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- W2016065400 abstract "Back to table of contents Previous article Next article Letters to the EditorFull AccessDeveloping Supportive Psychotherapy as Evidence-Based TreatmentDAVID J. HELLERSTEIN M.D.JOHN C. MARKOWITZ M.D.,DAVID J. HELLERSTEIN M.D.Search for more papers by this authorJOHN C. MARKOWITZ M.D.Search for more papers by this author,Published Online:1 Oct 2008https://doi.org/10.1176/appi.ajp.2008.08040565AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: In the April 2008 issue of the Journal , Carolyn J. Douglas, M.D. (1) discussed many issues involved in the surprisingly complex enterprise of teaching supportive psychotherapy. Dr. Douglas stated that “supportive therapy has not been sufficiently well defined in a manual or tested in controlled clinical trials to be considered evidence based” (1, p. 450). This assertion deserves exploration. Supportive psychotherapy may be the most prevalent psychotherapy (2) . In the 1998 National Survey of Psychiatric Practice, 36% of patients treated by psychiatrists received supportive psychotherapy, a higher percentage than that for insight-oriented therapy (19%), cognitive behavioral therapy (CBT) (6%), or psychoanalysis (1%). The practice of supportive psychotherapy seems likely to increase since 1) residency training in the United States currently requires competency in the area of supportive psychotherapy; 2) several supportive psychotherapy texts have been recently published (3 – 5) ; and 3) supportive psychotherapy applies to a wide range of patients and clinical situations. Psychotherapy research has usually examined supportive psychotherapy as a comparison treatment for more specific—putatively more “active”—approaches that may have received more rigorous therapist training, greater researcher allegiance (6) , and even a larger allotment of therapeutic hours. Thus, existing data pertaining to supportive psychotherapy are often suspect. Nevertheless, increasing literature on supportive psychotherapy suggests that it is active, efficacious, and often achieves lasting, meaningful results (3 – 5 , 7 , 8) . In a recent borderline personality disorder study (9) , supportive psychotherapy demonstrated generally comparable outcomes with those of dialectical behavioral therapy and transference-focused psychotherapy. In treating depression, supportive psychotherapy matched CBT despite fewer therapy sessions (10) . Perhaps now is the time to complete the process of establishing supportive psychotherapy as an evidence-based treatment. As the most common psychotherapy, supportive psychotherapy should receive high research priority and be developed, applied, and evaluated as rigorously as CBT or interpersonal psychotherapy. It can then be taught to residents and other students as a treatment with demonstrated efficacy and refined through further research.New York, N.Y.Drs. Hellerstein and Markowitz have participated in studies of supportive psychotherapy funded by NIMH. Dr. Markowitz has received royalties from psychotherapy-themed books.This letter (doi: 10.1176/appi.ajp.2008.08040565) was accepted for publication in May 2008.References1. Douglas CJ: Teaching supportive psychotherapy to psychiatric residents. Am J Psychiatry 2008; 165:445–452Google Scholar2. Tanielian TL, Marcus SC, Suarez AP, Pincus HA: Trends in psychiatric practice, 1988–1998, II: caseload and treatment characteristics. Psych Services 2001; 52:880Google Scholar3. Novalis PN, Rojcewicz SJ, Peele R: Clinical Manual of Supportive Psychotherapy. Washington, DC, American Psychiatric Publishing, 1993Google Scholar4. Pinsker H: A Primer of Supportive Therapy. Hillside, NJ, Analytic Press, 1997Google Scholar5. Winston A, Rosenthal RN, Pinsker H: Introduction to Supportive Psychotherapy: Core Competencies in Psychotherapy. Arlington, Va, American Psychiatric Publishing, 2004Google Scholar6. Luborsky L, Diguer L, Seligman DA, Rosenthal R, Krause ED, Johnson S, Halperin G, Bishop M, Berman JS, Schweizer E: The researcher’s own therapy allegiances: a “wild card” in comparisons of treatment efficacy. Clin Psychol Sci Pract 1999; 6:95–106Google Scholar7. Wallerstein RS: The psychotherapy research project of the Menninger Foundation: an overview. J Consult Clin Psychology 1989; 57:195–205Google Scholar8. Hellerstein DJ, Rosenthal RN, Pinsker H, Samstag LW, Muran JC, Winston A: A randomized prospective study comparing supportive and dynamic therapies: outcome and alliance. J Psychiatric Pract Research 1998; 7:261–271Google Scholar9. Clarkin JF, Levy KN, Lenzenweger MF, Kernberg OF: Evaluating three treatments for borderline personality disorder: a multiwave study. Am J Psychiatry 2007; 164:922–928Google Scholar10. Markowitz JC, Kocsis JH, Fishman B, Spielman LA, Jacobsberg LB, Frances AJ, Klerman GL, Perry SW: Treatment of HIV-positive patients with depressive symptoms. Arch Gen Psychiatry 1998; 55:452–457Google Scholar FiguresReferencesCited byDetailsCited byA randomized trial of interpersonal psychotherapy, problem solving therapy, and supportive therapy for major depressive disorder in women with breast cancer20 October 2018 | Breast Cancer Research and Treatment, Vol. 173, No. 2Psychotherapy Research, Vol. 25, No. 1A Multifaith Spiritually Based Intervention Versus Supportive Therapy for Generalized Anxiety Disorder: A Pilot Randomized Controlled Trial7 October 2013 | Journal of Clinical Psychology, Vol. 70, No. 6Archives of Women's Mental Health, Vol. 15, No. 3Promising Psychotherapies for Personality Disorders1 April 2010 | The Canadian Journal of Psychiatry, Vol. 55, No. 4Advances in Psychiatric Treatment, Vol. 16, No. 3 Volume 165Issue 10 October, 2008Pages 1355-1356THE AMERICAN JOURNAL OF PSYCHIATRY October 2008 Volume 165 Number 10 Metrics PDF download History Published online 1 October 2008 Published in print 1 October 2008" @default.
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