Tuesday, December 1, 2020

Comments by Nick Forand, Ph.D.

Showing 4 of 4 comments.

  • Actually I find this study to be quite compelling evidence in favor of MBCT. We know that individuals withdrawn off of maintenance antidepressants relapse at an alarmingly high rate when compared to individuals maintained on antidepressants (e.g., Hollon et al., 2005). Over the shorter term (1-2 years) maintenance meds are pretty good at preventing relapse, even though there may be other iatrogenic effects accumulating. So MBCT was at minimum able to overcome the known relapse rate associated with stopping the meds. That’s no small feat.

    The study also lasted only two years. We know that the relapse prevention effects of CBT and MBCT actually increase in comparison to medication maintenance over the longer term (e.g., Bockting et al., 2009). I suspect when longer-term follow-ups are conducted, these authors will observe the same effects.

  • Hi Suzanne,
    Thanks for your kind words. I am sorry you had this interaction with Dr. Campo. This is not typical of my interactions with him, so I can only hope that his comments were misunderstood. I do wish that we had extended an invitation to Mr. Whitaker (whom I had the pleasure to meet when I was a postdoc) and not invited Dr. Lieberman to speak, but please know that these actions do not necessarily represent the views of Dr. Campo or members of our department.

    I am also terribly sorry about your son. I am familiar with that piece in Psychology Today but did not realize it was you. What a terrible tragedy and it’s to our shame that our department contributed to it in some way. I have written some about the dangers of over-aggressive treatment and have a manuscript in preparation that deals with this issue in the treatment of depression. In general, although our treatments can be helpful, I believe the field more often errs on the side of more intensive treatment, which can be very damaging.

    Finally, I’m sorry to say that the units here are probably much the same as they were when your son was hospitalized. Unfortunately, this is attributable both to the culture of inpatient psychiatry but also to a lack of resources. This is a problem. However, I have some good news. We are about to welcome a well-regarded psychologist to our department who specializes in psychosocial treatment for psychotic illnesses. I am hopeful that he will improve the care for our sickest patients and perhaps also begin to shift the culture in the inpatient services toward a more holistic approach.

    This is the first time I’ve posted on this site, even though I’ve been reading it for several years. I’ve been reluctant to participate in part due to how psychiatrists (and sometimes psychologists) are sometimes characterized as corrupt, uncaring, and totally adherent to the medical model. Even though I am a psychologist and have had similar thoughts at times, this characterization does not match with my general impression of my colleagues. Certainly, there are some individuals who are bad at their jobs, and some who are freer than I would prefer with medications. But most are conservative prescribers who care about their patients and lean heavily on the psychosocial services provided by our therapists, including myself. I’ve seen them remove nearly as many prescriptions as they have made. Most of our psychiatrists are young, and I think this is a positive sign for the future.

    I wish you good luck in your efforts. Let me know if I can be of help to you here in Columbus.

  • Actually, I’ve mentioned having Mr. Whitaker speak at our grand rounds to Dr. Campo on more than one occasion and he has strongly considered it. Dr. Campo asked some very pointed questions of Dr. Lieberman when he spoke at our grand rounds in April 2013, based on his reading of Whitaker’s work. We also had Dr. Steingard in for grand rounds last September. Dr. Campo is a champion of integrated services and his philosophy, as well as the department’s, is strongly rooted in the biopsychosocial model. Of all the people in our field who deserve criticism, John Campo is near the bottom of the list.