Currently in the UK there are no national dedicated services working with dependency and withdrawal issues. The services that do exist cover less than three percent of the national population (see 3.2 for further information about these). However, psychological therapists are already working with a proportion of those who are likely to be dependent on such drugs and who have no access to other services. For example, a 2018 survey of BPS, BACP and UKCP members asked what percentage of their clients were taking prescribed psychiatric drugs – it showed that:
- 27% said between 25-50%
- 23% said between 50-75%
- 31% said more than 75%.1
Given that all therapists are likely to have already found themselves in the position of working with a client in withdrawal, therapists may provide vital support by acquiring some basic additional knowledge. They do not need to be ‘specialists’ in order to be helpful. Education and awareness of the issues raised in this guidance will allow therapists to consider whether, and how, to begin integrating issues of prescribed drug dependence within their practice.
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.
Therapists are often in the advantageous position of having a pre-existing therapeutic relationship with an individual. Based on this relationship it is possible that therapists can respond to prescribed drug issues, including withdrawal, in an integrated process.2 There are two distinct aspects to the role that psychological therapists can play:
The first is that of helping the client understand and manage any causes and effects of emotional distress that led them to be prescribed psychiatric drugs in the first place.* The second is to support the client during drug withdrawal if this becomes necessary, when, dependent upon the clients’ experience, the first role might need to be largely placed on hold.
* It is important to note, however, that some people are prescribed such drugs for physical conditions.