Chapter 17. Combining Supportive Psychotherapy With Medication

David J. Hellerstein, M.D.
DOI: 10.1176/appi.books.9781585623648.372220



It is commonly believed that optimal outcome of treatment for many psychiatric disorders can be achieved by combining pharmacotherapy and psychotherapy. Supportive psychotherapy (SPT) is most likely the most frequently used modality of psychotherapy in current clinical practice (Tanielian et al. 2001). In the 1998 National Survey of Psychiatric Practice, 36% of patients treated by psychiatrists received supportive psychotherapy versus 19% receiving insight-oriented therapy, 6% receiving cognitive-behavioral therapy (CBT), and 1% receiving psychoanalysis (Tanielian et al. 2001). Recently, the development of competency in SPT has become a requirement of residency training in the United States, and a number of texts about SPT have been published in recent years. Since the introduction of selective serotonin reuptake inhibitors (SSRIs) in the late 1980s, an increasing proportion of psychiatric patients have been treated with pharmacotherapy. From 82% to 90% of patients in psychiatrists' caseloads receive medications (Pincus et al. 1999; Tanielian et al. 2001).

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Table Reference Number
Table 17–1. Basic features of supportive psychotherapy for patients with depression
Table Reference Number
Table 17–2. Characteristics of the supportive relationship in pharmacotherapy (SR-PMT) compared with supportive psychotherapy


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