Guidance for Psychological Therapists
Enabling conversations with clients taking or withdrawing from prescribed psychiatric drugs
This guidance aims to empower and support conversations often already taking place between therapists and their clients. Therapists will need to decide for themselves whether, and to what extent, they wish to use this guidance in the context of their therapeutic work. These decisions will depend on their theoretical modality, practice setting and the individual needs of the client. The client’s agency, as always, should be supported and respected at all times. Clients should be encouraged to discuss withdrawal from prescribed psychiatric drugs with a knowledgeable prescriber who can give medical advice, oversee and manage any withdrawal process appropriately. While this guidance advocates the importance of informed client choice based on full information about potential benefits and risks, it does not advocate therapists telling their clients to take, not take, stay on or withdraw from psychiatric drugs. These matters should be left to the prescriber and client to decide.
© Council for Evidence-based Psychiatry 2019, revised January 2021.
This work is licensed under the Creative Commons Attribution-Non-Commercial-No Derivatives 4.0 International License. To view a copy of this license, visit creativecommons.org or send a letter to Creative Commons, PO Box 1866, Mountain View, CA 94042, USA.
Citation of Document
Guy, A., Davies J., Rizq, R. (Eds.) (2019). Guidance for Psychological Therapists: Enabling conversations with clients taking or withdrawing from prescribed psychiatric drugs. London: APPG for Prescribed Drug Dependence.
Section citations: If you are quoting from individual sections please use the following citations:
- Davies, J., Rizq., R & Guy, A. (2019). Introduction. In: A. Guy, J. Davies, R. Rizq (Eds) Guidance for psychological therapists: Enabling conversations with clients taking or withdrawing from prescribed psychiatric drugs. London: APPG for Prescribed Drug Dependence.
- Moncrieff, J. & Stockmann, T. (2019). Introduction for therapists on how psychiatric drugs work. In: A. Guy, J. Davies, R. Rizq (Eds.) Guidance for Psychological Therapists: Enabling conversations with clients taking or withdrawing from prescribed psychiatric drugs. London: APPG for Prescribed Drug Dependence.
- Rizq, R., with Bond, T., Guy, A., Murphy, D., Sams, P., Spada, M. M, & Whitney, G, (2019) Implications for therapeutic practice. In: A. Guy, J. Davies, R. Rizq (Eds.) Guidance for psychological therapists: Enabling conversations with clients taking or withdrawing from prescribed psychiatric drugs. London: APPG for Prescribed Drug Dependence.
- 4. Moncrieff, J. & Stockmann, T. (2019). What psychiatric drugs do by class. In: A. Guy, J. Davies, R. Rizq (Eds.) Guidance for psychological therapists: Enabling conversations with clients taking or withdrawing from prescribed psychiatric drugs. London: APPG for Prescribed Drug Dependence.
- Read, J. & Davies, J., with Montagu, L., Spada, M.M. & Frederick, B. (2019). What do we know about withdrawal? In: A. Guy, J. Davies, R. Rizq (Eds.) Guidance for psychological therapists: Enabling conversations with clients taking or withdrawing from prescribed psychiatric drugs. London: APPG for Prescribed Drug Dependence.
- Guy, A. with Frederick, B., Davies, J., Kolubinski, D., Montagu, L. (2019). The role of the therapist in assisting withdrawal from psychiatric drugs: What do we know about what is helpful? In: A. Guy, J. Davies, R. Rizq (Eds.) Guidance for psychological therapists: Enabling conversations with clients taking or withdrawing from prescribed psychiatric drugs. London: APPG for Prescribed Drug Dependence.
- Guy, A. with anonymous experts by experience (2019). Patient voices: Examples from real life. In: A. Guy, J. Davies, R. Rizq (Eds.) Guidance for psychological therapists: Enabling conversations with clients taking or withdrawing from prescribed psychiatric drugs. London: APPG for Prescribed Drug Dependence.
Contents
Click on any of the sections or sub-sections below to skip to that part of the guidance
Section 1: Davies, J., Rizq, R. & Guy, A.
1. Introduction
1.1 What are the aims of this guidance?
1.2 Who is this guidance for?
1.3 The medical model and the emerging crisis
1.4 Glossary
1.5 Scope
1.6 How to use this guidance
Section 2. Introduction for therapists on how psychiatric drugs work: Moncrieff, J. & Stockmann, T.
2.1 The place of prescribed drugs in Mental Health Services
2.2 How do psychiatric drugs work?
Section 3. Implications for therapeutic practice: Rizq, R., with Bond, T., Guy, A., Murphy, D., Sams, P., Spada, M. M, & Whitney, G.
3. Implications for therapeutic practice
3.1 The biomedical paradigm and its relationship to different therapeutic modalities
3.2 Key issues for therapists to consider when working with clients who are taking or withdrawing from prescribed psychiatric drugs
3.3 Practice-related guidance for therapists
Section 4. What psychiatric drugs do by class: Moncrieff, J., & Stockmann, T.
4.1 Interpreting the evidence on psychiatric drugs
4.2 Antidepressants
4.3 Benzodiazepines and related drugs
4.4 Antipsychotics
4.5 Lithium and other drugs referred to as mood stabilisers
4.6 Stimulants
4.7 Combined psychotherapeutic and psychopharmacological intervention in depression
4.8 Conclusion: Understanding psychiatric medication
Section 5. What do we know about withdrawal: Read, J. & Davies, J., with Montagu, L., Spada, M. M.
5.1 A general introduction to dependence and withdrawal
5.2 Evidence on the likelihood, range of possible experiences, duration and severity of withdrawal per drug class
5.3 Overall impacts of withdrawal on individuals
5.4 The withdrawal process and terminology
Section 6: Guy, A. with Davies, J., Kolubinski, D., Montagu, L.
6. The role of the therapist in assisting withdrawal from psychiatric drugs – what do we know about what is helpful?
6.1 The combined wisdom approach
6.2 Psychiatrist led multidisciplinary models
6.3 How are UK therapists already working with withdrawal?
6.4 Conclusion
Section 7: Guy, A