Martindale P
Division of Psychiatry, Bergen Pines County Hospital, Paramus, New Jersey.
Psychiatr Clin North Am. 1990 Jun;13(2):333-40.
It is difficult to discuss the issue of combining medication and psychotherapy without reference to the context in which it is occurring. Within public mental health hospitals, psychotherapy is comparatively unavailable, at least from physicians, because of limited supply. Yet the kind of medication that psychiatrists routinely prescribe are strongly colored by particular meanings germane to their use in involuntary treatment settings, among which is the perception of an element of force or coercion, either in how they are used or in their effects. This problem cannot be ignored by retreating behind an ill-fitting "medical model" of treatment, which leaves the patients overly responsible for rejecting treatment, however much their right to do so may be guaranteed by law.
在不提及药物治疗与心理治疗相结合所处的背景的情况下，很难讨论这一问题。在公立精神卫生医院，由于供应有限，心理治疗相对难以获得，至少从医生那里是这样。然而，精神科医生常规开的药物种类，因其在非自愿治疗环境中的使用所特有的特定含义而受到强烈影响，其中包括在药物的使用方式或效果方面对强制或胁迫因素的认知。不能通过退回到不适用的“医学治疗模式”来忽视这个问题，这种模式让患者对拒绝治疗承担过多责任，无论其拒绝治疗的权利在法律上得到多大保障。
