The Practice of Psychiatric Family Therapy

The Practice of Psychiatric Family Therapy

As profiled in a March 2011 New York Times article Talk Doesn’t Pay, So Psychiatry Turns Instead to Drug Therapy published in the Money & Policy section, much of 21st century psychiatry has fallen victim to “biological reductionism”. The hoped for integrative concept of the “biopsychosocial psychiatrist” is unfortunately honored more in the breach than in actual clinical practice. With the recent approval of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) at a cost of some $25 million dollars, we can expect this narrow restrictive focus to gain even more prominence. “Inclusion of a condition in the manual is often followed by increases in the use of medicines to treat it.” Add to this the ever expanding influence of Big Pharma such that “psychiatric drugs are among the most prescribed medicines in the U.S. Nearly $40 billion was spent last year on the top three types—antipsychotics, antidepressants and medication for attention deficit, hyperactivity disorder—according to IMS Health” and we truly have a prescription for disaster.

Armed with similar realizations and distressing sets of facts, beginning about 10-15 years ago I became progressively more disenchanted with conventional psychiatric practice. Many, if not most psychiatrists have signed on to the 15 minute “medication check“, seeing large numbers of people for very short periods of time and basically becoming prescription writers. That was completely unsatisfying to me. Family Psychiatry provides the ideal bridge between the biomedical and psychosocial worlds. Application of family systems theory and therapy helps optimize the treatment and rehabilitation of individuals with severe and persistent psychiatric illnesses.

It is essentially impossible to practice good pharmacotherapy without good psychotherapy. Kay Redfield Jamison said it best, “I cannot imagine leading a normal life without both taking lithium and having had the benefits of psychotherapy….Ineffably, psychotherapy heals.”  Whether it’s David Miklowitz’ Family Focused Therapy for families struggling with bipolar disorder, Marc Galanter’s network therapy approach for maintaining a sober lifestyle or the psychoeducation paradigm for addressing expressed emotion in families with schizophrenia, Family Systems Therapy is the treatment of choice for relationship difficulties, intergenerational conflict, and other problems endemic to the family life cycle. These collaborative resilience-promoting approaches focus on strengths and resources to help heal from painful experiences and enhance the quality of life and emotional well-being of families, couples and individuals.

Family involvement constitutes a critical support system for individuals with serious mental illness. Reciprocal influences between biology, individuals, their families, and other social systems operate in cycles that help maintain or reinforce disturbed behavior in the identified patient. Family Psychiatry addresses the familial, social and interpersonal aspects of theses illnesses. Management of biologically based severe mental illnesses occurs within the context of ongoing interpersonal processes that can influence their future course and outcome. By learning to think family, always viewing the patient in that context, we are more likely to provide the best possible psychiatric treatment.

Dr. Ronald B Cohen of www.familyfocusedsolutions.com discusses the importance of family-based therapy combined with psycho pharmacology when dealing with individuals with several and persistent mental illnesses.We can define Psychiatric Family Therapy as working with patients and their families to successfully adapt to the physical, psychological, emotional, and spiritual challenges of severe and chronic psychiatric illness. As an experienced systemic family therapist who completed post-graduate training at the Family Institute of Westchester, and a board certified psychiatrist, I specialize in helping families and couples in crisis and transition. The task is to help families address their unmet psychosocial needs in order to promote positive adaptation and healthy change. The goal is to solve problems in current relationships so as not to leave a damaging legacy for future generations.

Please feel free to ask any questions or to comment in the “Leave a Reply” box below. To request more information and/or schedule an initial consultation, click here (http://www.familyfocusedsolutions.com/contact/).

You are encouraged to forward this blog to anyone who would be interested in reading it.

 

Ronald B Cohen, MD, PC www.familyfocusedsolutions.com Ronald B. Cohen, MD
Bowen Family Systems Coach
1 Barstow Road, Suite P-10
Great Neck, NY 11021
(516) 466-7530
RBCohenMD@FamilyFocusedSolutions.com

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  1. Nina A. White, PhD, LMHC, LPC, MFT, NCC on January 19, 2013 at 9:41 am said:

    EXCELLENT! Confirming some of my thoughts and providing needed information to wake up many! Thank You!

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Bowen Family Systems Coaching with Ronald B Cohen, MD is the treatment of choice for complicated relationship problems and intergenerational conflicts. Include the whole family in resolving and improving what is going on right NOW! When the entire family works to make the difficult journey together, the results are almost magical.
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