There are examples in the theoretical and research literature of psychiatrist/ prescriber-led models to support withdrawal that may be of interest for further reading if a therapist has an opportunity to suggest this in a multidisciplinary team setting. They are most notably:
6.2.1 Breggin’s ‘person-centred collaborative approach’ to psychiatric care
This model was developed by the US psychiatrist Peter Breggin. It is a model for prescribers working with patients in psychiatric outpatient settings in the US, and is based on the core principles of working within an empathic relationship, communicating information openly and honestly and fostering empowerment and respect for the client’s viewpoint, wishes and needs.3
Whilst it can be used in any circumstance in which a person might need more support than can be provided in a one-to-one relationship (with a prescriber or therapist), it is suggested that this approach might be of particular use when working with ‘vulnerable’ clients, such as:
- Adults who are dependent on others such as their parents or state authorities
- Adults who are seriously disabled, emotionally or cognitively
- Adults receiving routine psychiatric drugs including the elderly
- Any individual whose judgment or ability to take care of themselves is seriously impaired.3
6.2.2 Fava and Belaise’s (2018) three-module approach6
This model for psychotherapeutic management of antidepressant withdrawal was developed in Italy by the psychiatrists, Gatti Fava and Guidi Belaise. It also advocates collaborative team working (e.g. comprising a psychiatrist trained in psychotherapy, a physician and clinical psychologists) to support the client’s withdrawal from, in this case, antidepressants. They used CBT as their core therapeutic modality and, as with the common wisdom model already described, focused on different tasks in preparation for, during and after withdrawal.
3. Breggin, P.R. (2013). Psychiatric drug withdrawal: A guide for prescribers, therapists, patients, and their families. New York, NY: Springer Publishing Company, LLC.
6. Fava, G.A. & Belaise, C. (2018). Discontinuing antidepressant drugs: Lesson from a failed trial and extensive clinical experience. Psychotherapy and Psychosomatics, 87, 257–267.