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Introduction to Supportive Psychotherapy
Reviewed by ROGER PEELE; MARYAM RAZAVI
Am J Psychiatry 2006;163:2023-2023.
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by Arnold Winston, M.D., Richard N. Rosenthal, M.D., and Henry Pinsker, M.D., series editor Glen O. Gabbard, M.D. Arlington, Va., American Psychiatric Publishing, 2004, 180 pp., $35.95.

Pop quiz: how many books does Amazon list for “psychoanalysis,” an infrequently used treatment in American psychiatry? How many for the most commonly used psychotherapy (supportive psychotherapy)? More than 2,000 for the former and 10 for the latter, and that 10 includes five that really do not qualify. Of the five books that do qualify, this one by Drs. Winston, Rosenthal, and Pinsker captures the experiences of this nation’s supportive psychotherapy center for the past two decades: New York’s Beth Israel.

Many of us say we are providing supportive psychotherapy. It is a common default position. But what is it? The authors of this book define it as part of a psychotherapy continuum from expressive to supportive, as “a dyadic treatment that uses direct measures to ameliorate symptoms and maintain, restore, or improve self-esteem, ego function, and adaptive skills—primary applied to the more impaired of patients.”

Since residency programs are now required to certify that each graduating resident has become competent in supportive psychotherapy, the knowledge base, skills, and attitudes of supportive psychotherapy need to be explicated. The American Association of Directors of Psychiatric Residency Training, leaning heavily on the Beth Israel team, arrived at five facts, 15 skills, and three attitudes to be evaluated in measuring the resident’s competency in supportive psychotherapy. This slim book covers all the requirements.

Pitched at a resident’s level, the text has more than 100 informative therapist reactions to patients that the authors rate from “excellent” to “obnoxious.” In addition to the depressed, anxious, and psychotic patients, application of supportive psychotherapy for those with substance abuse, medical illness, and in crisis are described.

Each of us comes into psychiatry with a repertoire of interactive skills that can change human behavior. This book provides an excellent resource to increase that repertoire.

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