Throughout this section it has been emphasised that it is not the role of the therapist to decide when drugs should be withdrawn, how this may be best achieved or what tapering protocols should be deployed. However, this does not mean that therapists cannot have a critical role to play in supporting the client during withdrawal. By using this guidance, therapists will be better informed about some of the possible variables impacting a client’s potential withdrawal experience. They may also be in a better position to communicate with other practitioners where appropriate (if the client does not wish to do so themselves), and to suggest that the client consults their prescriber in cases where adverse drug reactions arise before, during or after withdrawal.
Finally, if the therapist holds any particular concerns regarding how the prescriber may be understanding and managing an individual’s withdrawal, it may be advisable (again, if the client does not wish to do so themselves and with their consent) to communicate these formally to the prescriber. The ethical therapist, while practising within their own sphere of professional competence, will always be thinking about the importance of the relationship their client has with their prescriber, assessing any ways in which that relationship can be supported in service of the client’s needs and wants. This has been covered in more detail together with ethical considerations, such as the importance of ‘informed choice’, in 3.2.5.
This section reflects the current state of knowledge on what is helpful for psychological therapists to consider when working with clients withdrawing from, or preparing to withdraw from, psychiatric drugs. As withdrawal becomes better recognised throughout the mental health professions, it is hoped that appropriate and directed research will further add to this knowledge.
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.