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On behalf of our editorial group, I would like to thank you for your very welcome reflections on our book Psychotherapeutic approaches to schizophrenic psychoses: past, present and future1, and to comment on some central topics you address.
It is true, of course, that a book including 25 chapters written by more than 30 contributors from different parts of the world will be multifaceted. This was indeed our goal, which, we hope, will serve to increase in the best possible way a widening interest in psycho-therapeutic interventions and treatments for psychotic patients.
You delineate two important topics in our book, which you feel to be in need of comment: (1) integration versus reductionism; (2) research: friend or foe?
In our book, we have repeatedly emphasized the need for a more integrated approach to the study and treatment of patients included in the schizophrenia group. It may be true that the emphasis on the importance of psychodynamic approaches seems in some sections of the book almost to put aside an integrative goal, as a reaction to the globally dominant position of usually very one-sided drug treatment, backed by the pharmaceutical industry. This has been especially true of the American situation. Twelve years ago, an authoritative team appointed by the American Psychiatric Association even published guidelines, virtually denying every therapeutic approach based on psycho-dynamic ideas, individual- or family-centred (Lehman & Steinwachs, 1998). Largely due to protests presented by the American branch of the International Society for the Psychological Treatment of the Schizophrenias and Other Psychoses, these points were somewhat - but only somewhat - alleviated in the second edition of the guidelines.
Even in Finland, a “valid treatment recommendation” from 2003 did not include any mention of the need-adapted treatment orientation, which had spread widely in the country during the 1980s in connection with our national schizophrenia project. I can tell you