of medicine focused on the complexities of the human mind. While understanding the etiologic and remediating factors of mental illness has been a mainstay of psychiatric practice, clinical methods have varied over time. Psychiatry has seen shifts from Freudian psychoanalysis to more structured, manualized therapeutic approaches. Emerging science has taken the profession further away from its therapeutic roots, in favor of psychopharmacologic and neurologic discovery. Nevertheless, psychiatry continues to be a practice defined by interdisciplinary collaboration as well as conceptualization sensitive to familial and cultural factors. This is demonstrated through the American Psychiatric Association’s (American Psychiatric Association, 2016a) values of “prevention, access, care and sensitivity for patients and compassion for their families; respect for diverse views and pluralism within the field; and respect for other health professionals” (para 3).

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Notes

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    Note: References that are prefaced with an asterisk are recommended readings.

References

Note: References that are prefaced with an asterisk are recommended readings.

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Authors and Affiliations

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Correspondence to Kenneth Phelps .

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Editors and Affiliations

Additional Resources

Additional Resources

Literature

Beck, J. (2011). Cognitive therapy: Basics and beyond (2nd ed.). New York, NY: Guilford Press.

Dewan, M. J., Steenbarger, B. N., Greenberg, R. P. (2012). The art and science of brief psychotherapies: An illustrated guide (2nd ed.). Arlington, VA: American Psychiatric Publishing, Inc.

Heru, A. M., & Drury, L. M. (2007). Working with families of psychiatric inpatients: A guide for clinicians. Baltimore, MD: Johns Hopkins University Press.

Keiter, G. I., Heru, A. M., & Glick, I. D. (2010). Clinical manual of couples and family therapy. Arlington, VA: American Psychiatric Publishing, Inc.

Linehan, M. M. (2015). DBT skills training manual. New York, NY: Guilford Press.

Measures/Instruments

Beck Scales. https://www.beckinstitute.org/get-informed/tools-and-resources/professionals/patient-assessment-tools/

Child/Adolescent Psychiatry Screen (CAPS). http://www2.massgeneral.org/schoolpsychiatry/childadolescentpscychiatryscreencaps.pdf

Generalized Anxiety Disorder 7-item scale (GAD-7). http://www.integration.samhsa.gov/clinical-practice/GAD708.19.08Cartwright.pdfMulti-Health Systems, Inc., http://www.mhs.com

Patient Health Questionnaire (PHQ-9). http://www.cqaimh.org/pdf/tool_phq9.pdf

Screen for Child Anxiety Related Disorders (SCARED). http://psychiatry.pitt.edu/sites/default/files/Documents/assessments/SCARED%20Child.pdf

Yale-Brown Obsessive Compulsive Scale Symptom Checklist. http://healthnet.umassmed.edu/mhealth/YBOCSymptomChecklist.pdf

Organizations/Associations

American Academy of Child and Adolescent Psychiatry. http://www.aacap.org

Association for Behavioral and Cognitive Therapies. http://www.abct.org/Home/

Association of Family Psychiatrists. http://familypsychiatrists.org

American Psychiatric Association. https://www.psychiatry.org

Beck Institute. https://www.beckinstitute.org

National Alliance on Mental Illness. https://www.nami.org

Glossary of Important Terms for Care in Psychiatry

Atypical antipsychotic

Group of psychiatric drugs, also known as second-generation antipsychotics that block receptors in the brain’s dopamine pathways; they are commonly used to treat psychosis, autism, and mood disorders.

Benzodiazepine

Group of psychiatric drugs, also called “benzos” that lead to sedative and anxiolytic effects; they are commonly used to treat acute anxiety while other antidepressant drugs are taking effect.

Countertransference

Emotional reactions of a therapist to a patient.

Ego-dystonic

Thoughts (e.g., violent, sexual, religious, impulses) that are in conflict with the person’s self-image, often seen in those with OCD .

Electroconvulsive therapy (ECT)

Procedure where small electrical currents pass through the brain to trigger small seizure activity en route to relief from severe mental illnesses.

Emotional regulation

Inhibiting and modulating one’s emotional experience.

Enabling

When family or friends, in an attempt to help resolve a specific problem (e.g., distress from cravings), perpetuate or exacerbate the problem (e.g., substance abuse ) due to accommodation made for harmful behaviors (e.g., providing substances or money).

Expressed emotion

Interactions in the family environment that are critical, hostile, or emotionally over-involved; these are known to exacerbate psychiatric illnesses.

Family accommodation

Family members take part in compulsive rituals, avoidance patterns, or modifications of routines in an attempt to assist a patient with OCD .

Forensic interviewing

Structured evaluation (not treatment) used to determine facts of a case related to child maltreatment, as well as the role of an individual’s mental illness in criminal or civil litigation.

Intensive Outpatient Treatment (IOP)

Part-time or full-time day treatment program used for those who do not meet criteria for hospitalization but need a higher level of care than traditional outpatient care.

Involuntary commitment

Legal process where an individual who is determined to have symptoms of severe psychiatric illness (e.g., pose harm to self or others, lack self-care abilities) is court-ordered to treatment in an inpatient psychiatric hospital or outpatient community treatment program.

Mood stabilizer

Group of psychiatric drugs used to treat mood disorders, such as bipolar disorders and schizoaffective disorder.

Psychological testing

Evaluation of psychological symptoms by objective and standardized measures, commonly used in the diagnosis of neurocognitive and neurodevelopmental disorders.

Selective serotonin reuptake inhibitor (SSRI)

Group of psychiatric drugs often used as a first-line pharmacologic treatment for depressive and anxiety disorders; they work by blocking the reuptake of serotonin in the brain.

Serotonin norepinephrine reuptake inhibitor (SNRI)

Group of psychiatric drugs often used as a pharmacologic treatment for depressive disorders (occasionally anxiety and nerve pain as well) that block the reuptake of serotonin and norepinephrine.

Transference

Unconscious redirection of feelings and desires from one person (often from one’s family of origin) to another (often one’s treatment provider).

Tricyclic antidepressant

Group of early antidepressant medications that work by blocking the reabsorption of neurochemicals (e.g., norepinephrine, serotonin)] in the brain; this class of medications is rarely used nowadays due to high frequencies of associated side effects.

Typical antipsychotic

Group of early antipsychotic medications often replaced by newer atypical antipsychotics due to side effects that are used in the treatment of psychosis and acute mania.

Urine toxicology screen (UTOX)

Test that checks for drugs or other chemicals that could contribute to the presentation of psychiatric illness.

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Phelps, K., Hodgson, J., Heru, A., Jensen, J. (2018). Medical Family Therapy in Psychiatry. In: Mendenhall, T., Lamson, A., Hodgson, J., Baird, M. (eds) Clinical Methods in Medical Family Therapy. Focused Issues in Family Therapy. Springer, Cham. https://doi.org/10.1007/978-3-319-68834-3_9

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