Final Phase

In the final phase of treatment, the antidepressant drug is finally discontinued. We are reluctant to decrease antidepressant drugs in the initial phase of treatment, because this may be a source of further distress. At the same time, we do not intend to keep a patient indefinitely on a medication that has yielded limited benefit. Patients are monitored closely for signs of relapse. In this phase, attention is given to the transformation of cognitive insights into behavioral changes, with particular reference to lifestyle modification. For instance, a patient may become aware of his/her cognitive errors in an interpersonal situation but be unable to endorse alternative modalities of interaction. This phase of psychotherapy extends over two to four sessions. Furthermore, we place emphasis on continuation of self-therapy once the psychotherapy sessions are over and on education recognizing prodromal symptoms of relapse.

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