The fear of reducing medication, and where have all the patients gone?

In spite of the enormous effort made by the Boston group, the findings were few. The high rate of dropouts and refusals to be assessed raise serious questions. One significant point that should be raised is that there was no difference in the use of medication between the treatments, and there should have been to foster underlying change with expressive psychotherapy. Also, treatment was not attempted without medication. Did patients drop out to avoid medication? Would a more flexible technique such as multiple crisis intervention have reduced dropout? Did selecting subjects with normal Wechsler Adult Intelligence Scale scores eliminate severe thought disorders, making differential improvement impossible? Was eliminating the sickest third of patients a mistake?