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[Non-response to psychotherapy: concepts, problems and referral options]
1Fachrichtung Psychologie, Lehrstuhl Behaviorale Psychotherapie, Technische Universität Dresden, Hohe Str. 53, 01187, Dresden, Deutschland. juergen.hoyer@tu-dresden.de.
Der Nervenarzt
|March 14, 2024
Summary
Many patients do not respond to psychotherapy. This review examines nonresponse and recurrent nonresponse in psychotherapy, proposing new clinical decision-making strategies.
Area of Science:
- Psychiatry and Behavioral Sciences
- Clinical Psychology
Context:
- Psychotherapy is a widely used treatment for mental health conditions.
- A significant number of patients do not achieve satisfactory outcomes from psychotherapy.
- Understanding and addressing nonresponse is crucial for improving treatment efficacy.
Purpose:
- To review the existing literature on psychotherapy nonresponse and treatment resistance.
- To clarify definitions and explore theoretical and empirical findings related to nonresponse.
- To propose improved study designs and treatment strategies for nonresponse.
Summary:
- The term "treatment resistance" is less applicable to psychotherapy than "nonresponse" or "recurrent nonresponse."
- Research on switching treatments (pharmacotherapy to psychotherapy, or psychotherapy to psychotherapy) is limited.
- A clinical decision-making flowchart for managing psychotherapy nonresponse is proposed.
Impact:
- Highlights the need for more research into psychotherapy nonresponse.
- Advocates for integrating error management principles into psychotherapy research, training, and supervision.
- Suggests developing evidence-based guidelines for managing nonresponse and recurrent nonresponse in clinical practice.
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