Ellison J M, Harney P A
Harvard Medical School, Belmont, Massachusetts 02178, USA.
J Psychother Pract Res. 2000 Winter;9(1):7-17.
Many depressed patients experience only limited improvement despite provision of appropriate therapies within a collaborative treatment arrangement (the integrated provision of psychotherapy and pharmacotherapy). In the interest of enhancing these patients' partial responses, it is valuable to examine the treatments provided and also the collaborative framework in which they are offered. The authors use vignettes to illustrate how each of several factors-the adequacy of treatment with each modality, behavioral impediments to response, compliance with treatments, recognition and appropriate matching of treatments to relevant concurrent diagnoses, and appropriate communication between collaborating clinicians-may affect treatment outcome. Recommendations are offered for clinicians engaging in a collaborative relationship, including attending carefully to the patients' comments about a complementary modality of treatment and the clinician delivering it, communicating useful information to the collaborating therapist, and being receptive to information that is offered by the collaborating therapist.
尽管在协作治疗安排（心理治疗和药物治疗的综合提供）中提供了适当的治疗方法，但许多抑郁症患者的改善仍然有限。为了提高这些患者的部分反应，检查所提供的治疗方法以及提供这些治疗方法的协作框架是很有价值的。作者使用案例来说明几个因素中的每一个——每种治疗方式的充分性、反应的行为障碍、对治疗的依从性、对相关并发诊断的治疗识别和适当匹配，以及协作临床医生之间的适当沟通——如何影响治疗结果。为建立协作关系的临床医生提供了建议，包括仔细关注患者对补充治疗方式及其实施医生的评论，向协作治疗师传达有用信息，并接受协作治疗师提供的信息。
