Twenty-first century psychotherapies

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Many psychiatrists have criticized the continued use of psychopharmacological treatments instead of psychological interventions Moncrieff, ; Moncrieff and Cohen, However, little evidence supports this idea.

An alternative, drug-centered model suggests that psychotropic drugs create abnormal states that may coincidentally relieve symptoms. Drug-induced effects of antidepressants vary widely according to their chemical class from sedation and cognitive impairment to mild stimulation and occasionally frank agitation. Results from clinical trials could be explained by drug-induced effects and placebo amplification.

According to the Moncrieff et al.

With similar statistical effects, very different changes occur that are in favor of psychotherapy over psychopharmacological treatments when considering an overall assessment of the quality of life and self-esteem. These types of treatment could be seen as the cure for symptomatic aspects while a true change can only be achieved with psychotherapy.

With the pharmacological approach, a selective symptomatic reduction could be achieved. The distress, chemically inhibited but still unresolved, will tend to recur or will require a further increase in the pharmacological treatment. Psychotherapy, instead, leads to a true change in the person that will persist over time.

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The clinical psychological treatment, when effective, can be used to treat and cure the disorder. Charney noted that the future of diagnostic classification of mental disorders could be based on neuroscience, biology, and genetics, with the creation of a possible Pathophysiologically Based Classification System, perhaps in DSM 6, forgetting another time Hippocrates' principles and the biopsychosocial model Charney et al.

I hope that in the next years, this specialty section could become a functional platform for clinicians and researchers to discuss empirical findings, opinions, theories, methods, and hypotheses in clinical health psychology. To motivate the researchers in this area, I propose 10 key topics that could be interesting and promising drivers of research in our field. The future research has to move from an old logic that emphasizes the contrast between pharmacological treatments and psychological ones to an integrative approach due to a large amount of evidence for the effectiveness of combination treatment over pharmacotherapy or psychotherapy alone, with depression being a typical example to consider Guidi et al.

More research has to be conducted to study the best combination or sequential approach to psychotherapy and pharmacology for each psychopathology and each patient Guidi et al.

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Neuroimaging evidences can help us understand psychological and psychopathological phenomena to better develop our knowledge of models and treatment procedures Allen et al. Next to traditional areas of collaboration between medicine and psychology, such as psychocardiology Ginsberg et al. The psychosomatic field that focuses on the direct psychobiological effects of cognitions and emotions on the pathophysiology of medical diseases is a growing field of research Guidi et al. Positive psychology and positive psychotherapy are interesting new approaches in mental health care, and more investigation is needed in Frontiers journal Clinical and Health Psychology section too Schrank et al.

The use of mHealth platforms and new technologies could help clinicians in some critical situations provide the continuity of health assistance after a traditional period of inpatient care and opportunities to monitor and motivate patients, specifically in the follow-up phase of the treatment Castelnuovo et al.

Clinical health psychology has to develop new protocols and adapt old ones to new emerging populations and contexts, such as chronic patients Castelnuovo et al. The efficacy of the empirically supported treatments ESTs from the evidence-based medicine EBM perspective has already demonstrated, and the Common Factors approach typically considers each psychological interventions positively due to the presence of successful common core elements Castelnuovo, a.

More investigations have to be on the mediators and moderators that would allow and enhance change in clinical psychology and psychotherapy Holmbeck, ; Labus, ; Perz et al. New validated questionnaires, scales, and semi-structured interviews need to be developed to give health care professional reliable and valid psychometric tools that would have a clinical effect Belar et al. Future research in this field should consider the clinimetrics paradigm Streiner, ; Fava and Belaise, ; Horn et al. The Italian Consensus Conference on Pain in Neurorehabilitation that produced specific recommendations in clinical health psychology is one example that should be followed Aloisi et al.

Clinical Psychology, alternatively Clinical Health Psychology, cannot forget its deep, specific, and peculiar psychological model that built on the biopsychosocial framework Engel, , , and it has to consider that evidence-based approach must be counterbalanced by the etiquette based approach Kahn, ; Castelnuovo, using the forgotten but functional Hippocrates' principles both in traditional contexts and in innovative technology and internet based ones Mantovani et al.

The author confirms being the sole contributor of this work and approved it for publication. The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Ahn, A. The limits of reductionism in medicine: could systems biology offer an alternative?

PLoS Med. Allen, J. Discovering the impact of psychotherapeutic hospital treatment for adults with serious mental illness. Menninger Clin. Aloisi, A.

PEP Web - Attachment, Psychoanalysis, and the Search for a 21st-Century Psychotherapy Practice

The role of gender, psycho-social factors and anthropological-cultural dimensions on pain in neurorehabilitation. PubMed Abstract Google Scholar. Angermeyer, M. Public attitudes towards psychiatry and psychiatric treatment at the beginning of the 21st century: a systematic review and meta-analysis of population surveys. World Psychiatry 16, 50— Evidence-based practice in psychology. CrossRef Full Text. Aybek, S. Imaging studies of functional neurologic disorders. Bauer, R. Evidence-based practice in psychology: implications for research and research training.

Belar, C. Self-assessment in clinical health psychology: a model for ethical expansion of practice. Changing educational needs of psychologists: do we need more medical knowledge, basic science and more psychological science? Settings 15, 12— Beutler, L. Identifying empirically supported treatments: what if we didn't? Campbell, L. Recognition of psychotherapy effectiveness: the APA resolution. Psychotherapy 50, 98— Castelli, L. Editorial: PsychOncology: clinical psychology for cancer patients-cancer: the key role of clinical psychology.

Castelnuovo, G. Empirically supported treatments in psychotherapy: towards an evidence-based or evidence-biased psychology in clinical settings? No medicine without psychology: the key role of psychological contribution in clinical settings. Psychological considerations in the assessment and treatment of pain in neurorehabilitation and psychological factors predictive of therapeutic response: evidence and recommendations from the Italian consensus conference on pain in neurorehabilitation.

Psychological treatments and psychotherapies in the neurorehabilitation of pain: evidences and recommendations from the Italian consensus conference on pain in neurorehabilitation. Obesity and outpatient rehabilitation using mobile technologies: the potential mHealth approach. Diabetes Res. Not only clinical efficacy in psychological treatments: clinical psychology must promote cost-benefit, cost-effectiveness, and cost-utility analysis.

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Teaching evidence-based practice: implications for psychology. Cox, G. Psychological therapies versus antidepressant medication, alone and in combination for depression in children and adolescents. Cochrane Database Syst. Cuijpers, P. Anxiety 31, — Dezetter, A. Costs and benefits of improving access to psychotherapies for common mental disorders. Health Policy Econ. Dornelas, E. Introduction: integrating health psychology into clinical practice. Emmelkamp, P. Advancing psychotherapy and evidence-based psychological interventions. Methods Psychiatr.

Psychotherapy in a New Dimension, 1st Edition

Engel, G.