Concurrent Use of Pharmacotherapy

Finally, it is recommended that therapists consider and discuss with their patients the option of concurrent pharmacotherapy. Although not all patients wish to take medication and many cannot tolerate the accompanying side effects, studies to date suggest a modest advantage of combined pharmacotherapy and psychotherapy. Although these studies have not focused specifically on severely depressed patients, they have included sizable numbers of such patients in their samples. In general, studies of combined treatments suggest an increase in response rates of approximately 10-15% (Hollon, Thase, & Markowitz, 2002).

When conducting CT with a patient who is taking an antidepressant, it is advisable to inquire regularly about the patient's experience of the medication, including possible side effects, beliefs about usage, and so forth. In addition, therapists who are not prescribing medication themselves are advised to make periodic contact with the prescribing physician for continuity of care. Maintaining a team approach with a severely depressed patient ensures that everyone is informed of progress and compliance, and provides an opportunity for individuals involved in the case to consult with one another. It is also important to monitor and to inquire about patient attributions for change, and in particular to assess and explore any patient beliefs that suggest all positive change is due to medication and ignore behavioral or cognitive change that may accompany or follow medication use.

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