Introduction
I. Theory
1. Essential Problems in Psychosis and Basic Definitions
2. Biological and Psychological Models of Psychosis
3. Psychosis: An Autobiographical Play Staged in the Real World
4. Disturbances of Figurative Language, Concrete Metaphors, and
Delusional Identities
II. Psychotherapy Technique
5. Treatment Overview and Patient Selection
6. Engaging the Patient
7. Eliciting the Patient’s Story
8. Discussing Reality with a Psychotic Person
9. Assessing Coping Strategies and Introducing Three
Cognitive-Behavioral Therapy for Psychosis (CBTp) Models
10. Working CBTp and Psychodynamic Formulations
11. Working with Voices and Other CBTp Techniques
12. Challenging Delusions
13. Psychodynamic Interpretation of Psychotic Symptoms
14. The Case of Ariel
15. The Cases of Asha and Kasper
III. Psychotherapy for Psychosis in the Public Sector
16. Current Clinical Conditions in Public Mental Health
17. A Template for Ambitious Psychotherapy in the Public Sector
References
Index
Michael Garrett, MD, is Professor of Clinical Psychiatry and Director of Psychotherapy Education in the Department of Psychiatry and Behavioral Sciences at the State University of New York (SUNY) Downstate Medical Center in Brooklyn. He is Certified in Psychiatry by the American Board of Psychiatry and Neurology and is a faculty member at the Psychoanalytic Association of New York, affiliated with NYU Langone Health. Dr. Garrett’s research interests include the relationship between psychosis and ordinary mental life, and psychotherapy for psychosis. He is a four-time recipient of the SUNY Downstate Distinguished Educator Award.
"This is the unique and definitive work on integrating
psychodynamic therapy and CBT in the psychotherapy of
psychosis--there is no other book like it. To really understand
psychotic experience, one must understand the emotional component
that is its motivating center. Addressing emotional as well as
cognitive phenomena increases the power of the treatment.
Explaining complicated ideas in a straightforward manner, this book
can be used by a wide range of mental health practitioners. I teach
medical students, psychiatry residents, psychoanalytic candidates,
and postgraduate analysts, and I would use this book with all of
them."--Eric R. Marcus, MD, Professor of Clinical Psychiatry,
Columbia University College of Physicians and Surgeons, and
supervising and training analyst, Columbia University Center for
Psychoanalytic Training and Research
"Psychosis can profoundly interrupt a person's basic sense of self
and participation in the world. The mental health field needs to
move beyond offering generic support, education, or help solving
discrete problems. This book conceptualizes psychosis as a disorder
of the whole person and presents a blueprint for integrative
psychotherapy. The writing is engaging, thoughtful, practical, and
likely to offer insight to both developing and experienced
clinicians."--Paul H. Lysaker, PhD, Richard L. Roudebush VA Medical
Center, Indianapolis; Department of Psychiatry, Indiana University
School of Medicine
"Garrett demonstrates his masterful skills as a clinician through
the careful manner in which he elicits the patient’s story, his
tactful discussions with patients of the nature of reality (very
tricky with a psychotic person!), and the gentle way he challenges
patients about their delusions and presents psychodynamic
interpretations for them to consider as alternative explanations.
His approach grafts onto his rich psychodynamic training an
appreciation of how cognitive therapy can help patients bridge the
gap from a psychotic worldview to a coherent understanding of the
meaning of their symptoms, and begin the journey to
recovery."--Alex Kopelowicz, MD, Department of Psychiatry and
Biobehavioral Sciences, David Geffen School of Medicine at UCLA
"This compelling book marries two therapeutic traditions that are
rarely discussed together. It well equips clinicians to traverse
the complex psychological terrain of psychosis, resulting in a
deep, holistic understanding that is vital for achieving long-term
recovery. The book is infused with nuanced, captivating clinical
anecdotes that bring the theory and practice of this
person-centered therapy to life. It will enhance the work of
clinicians who conduct psychotherapy with people with psychosis in
all practice settings and will be a valuable addition to mental
health training curricula."--Dimitri Perivoliotis, PhD, staff
psychologist, VA San Diego Healthcare System; Department of
Psychiatry, University of California, San Diego
"This book describes an innovative approach to psychotherapy for
people with schizophrenia-spectrum disorders. Garrett describes a
thoughtful, humanistic strategy for aligning with people with
psychosis, generating deep understanding, and guiding functional
change. He takes the reader on an integrative journey that merges
biological approaches, CBT, and psychodynamic therapy into an
optimal care model. Recovery oriented, compassionate, and person
centered, this is an inspiring clinical guide."--Douglas L.
Noordsy, MD, Department of Psychiatry, Geisel School of Medicine at
Dartmouth
"Psychotherapy for psychotic disorders is an important but
neglected area of research, training, and clinical practice. This
highly reader-friendly and lucid book is based on Garrett's decades
of extensive work in this field. I strongly recommend it to
clinicians, researchers, educators, and trainees interested in
broadening their knowledge of serious mental illness and its
treatment."--Dilip V. Jeste, MD, Distinguished Professor of
Psychiatry and Neurosciences, University of California, San
Diego-This book is of high quality in terms of its thoroughness and
functional use in clinical practice….The book takes basic CBT
principles such as identifying cognitive distortions, in this case
psychotic delusions, and combines it with psychodynamic techniques
to help patients gain insights into these delusions and improve
their ability to distinguish reality from delusional
beliefs.--Doody's Review Service, 11/8/2019
"This is the unique and definitive work on integrating
psychodynamic therapy and CBT in the psychotherapy of
psychosis--there is no other book like it. To really understand
psychotic experience, one must understand the emotional component
that is its motivating center. Addressing emotional as well as
cognitive phenomena increases the power of the treatment.
Explaining complicated ideas in a straightforward manner, this book
can be used by a wide range of mental health practitioners. I teach
medical students, psychiatry residents, psychoanalytic candidates,
and postgraduate analysts, and I would use this book with all of
them."--Eric R. Marcus, MD, Professor of Clinical Psychiatry,
Columbia University College of Physicians and Surgeons, and
supervising and training analyst, Columbia University Center for
Psychoanalytic Training and Research
"Psychosis can profoundly interrupt a person's basic sense of self
and participation in the world. The mental health field needs to
move beyond offering generic support, education, or help solving
discrete problems. This book conceptualizes psychosis as a disorder
of the whole person and presents a blueprint for integrative
psychotherapy. The writing is engaging, thoughtful, practical, and
likely to offer insight to both developing and experienced
clinicians."--Paul H. Lysaker, PhD, Richard L. Roudebush VA Medical
Center, Indianapolis; Department of Psychiatry, Indiana University
School of Medicine
"Garrett demonstrates his masterful skills as a clinician through
the careful manner in which he elicits the patient’s story, his
tactful discussions with patients of the nature of reality (very
tricky with a psychotic person!), and the gentle way he challenges
patients about their delusions and presents psychodynamic
interpretations for them to consider as alternative explanations.
His approach grafts onto his rich psychodynamic training an
appreciation of how cognitive therapy can help patients bridge the
gap from a psychotic worldview to a coherent understanding of the
meaning of their symptoms, and begin the journey to
recovery."--Alex Kopelowicz, MD, Department of Psychiatry and
Biobehavioral Sciences, David Geffen School of Medicine at UCLA
"This compelling book marries two therapeutic traditions that are
rarely discussed together. It well equips clinicians to traverse
the complex psychological terrain of psychosis, resulting in a
deep, holistic understanding that is vital for achieving long-term
recovery. The book is infused with nuanced, captivating clinical
anecdotes that bring the theory and practice of this
person-centered therapy to life. It will enhance the work of
clinicians who conduct psychotherapy with people with psychosis in
all practice settings and will be a valuable addition to mental
health training curricula."--Dimitri Perivoliotis, PhD, staff
psychologist, VA San Diego Healthcare System; Department of
Psychiatry, University of California, San Diego
"This book describes an innovative approach to psychotherapy for
people with schizophrenia-spectrum disorders. Garrett describes a
thoughtful, humanistic strategy for aligning with people with
psychosis, generating deep understanding, and guiding functional
change. He takes the reader on an integrative journey that merges
biological approaches, CBT, and psychodynamic therapy into an
optimal care model. Recovery oriented, compassionate, and person
centered, this is an inspiring clinical guide."--Douglas L.
Noordsy, MD, Department of Psychiatry, Geisel School of Medicine at
Dartmouth
"Psychotherapy for psychotic disorders is an important but
neglected area of research, training, and clinical practice. This
highly reader-friendly and lucid book is based on Garrett's decades
of extensive work in this field. I strongly recommend it to
clinicians, researchers, educators, and trainees interested in
broadening their knowledge of serious mental illness and its
treatment."--Dilip V. Jeste, MD, Distinguished Professor of
Psychiatry and Neurosciences, University of California, San
Diego-This book is of high quality in terms of its thoroughness and
functional use in clinical practice….The book takes basic CBT
principles such as identifying cognitive distortions, in this case
psychotic delusions, and combines it with psychodynamic techniques
to help patients gain insights into these delusions and improve
their ability to distinguish reality from delusional
beliefs.--Doody's Review Service, 11/8/2019
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