Treatment Resistance and Patient Authority
The Austen Riggs Reader
Eric M. Plakun (Editor, Austen Riggs Center)
With a Foreword by Otto F. Kernberg
Therapeutic hope for “treatment resistant” patients.
The Austen Riggs Center is nationally recognized as the leading psychiatric hospital for treatment-resistant patients, who willingly seek help but just cannot respond to treatment. Here, leaders in treating such challenging patients offer a comprehensive psychodynamic approach for treatment and offer hope for recovery.
In this book, readers are given an in-depth view into the psychodynamics systems perspective of treatment resistant disorders, with illustrations of the value of including family therapy, and developing and using a psychodynamic treatment team. Also offered is the first description published in book form of the newly-defined area of psychodynamic psychopharmacology—an approach to the use of medications that attends to the meaning of medications to the patient and clinician, as well as to their pharmacologic effects.
Important clinical problems such as trauma, psychosis, suicide, family resistant, integrated treatment, and psychopharmacologic failures are covered in detail. Throughout, practical principles are reported in text boxes to help the reader apply learning from Riggs to other outpatient, residential, day treatment, and inpatient settings.
The Austen Riggs Center is on the forefront of dealing with difficult-to-treat patients, and this book provides an invaluable resource for both understanding treatment resistance and implementing effective techniques to treat it in clinical practice.
Book Details
- Hardcover
- June 2011
-
ISBN 978-0-393-70661-1
- 6.4 × 9.6 in
/ 320 pages
- Territory Rights: Worldwide
Endorsements & Reviews
“This is a wonderful book about the healing benefits of psychodynamic psychotherapy…. [A]n invaluable book for academic, public sector, hospital-based, and private practice psychiatrists. By emphasizing the importance of a psychodynamic approach, this book may even nudge the field of psychiatry toward an acceptance of the efficacy of an intensive dynamic psychotherapy, in conjunction with the psychodynamically informed use of medications, and help improve the general state of in- and out-patient psychiatric practice for patients with severe mental illness.” — The American Journal of Psychiatry
“In an era when extended hospital treatment is diminishing rapidly in the face of an increasing cohort of difficult-to-treat patients who often have treatment-resistant illness, this is an excellent and important contribution to the literature…. [W]ell written and seamlessly edited…. [A]n important resource of its own in this very challenging work.” — Journal of Psychiatric Practice
“We live in an age when psychiatrists respond to treatment 'failure' by ever more elaborate tweaking of the drugs we prescribe our patients. We end up with elegant drug regimens, but increasingly find that our patients are getting worse, not better. This wonderful book, replete with clinical case examples, reminds us to take a deeper look into the minds of our patients. Sometimes a 'treatment failure' reflects our own failure to listen to how patients are interpreting the medications, or how they are viewing us as human beings. This book is long overdue and will enhance the reader's clinical practice.” — Daniel Carlat, MD, publisher, The Carlat Psychiatry Report and author, Unhinged: The Trouble with Psychiatry
“I have spent several months of each of the past seven years at the Austen Riggs Center as the Senior Erik Erikson scholar, where I have been witness to Riggs' impressive clinical work with previously treatment resistant patients, including those with histories of abuse, trauma, and major losses. I have come to the conclusion that Riggs provides a uniquely caring therapeutic environment that respects patients' autonomy in the service of their growth, which neither humiliating them nor shrinking from engaging their aggression. This book illustrates the technical aspects of Riggs treatment and makes them accessible to clinicians working in other settings. It is a most significant contribution to the mental health field.” — Vamik D. Volkan, MD, Emeritus Professor of Psychiatry, University of Virginia, and Senior Erik Erikson Scholar of the Erikson Center for Education and Research of the Austen Riggs Center
“In this managed care era of psychiatric treatment driven by economics, Austen Riggs stands alone in its individualized, psychodynamically-informed but multimodal approach to hospital care for treatment of individuals who have failed multiple efforts. Treatment Resistance and Patient Authority is an outstanding contribution and a must-read for all of us, regardless of the treatment setting, engaged in trying to understand and care for these severely ill individuals.” — Steven S. Sharfstein, MD, President and Chief Executive Officer, Sheppard Pratt, Past President, American Psychiatric Association, Clinical Professor and Vice Chair, Dept. of Psychiatry, U Maryland
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