www.isps.org

THE INTERNATIONAL SOCIETY FOR THE PSYCHOLOGICAL TREATMENTS OF THE SCHIZOPHRENIAS AND OTHER PSYCHOSES

Vol. no. 8 - August 2004

ISPS- membership – now available Welcome to MADRID - Spain for institutions and organisations 13 – 16 June The board is also busy discussing the 2006 possible development of a new inter- Dear members and national journal as part of the ISPS- friends of the ISPS activities. It may be a little early still in the process of building a new organisation, as the ISPS is, but the work of establishing such a journal needs thorough prepara- As you will obviously discover from this tion, so it may be the time to make a Newsletter, the positive development principal decision. building our international organisation The board is also glad to announce that continues. There is now no month with- new books in the ISPS-series are now out a new local chapter being established. well under way, and that two or three new books hopefully will surface this year. THE 15TH INTERNATIONAL SYMPOSIUM So, the ISPS is gradually growing into a FOR THE PSYCHOLOGICAL TREATMENT OF And, we will direct your attention to two strong and, hopefully, influential organi- SCHIZOPHRENIA AND OTHER PSYCHOSES very important and well-written new sation. And, I guess that's what we're after, books. John Read, Loren Mosher and influence? We want to make an impact Richard Bentall's book "Models of Madness: on decision makers, directors, clinicians, Psychological, social and biological approaches relatives and users; to persuade them to schizophrenia", published for the ISPS- about the usefulness of the psychological series by Brunner-Routledge. Buy it and treatments available for the treatment of read it! Spread the word! And, John Schizophrenia and other psychoses.To F.M. Gleeson and Patrick McGorry's accomplish such influence, the ISPS must book "Psychological interventions in early come forward as a serious and reliable psychosis: a treatment handbook", has been organisation, and our work must build published by Wiley. This book points to on reliable and evidence-based research the very important issue of refining and and strategies. adapting our treatments towards the The board have now decided to open needs of specific subgroups of our membership also for institutions and patients, i.e. first episode patients in this organisations; by this we want to invite case. Note from the Editor – We will be hospital and health service organisations publishing a review of this book in the to express their support for the humanis- next issue of the Newsletter. tic treatment traditions represented by The preparations for the 2006 ISPS the ISPS. We also hope that this can, in conference are well underway, and we time, be an important source of income want to encourage you all to submit your for our organisation, as the income from proposals for seminars, workshops, the membership fee will be too small in posters etc. Manuel González de Chávez the long run, to drift an international and the rest of the organisational society. In our upcoming board meeting committee will be most pleased to receive in Vancouver this autumn, the board will your proposals. As mentioned above, decide on the details regarding member- some of us will enjoy the IEPA-conference ship for institutions, and we hope that all in Vancouver Sept./Oct. this year. Hope our members will encourage their own to see many of you there, and on behalf institution to become a member of the of the board I wish you all the best. ISPS. Jan Olav Johannessen, Chair newsletter

Editorial Objectives of ISPS ISPS secretariat The ISPS secretariat is a link between our Promote the appropriate use members and the executive committee; I n this issue of the newsletter you will find maintaining the website, printing and information about ISPS activities around the world. of psychotherapy and psycho- logical treatments for persons distributing the ISPS newsletter, keeping a Meetings and conferences have brought people with schizophrenias and other database of ISPS members and local groups, together in many countries. The number of local psychoses and answering any queries for information groups is increasing, and the local groups are and other services. growing in size. We are especially happy to see Promote the integration of The secretariat is partly hosted by the Centre increasing interest and activities in Eastern Europe, psychological treatments in for Psychotherapy and Psychosocial and that local groups are emerging in Asia and treatment plans and compre- Rehabilitation of Psychoses (SEPREP), a non- Africa. Book reviews, clinical experiences and hensive treatment for all commercial Norwegian foundation and network of users, clinicians and researchers information on research are also included in this persons with schizophrenias and other psychoses promoting psychological treatment of the issue of the newsletter. Earlier issues of the news- psychoses. In addition, Antonia Svensson in letter may be available for local groups in their Promote the appropriate use Athens works part-time as ISPS Organiser and work to give information to potential members, of psychological understanding does most of the work of the secretariat that and you may contact [email protected] to order copies. and psychotherapeutic can be done electronically. Antonia can be approaches in all phases of contacted on the [email protected] g email address. the disorders including both T he objective of ISPS is to promote psychological Address to the ISPS secretariat treatments for psychoses in various ways; like early in the onset and in longer ISPS c/o SEPREP, Jernbanetorget 4 A, international congresses, local meetings and net- lasting disorders N-0154 Oslo, Norway working. Learning about initiatives and successful Promote research into Tel +47 23 10 37 77 / Fax +47 23 10 37 79 events in other countries may trigger similar individual, family, group E-mail: [email protected] g Website: www.isps.org initiatives elsewhere. This is why it is important to psychological therapies, Bank account: 5005 06 56648 share your experiences with others in the ISPS preventive measures and other Den norske Bank, Oslo, Norway networks. By submitting your reports to the ISPS psycho-social programmes for newsletter you will reach people in many parts of those with psychotic disorders ISPS honorary life time members the world. • Yryö Alonen, Finland Support treatments that include individual, family, • Gaetano Benedetti, Switzerland T he ISPS website is visited by many members and group and network approaches • Johan Cullberg, Sweden others, but could be used much more. We especially and treatment methods that • Stephen Fleck, USA want to remind the local groups of the possibility are derived from to get your own free website as a part of the ISPS psychoanalysis, cognitive- • Murray Jackson, UK website. The website is accessible to millions all over behavioural, systemic and • Jarl Jørstad, Norway the world, there is room for much more material psycho- educational • Julian Leff, UK approaches than in the newsletter, and news and adverts are • Christian Müller, Switzerland immediately available. You may contact ISPS by Advance education, training • Barbro Sandin, Sweden email [email protected] to establish free webpages for and knowledge of mental • Harold Searles, USA your local group. There are also several national and health professionals in the international groups having discussions by emails. psychological therapies • Helm Stierlin, Germany • John Strauss, USA A growing ISPS may also find that the diversity of • Lyman Wynne, USA approaches in the understanding and treatment of The ISPS executive committee 2003 – 2006 psychoses will bring new challenges. Our ability to respect each other and to build an organisation • Jan Olav Johannessen (Norway) containing a broader spectrum of approaches may • Brian Martindale (UK) be put to test. By using our energy on seeing what • Patrick McGorry (Australia) we share and working for the objectives of ISPS, this • Ann-Louise Silver (USA) diversity may be a strength and help us all to work for a better future for persons suffering from • Lyn Chua (Singa-pore) psychoses. • Manuel Gonzalez de Chavez (Spain) • Ivan Urlic (Croatia) • John Read (New Zealand) Torleif Ruud Editor Co-opted board member: • Torleif Ruud (Norway).

2 Vol. no. 8 - August 2004 newsletter C A L G R S L O O U P I S P S News from Local Groups ISPS UK In terms of content, we are increasingly • Dr. Brian Martindale, UK ("Psycho- aiming to involve ISPS in national issues in dynamics. The family and psychosis. Old Institutional Membership: The network has the field of psychosis. Influencing and de- wine in new bottles – does anyone want a new category of membership, ‘Institutional bating national clinical guidelines, encour- to drink it?"); member’. The purpose of this is to have a aging our members to get involved in local • Jaikku Seikulla, PhD, Finland ("The social good way of relating to Boards of Organi- clinical governance activities and organising network increases the treatment resources sations with complementary goals and to meetings such as the two very successful in the difficult psychotic crisis"); be able to provide enough information to national meetings on groups and psychosis those organisations to attract members to and the two one day very popular confe- • Solfrid Vatne, PhD, Norway (Recognition as a method in milieutheraputic work?"); join as individuals when they would get full rences in the last year on in-patient wards benefits. Our first Institutional member is and persons with psychosis. • Dr. Reidar Kjaer, Norway ("Personal the- Community Housing and Therapy, an organi- Last but not least, a great deal of energy rapy for Psychosis ad modum Hogarty"). sation with a long history of providing small has been devoted to our national residential In addition there will be small groups etc. group home therapeutic environments main- conference which will take place in mid- Dr. Kjell Granerud is the main organizer ly for persons with psychotic vulnerabilities. September 2004 in Manchester – with the of the conference. main focus being ‘tuning into psychosis’. The thinking behind this conference is that Hamar is beautiful Committee News: Our tradition is to aim little town, situated often there is too great a focus on the ‘doing SWEDEN to have representation on the committee in the centre of on the one hand of all the major disciplines to or talking to’ aspects of therapy – but Trondheim perhaps insufficient attention to the more the eastern in the mental health field and on the other NORWAY receptive qualities of staff towards those part of all the major psychological modalities as Norway, well as user and carer representation. To with psychosis and the difficulties and po- with easy Hamar make the representation and networking tentials of listening to and their ‘products’. access Bergen more manageable we have been encoura- More information is available on the ISPS Oslo website. from Oslo ging our committee members to form small airport, Stavanger sub-networks of associates who will take on As will be clear, ISPS UK is beginning to Garder- areas of facilitation within the discipline or establish itself more firmly in the mental moen. So if modality. We hope to use our forthcoming health field as a result of the efforts of an you want to see Norway conference as a means of launching net- increasing number of enthusiastic and cre- at its best.... Registration works such as a UK wide ISPS nursing net- ative persons sympathetic to the objectives details from [email protected] work. Recently we have our first social of the organisation. or fax +47 62 58 14 01. worker representative on the board and we have focussed energy on trying to launch Annabel Thomas, ISPS UK Organiser Jan Olav Johannessen a carers and users network. Brian Martindale, Chair ISPS UK is now registered as a Charity and ISPS NORWAY THE MEDITERRANEAN this necessitates more transparent proce- ISPS ACTIVITIES dures and financial accountability. The local chapter of ISPS-Norway will be Our next General Meeting will formally organised the 15th of October this ISPS CROATIA be held in Manchester year. Earlier there was a Scandinavian ISPS, In the Inter-University Center in Dubrovnik, this September. but this has now been reorganised into national chapters. We have an interim board Croatia, the traditional 8th School of A considerable success with 10 members from all over Norway. Psychotherapy of Psychoses was held from has been the holding October 14th–15th 2004 we will hold a na- May 05 – 08, 2004, organized by Sladana of telephone tional conference in Hamar, Norway, on Ivezic and Ivan Urlic. With the theme conferences the theme: ‘Individual adapted therapy in ''Toward Comprehensive Psychotherapy which has UNITED KINGDOM psychosis; are such need-adapted approa- of Psychoses'' this year the focus was on proved to ches possible in the cooperation between ''Early Intervention for Psychoses''. be an Manchester individual therapy, group therapy, milieu- This international professional event effective way therapy and other therapy forms’. We have brought together psychiatrists and clinical of maintaining the London also invited people from the other Nordic psychologists from Croatia, Slovenia, and work of the countries to participate. UK. The programme covered the overview committee in Key-note lecturers will be: of early intervention in psychoses, the family between our three or four face-to-face intervention, epidemiology of psychoses meetings per year. • Malcolm Stewart, PhD, from New Zealand ("The stress/vulnerability model revisited. and pharmacology of early intervention. Our own Newsletter (see ISPS website) has Especially interesting was the presentation Strengthening its usefulness for service grown and is now produced four times a of Mark Agius from UK, regarding the con- users and families"); year and together with our successful email cept of the prodrome and IRIS guidelines discussion group is proving to be a vehicle • Professor Howard Kibel, US ("The on early intervention. Slovenian colleagues both for information and lively debate. psychosis-patient in group-therapy – is presented very interesting clinical cases that individual adaptation a paradox"); were discussed in small groups. Vol. no. 8 - August 2004 3 newsletter A L S L O C G R O U I S P P S

from these countries there were participants two clinical presentations, one by Jessica HUNGARY SLOVENIA from Romania, USA, Argentina, Poland, Wall on her work with an autistic adolescent Zagreb and Iran, contributing to the fruitful inter- girl, and the other by Greg Rosen, presen- national professional exchange. The topic ting his work with an adult schizophrenic of the psychological treatment of woman. We will hear from Joanne Green- Pula schizophrenic patients was well treated. berg, author of I Never Promised You a Rose CROATIA The Congress has been a success, able to Garden, and from Daniel Dorman and BOSNIA AND combine very interesting scientific content Catherine Penney, whose work is documen- Zadar HERZEGOVINA with some excellent social events such as ted in the recently published Dante’s Cure: the moonlight welcome party at the seashore A Journey out of Madness. Our non-U.S. Adriatic Sea with dancing and the enchanting trip to speakers include Chris Burford, from Great Britain, who contributed informally at our Dubrovnik the" magic" mountain Etna. ITALY previous meeting, Danielle Bergeron from A post-congress workshop, held by Jeffrey Canada, Françoise Davoine and Jean-Max Young (USA) and Tullio Scrimali at the Gaudillière from France. We are pleased The closing activity of the event was dedi- Aula Magna Vittorio Guidano, at ALETEIA and honored that they are making this great cated to the organization of the First Croa- School, on "Complex Systems Cognitive trip to contribute to our continuing tian Congress of Social Psychiatry that will Therapy and Schema Therapy", followed development! be held September 22–26th 2004 in Split; Volcanic Mind. During this workshop the the main goal of the congress will be the Italian version of the Young Schema Questi- This has been a year of growth and increa- psychotherapy and psychosocial treatment onnaire was presented as well as the norma- sing stability for ISPS-US. We now are an of psychoses in the frame of reference of tive data collected among a sample of Italian official non-profit organization. This means the comprehensive therapeutic approach. normal controls. that we can accept tax-deductible donations, The organizers of the congress are S. Ivezic and we can use them! And we can and will Ivan Urlic was present as a delegate of ISPS, and I. Urlic. The great impulses for that apply for grants. We have an Executive in order to foster the local and international event were the experiences from Dubrovnik Director, Karen Stern, whom we hired organization, especially the ISPS in Italy. schools and the wish to foster our professi- following her great contributions to the The overall impression was that the good onal experiences through ISPS Croatia. success of our previous annual meeting in organization of the conference, the cordi- Philadelphia. Karen worked for eleven years Ivan Urlic Palermo ality of our hosts - especially of the main teaching English as a Second Language ITALY organizer prof. Scrimali - and the richness until the arrival of her son Oliver. Now she ISPS ITALY Messina of the programme, was recommending the Mt. Etna is working at home part-time. She has mo- support of the ISPS to this traditional pro- ved our projects forward and keeps on top SICILY fessional meeting. It should be added that, Catnia of organizational issues; she works closely in terms of ISPS in Italy, there is a feeling with Antonia Svensson. Our web-designer, of the need to organize ISPS in such a way Clara Hall, is continuing to build a stronger that the excellent cognitive focus from Sicily webpage, which is bringing us new members is complimented by a structure that and helping us connect with organizations Volcanic Mind, The Traditional Summer represents other modalities in the field of with agendas overlapping ours. We feature International Conferences 24 – 26th June psychoses. a membership directory of individuals and in Catania, Italy. Honorary Chair: A.T. Beck organizations. We are posting members’ (USA), Chairs: Tullio Scrimali (Italy) and Tullio Scrimali, Ivan Urlic articles, and are posting Brian Koehler’s Arthur Freeman (USA). erudite list-serve contributions. And this Volcanic Mind 2004 was held, as scheduled, autumn, Michael Robbins’ e-seminar in during the month of June, in Catania, Sicily. ISPS US USA Chicago psychosis will begin its work. The faculty The Congress was preceded by a two day includes Michael Robbins, Anni Bergman, As I write, pre-congress workshop in Enna on Clinical Bertram Karon, Brian Koehler,Eric Marcus, ISPS-US members Psychophysiology and Cognitive Psychothe- Richard Munich and myself; there will be rapy and on Attachment Theory and Cogni- are putting last minute 39 participants. tive Therapy. During the pre-congress work- touches on our sixth annual meeting, to be We are grieving the loss of our feisty Loren shop some American, Serbian and Argenti- held on September 18 and 19, 2004 in Mosher whose energy at the ISPS meeting nean Colleagues were hosted by Tullio Chicago. See the specifics at our webpage in Melbourne gave no hint that he would Scrimali, in Enna at the "Sky College" which www.isps-us.org. This will be our most soon be gone. While we have contributed at the guest-rooms of Aleteia, International ambitious meeting, with four tracks, and to the Soteria Project Fund, a more substan- School of Cognitive Therapy, Tullio Scrimali the first annual meeting we will hold at a tial contribution is our dedication to help founded and actually directs. hotel, the Courtyard by Marriott. Our theme, “Extremes of Experience: Psychosis Jim Gottstein, an activist lawyer in Ancho- In the program of Volcanic Mind there were through many lenses” reflects the eclectic rage, Alaska, in his efforts to launch a Sote- many presentation on the integrated treat- interests of the meeting’s chair, David Gar- ria-Alaska project. Jim will be attending our ment of schizophrenia such as those presen- field, author of Unbearable Affects: A Guide meeting in Chicago, where we will strategize. ted by Ivan Urlic from Croatia, Tullio Scri- to Psychotherapy of Psychosis. We will be hono- I still have copies of the great ISPS issue of mali, from Italy, Clare Reeder from Great ring Leston Havens, M.D. who has inspired the Journal of the American Academy of Britain and Lijljana Trajanovic from Serbia and guided us over the decades. Our meet- Psychoanalysis and Dynamic Psychiatry, 31, and Montenegro. Besides other colleagues ing will be experience-near, the centerpieces 1, Spring 2003, “The Schizophrenic Person and

4 Vol. no. 8 - August 2004 newsletter A L S L O C G R O U I S P P S the Benefits of the Psychotherapies—Seeking a ISPS NEW ZEALAND ISPS Uganda PORT in the Storm” which I guest-edited with T. K. Larsen. Contributors, many of whom Immediately following the David Kakaire and colleagues are starting were on the ISPS Task Force on the PORT successful ISPS Melbourne Auckland up a local group of ISPS in Uganda. They Report, include Wilfried Ver Eecke, Siobhan conference in 2003, we Kiwis have formed a group of 14 people who O’Connor, David Garfield, Garry Prouty, organized a two-day satellite NORTH ISLAND have met and held planning meetings Brian Koehler, Bertram Karon, Birgitte Bech- conference in Auckland, and seminars. The group gaard, Anthony Lehman with Donald Stein- called The Psychology of Wellington has recently applied wachs, Silke Bachmann with Franz Resch Psychosis: Making Sense for a start-up grant AFRICA and Christoph Mundt, Frank Margison, of Madness. Two hund- NEW ZEALAND from ISPS and is Uganda William Gottdiener with Nick Haslam, red showed up to hear awaiting the board’s T. K. Larsen with Andreas Bechdolf and Richard Bentall, Christchurch decision. For more Max Birchwood, John Gleeson with T. K. Tony Morrison, SOUTH ISLAND information contact Larsen and Patrick McGorry and John Read Courtenay David Kakaire with Colin Ross – a powerhouse group, all Harding, and Invercargill [email protected] in various ways challenging the findings a host of home- and methods of the PORT report. I believe grown talent from ISPS IN LATIN AMERICA we played a strong part in the removal of a mix of professions (and including a Maori those two recommendations. Copies are practitioner and service-users), explore a ISPS COLOMBIA available at just $10, check made out to me, fascinating range of approaches. Most who and sent to 4966 Reedy Brook Lane in attended signed up for the offer of a year’s A new group is now recruiting professionals Columbia, MD, 21044. People are using this free membership of ISPS. Obviously an interested in ISPS.Contact either: entire book in at least six university courses. offer so generous they couldn’t refuse. Juan Carlos Rojas, Carrera Nº 42 -3-a-89 Apartado Aereo 32974, Cali, Colombia We are pleased that the revised PORT report Since then we have formed an interim teléfono: 0057-2-552 44 76 removes the onerous recommendations 22 steering group of two psychologists (Jim fax: 557 90 40 Casillero 203 c and 26 (which recommended against Geekie and myself), two psychiatrists (Patte [email protected] psychodynamic therapy for schizophrenia Randall, Mike Ang) and an Occupational even in combination with medications, and Therapist (Dale Rook). We have decided Or: against psychodynamic family therapy). to make the conference an annual event, Pedro Gomez Méndez, Centro Medico The revision appeared in the final issue of but have changed its name to Making Sense Gemelli, Calle 80 nº 47-43, Consultorio 5c Schizophrenia Bulletin, a journal founded of Psychosis (see www.isps.org to register). Barranquilla, Colombia by Loren Mosher, which stopped publica- Teléfono: 300 800 3595 tion just months before Loren’s death. We are very pleased that our keynote [email protected] However Lehman et al. comment that these speaker in October (18th & 19th) will be recommendations were unnecessary because Ron Coleman, a leading light in the Hearing Voices movement in Europe. Once again we psychodynamic therapy has been found not ISPS ARGENTINA to work and is no longer practiced. Thus also have an impressive array of diversity in we at ISPS are proclaimed either dead or the other presentations. And we are proud ISPS contact persons in Argentina include: severely delusional. Our fight continues to say that this is, and will continue to be a Violeta Arce, [email protected] against cynical biological reductionism, conference without drug company funding or influence. Jorge Garcia Badaracco which leaves very many sufferers and their [email protected] families despairing that recovery or funda- At our August steering group meeting we mental improvement is impossible. decided to propose, at the conference, that Alfredo Eidelsztein [email protected] Our projects for the near future include New Zealand formally establish its own ISPS the following: 1) We plan to launch an e- branch. So be warned, attendees will be Hernán D. Simond (TMP) journal, to which people could subscribe, targeted to take on official branch positions, [email protected] receiving issues that they could print out, including the dreaded role of Treasurer! in Adobe files, or alternatively people could We expect another full house, and hope ISPS PANAMÁ download individual articles at a manage- that some of you from overseas will venture able fee, from our website. 2) Our research down to the land of the All Blacks and A new group is Panamá committee, led by William Gottdiener, is Gandalf to join us. We promise it will be now recruiting fun as well as informative and nurturing of Colombia preparing a clinical survey which we will professionals those who want to approach the topic from distribute by mail and post on our webpage. interested in a human and humane perspective. ISPS. Contact: 3) We plan an aggressive outreach to related LATIN AMERICA organizations and to individuals working John Read, Auckland Mariola Young at the mental hospitals and other related Torquemada institutions in the United States. 4) We hope ISPS India 9a- Apdo2327 Panamá to develop more ISPS-US branches, and to Ishita Sanyal (winner of the 2003 David B. Tlfono :5o7-2176638, strengthen those in existence. Feinsilver award) is starting up a local ISPS [email protected] group in India. The group have recently Argentina Thus, we are continuing to grow and our been granted $1000 (US) from ISPS as a friendships within the organization become start-up grant. increasingly vital. We look forward to Interested persons should contact Ishita making great contributions to the ISPS Sanyal [email protected] meeting in Madrid. Vol. no. 8 - August 2004 5 newsletter

In memory of Loren Mosher 1933-2004 By John Read

I’m sure many ISPS members could report for the ISPS Newsletter, after oren Mosher L have filled this space with their own hearing his presentation at the confe- died, at the age of fond memories of this very special rence and sharing some great evenings 70, in Berlin in man. (where I learned as much about Italian July 2004. He had wines as about Soteria House): “Thank been struggling I, for instance, first ‘met’ Loren as a you Loren for still sparkling with your with a liver disease. clinical psychology intern working in cynical optimism after all these years.” His wife, Judy a depressing U.S. psychiatric hospital. Schreiber, three Like countless others around the world, The four short years I was fortunate children and then and today, I had entered training enough to know him left some great close friend and to become a mental health professi- memories. His agreeing to become a colleague onal with the expectation of being co-editor on ‘Models of Madness’ was Volkmar Aderhold were with him to taught how to understand and relate a real high. How often do you get to help him on his way. helpfully to ‘mad’ people. I was beginn- work with someone who has been a hero for twenty years? However I could oren received his MD from Harvard ing to succumb to the many messages L have done without the six months when Medical School. He underwent psych- that this was ‘naïve’, because these Loren was threatening to withdraw iatric training at Harvard and the ‘patients’ had an incurable brain-dis- because the book wasn’t ‘hard-hitting’ National Institute of Mental Health’s ease which, at best, could be controlled enough! Other memories include his Intramural Research Program in Beth- by drugs. My dwindling faith was kept insisting on taking me out for breakfast esda, Maryland. After a year as an alive by a single research paper from in a fancy Hamburg hotel on my birth- Assistant Professor of Psychiatry at Yale a man whom I had never heard of and day when I was alone and far from he left, in 1968, to become the first who certainly wasn’t on my prescribed home. Then there was his visit to little Chief of the NIMH’s Center for Studies reading lists: Community residential treat- old New Zealand. He presented his of Schizophrenia. While in this post ment for schizophrenia (Hospital & Commu- Soteria research to 200 service-users, he founded the Schizophrenia Bulletin. nity Psychiatry, 1978, 29, 715-723). staff and mangers. At the end of the In 1980 he became Professor of Psychi- I suspect many others were saved from day there was a unanimous vote in atry at the Uniformed Services Univer- disillusionment and a premature aban- favour of introducing a Soteria House sity of the Health Sciences in Bethesda. donment of their chosen profession in Auckland. (We are still working on He left USUHS in 1988 to direct the by Loren’s many subsequent contribu- it.) When he spent the next morning Montgomery County Mental Health tions to the research literature. Not with a small group of staff who work system. Between 1996 and 1998 he was only were there people out there some- in first episode psychosis teams he spent the Clinical Director of the San Diego where actually doing the sort of work more time quizzing them about, and County Mental Health System. At the we wanted to do, but were discouraged supporting, their work than talking about time of his death he was a Clinical from trying, but there was research to his own. How in keeping that was with Professor of Psychiatry at the University show that we were right – it worked! his beliefs about effective mental health of California at San Diego and Director I didn’t really meet Loren until 2000, services: ‘Be with’ and listen first. of Soteria Associates. at the ISPS conference in Stavanger, oren could be irritating too. His oren, of course, was so much more Norway. I was sitting outside my hotel, L L refusal to mince words when it came than is conveyed by this brief summary preparing the seminar I was to give to the awful influence of the drug com- of his career. He became a source of later in the day. At a nearby table three panies over our research and practice hope and inspiration to thousands people were talking about how hard did not endear him to those doing who knew him, personally or through it is to get some psychiatrists to realise their best to promote psychological his research papers or other writings. the obvious fact that people are driven approaches while still accepting drug He was a voice for all those aspiring, crazy by bad things happening to them. company money. (See his incisive 1998 as users of mental health services or One of them, the shortest despite his letter of resignation from the American as mental health workers, to alter the hat, was Loren Mosher. When he said his name I had to stifle one of those Psychiatirc Association on his website path of mental health services to a more www.moshersoteria.com). Like most humane and effective pathway based awful ‘not the Loren Mosher?’ comm- determined fighters for a cause, Loren on compassionate human relationships ents (although I suspect Loren would could polarize as well as inspire. But rather than just diagnoses and drugs. have loved it!). It seems worth repea- ting now what I wrote in the conference when I made the mistake of raising

6 Vol. no. 8 - August 2004 newsletter this with him he laughed and said: to complete your book, soon to be The ISPS book “If I can’t say what I really think at this published: Soteria: Through Madness to 'Models of Madness' stage of my life, when will I?” Deliverance. has sold so well Despite being painfully out of step Shortly after he died Judy said that since its June with many in his chosen profession, Loren must be having his first drink launch that Loren never gave up the hope that with Ronnie Laing. I hope you were a second print- mental health services could change right Judy. Goodbye Loren. Rest run has already direction. Right up to the end he peaceful. Rest assured that your ideas been ordered. travelled the world tirelessly, but always and hope live on in too many of us, The publishers have kindly agreed to humorously, promoting the ideals he all over the world, to be forgotten. dedicate the book, in this and subsequent had proven effective at Soteria House. print-runs, to Loren Mosher, one of We are lucky indeed that you managed Thank you for being you. it's co-editors, who died in July.

THE 15TH INTERNATIONAL SYMPOSIUM FOR THE PSYCHOLOGICAL TREATMENT OF SCHIZOPHRENIA AND OTHER PSYCHOSES Call for papers Madrid – Spain Topics areas: 13 – 16 june Global views 2006 Integrated therapies 50th Isps anniversary / A hundred Online abstract years of schizophrenia psychotherapy submission Improving services & Helping persons and instruction through families with psychotic problems www.ispsmadrid2006.com Key dates

Deadline for symposium, Forum, Workshop abstracts submission: 15th December 2004 Mailing of the 1st Announcement and call for papers: February – March 2005 Mailing of the 2nd Announcement and call for papers: September – October 2005 Deadline for other abstracts submission: 15th December 2005 Deadline for early registration fee: 15th December 2005

SCIENTIFIC SECRETARIAT TECHNICAL SECRETARIAT Dr. Manuel González de Chávez Viajes Iberia Congresos Chairman of the Organizing Committee San Bernardo, 20 6º Chief of Psychiatric Service Hospital General 28015 Madrid - Spain Universitario “Gregorio Marañón” Ph. +34 91 531 94 49 Ibiza, 43 – 28009 Madrid – Spain Fax +34 91 296 37 32 Ph. +34 91 586 81 32 fax +34 91 426 51 10 E-mail: E-mail: [email protected] g [email protected]

Vol. no. 8 - August 2004 7 newsletter

search data that some of the most common (as is often the case) prodromal symptoms of schizophrenia are the material concen- BOOK REVIEW common adolescent experiences. trates on conflicts Of their two hypotheses, the first fitted the within the family. Why does Schizophrenia great majority of their patients: "Some people However there is a whole Develop at Late Adolescence? with a psychosis are not very independent, chapter on peer and romantic conflicts and have an idealised, less elaborate view which demonstrate the author's theoretical A cognitive-developmental of their parents and others." The second position. They argue that "The study shows approach to psychosis hypothesis is: "Some individuals with a very clearly that the client's cognitions are psychosis have gone part way towards an not bizarre and incomprehensible". by Chris Harrop and Peter Trower, adult, autonomous view of their parents, published by John Wiley: but cannot relate to their peers and end The last section has a large number of Chichester, England (2003) up stranded in a social and psychological therapeutic suggestions to help clients with 'no man's land'. different problems ranging from the "Bad The authors discuss why it might be difficult Me anxiety episode", to "the empty self By Chris Burford for some people to individuate from their feeling", to "controlling the parameters of parents and why some people are "blocked". interaction". The chapter titles include his slim and attractively designed volume T The explanations explored here are in the 'character-based' training, overcoming inter- takes on one of the biggest mysteries of idiom of social psychology about parents personal blocks to self-construction, and psychosis: the timing of the onset of an and peers rather than in a psychodynamic overcoming symptoms, including voices. illness that mainstream psychiatrists con- idiom, but clearly are discussing issues that In only 222 pages the book succeeds in tinue to believe is biological. could also be seen as "object related" posing a credible theory for the core riddle Chris Harrop and Peter Trower both have processes. of psychosis, which continues to elude the doctorates in psychology, and are Lecturer biological determinists. Therapeutically it and Senior Lecturer respectively in the Section 2 poses the hypothesis that a sense provides a range of approaches to working School of Psychology at the University of of self is central to humans and the progress with people with psychosis and adolescent Birmingham. But they also have substantial of the adolescent to adulthood. It gives test problems. These include tips for the thera- clinical experience of providing a psycho- exercises to reflect on ones own experiences pist about recognising the adolescent still logy service to adolescents in the Birming- of this, and draws theoretically on writers within oneself. ham area and have a strong endorsement such as Rogers and the ego-psychologists Its model is dynamic without being psycho- from Max Birchwood. like Kohut. The bit I found most challenging, dynamic. Indeed treatment based on trans- In addition Peter Trower has considerable probably because of some long forgotten ference, can sometimes be a problem if as experience with Rational Emotive Therapy. reservation about Sartre, was the theoretical so often therapists are older than clients in This is in line with the increasing interest exploration of psychological experiences early onset psychosis work. It helps the whole in emotion among practitioners of CBT. from the standard point of the existential range of issues of concern to the client to The book draws on continental European analysis of the self as subject and object. be available for discussion in relatively trans- existential philosophical traditions, parti- This potentially links up further back in parent way, even if the theoretical paradigm cularly of Sartre, about when we are the historical development with some of the is philosophically intricate. The book could perceiving subject and when the object of continental dialectical assumptions that be lent freely to any intelligent young client attention, to propose a theory and a the- Freud draws on, and which were later ela- who wanted to explore, and to families rapy of psychosis in which the perception borated as "object-relations". Interestingly struggling to distinguish what is adolescence of one's Self in relation to others is the the authors propose a dynamic process of and what is psychosis. Such transparency is central concept. intra-personal cycles and inter-personal itself an achievement for a time of life often The book starts, typically of the broader cycles. Probably worth re-reading. marked by inter-generational conflict. CBT tradition, with an introduction about Section 3 is about an in-depth naturalistic This book is modest and humane in tone, mental illness that could well be read by the study of these fundamental dynamics in a despite its ambitious title. It locates itself intelligent reader, including someone who sample of 21 people derived from 35 con- persuasively in the converging spectrum of might be just recovering from a psychotic secutive referrals from psychiatrists and psychological approaches to psychosis in illness themselves. Personal examples bring other mental health workers in three NHS making its claim that an assumption about the text to life, and the key statistics appear trusts in the Midlands of the UK. There is the struggle to construct the self, is central well cited and authoritative. There is a guide detailed information about methodology to the emotional, cognitive, and dynamic to help readers dip into chapters selectively. for researchers who want to replicate or tides that drag our clients sometimes Section 1 discusses different views of what vary the approach. apparently irretrievably out to sea. "schizophrenia" is. In 20 pages it then pre- This book is worth the price by reason of sents an impressive survey of the evidence An appendix gives details of the "Self and its concision and practical readability. It against psychosis being a biologically deter- Other Scale" (e.g. "When I am alone I feel succeeds in formulating a central concept mined condition. It shows that examples the need to contact someone" or "Some- that connects well with many converging of psychological states interacting with times I only feel like me when I am alone"), lines of research and therapeutic interven- structural states in the brain, are not at all for which norms have been developed with tion. It tackles what in many ways is the cen- rare. It questions the idea of "schizophrenia" Birmingham University students, and for a tral question in schizophrenia and psychosis being pure and separate from the range of wider age range for one version of the scale. theoretically and practically. I suggest this other psychoses. Compared to the students I was apparently rich, practical and hopeful book is obliga- In discussing why the peak presentation of somewhat more secure but considerably tory reading for anyone working in an early psychosis is in late adolescence (82% of more alienated. onset service, or indeed anyone who has cases of schizophrenia in the WHO survey Because the subjects had few relationships tried to help any young person struggling occurring between 15 and 35) it gives re- outside family and mental health services on the sea-shore of psychosis.

8 Vol. no. 8 - August 2004 newsletter

ABUSE- a precurser to mental illness By Ishita Sanyal A study was conducted by the author in Kolkata, India on 120 persons, 60 of whom are suffering from mental illness. As a Psychologist, Director of Disha and Secretary of Turning Point, I have noticed that a history of abuse is prevalent among the majority of mentally ill persons who come to us for treatment

The aim of the study was to know and This is also true for Indian parents. 10% being sexual. Homosexuality was understand whether abuse is acting as Moreover, in India, due to competition he leading cause of abuse, where a pre-cursor to mental illness, especially in school, difficulty in admission, strin- perhaps the abuser found the child amongst children. I have done this gent rules and disciplines in school safe to satisfy his pleasure. Emotional study to know the facts and figures and (where a child is under the pressure abuse cuts to the very core of a person, also to verify whether what is noticed to get T.C. if he chats with his friends creating scars that may be longer really has a scientific fact behind it. at school/use mother tongue in place lasting than physical ones leading to of English) parents are also under irritation, anger, aggression, withdra- Special attention was paid while doing wal, defiant attitude and depression. the study on children as they often re- emotional pressure. They are helpless, fuse to speak the truth when they find and in their effort to make their child A person whom the victim can confide their opinion is recorded. Both open “the best” put stresses on the child. If in is often a good friend, spouse, and ended and closed questionnaires were a child fails to satisfy the expectations 45% said that they feel free to confide used to determine the nature of abuse he is often abused emotionally without in the professionals. 10% of these vic- here in India, abuser and mental state the parents being aware of the effect tims of abuse who have developed a after the abuse. A detailed study was that it can cause on the child. mental illness admit that they too like done to know whether the victim was So it is only when we see a photograph to abuse others and afterwards feels able to overcome its effects, the possib- of a helpless kid suffering from trauma guilty (50%) and get pleasure (50%) le handling strategies and whom they due to physical abuse by the teacher All individuals who are suffering from can safely confide to. An attempt was or friends in the headlines of news-paper, mental illness think that abuse has also made to know whether the abused we come to know about the real fact. a tremendous negative impact on their person turns to be an abuser himself A parent generally comes for professi- mind and that one of the factors of and also his true feelings after abusing onal help only when the effect of abuse their illness can be the effect of abuse. a person. develops a problem in performance. Emotional abuse is the leading form It is evident nowadays that the incident Parents generally are not aware of the of abuse in Kolkata. The nature of of abuse, more particularly of child fact that comparing a child, using dero- abuse includes verbal abuse and con- abuse, is no longer an uncommon gative comments or physical punish- stant criticism to more subtle tactics incident. A child is abused by a teacher, ment exceeding a certain extent can like intimidation, manipulation, and friends, parents, and family members cause a trauma on the mind of the child. refusal to ever be pleased. Emotional and often the incident remains unno- Safe at home ?? abuse is like brainwashing in that it ticed by others. A child hardly develops Facts and figures-98% of mentally ill systematically wears away at the victim's courage to speak against his caregivers, self-confidence, sense of self-worth, teachers and friends even when abused persons have a history of abuse in their childhood of which family and trust in his perceptions, and self- con- violently. Moreover, in Indian culture cept. Whether it be by constant bera- where a child learns to respect and parents constitute 50% cause of abuse. 30% of the other group has a history ting and belittling, by intimidation, or obey whatever the elders say, a child under the guise of "guidance" or teach- hardly dares to speak against them. of abuse. Those who are abused in this group think that they have been able ing, the results are similar. Eventually, Deviation from this routine is seen as the recipient loses all sense of self and a defiant, revolting and unruly behavi- to overcome it. all remnants of personal value. Emo- our pattern. The nature of abuse is emotional in 65% of cases, 25% being physical and tional abuse victims can become so “It is a sad irony that many abusers genu- convinced that they are worthless that inely love their children, but they find them- they believe that no-one else could selves caught in life situations beyond their want them. They stay in abusive situa- Sexual control and they do not know how to cope. tions because they believe they have They are often isolated from friends and Physical nowhere else to go. Their ultimate family and may have no-one to give them Emotional fear is being all alone. This fear and emotional support. They may not like them lack of self confidence is probably and may not know how to get their acting as a precursor to mental emotional needs met.” (National Committee illness. for the Prevention of Child Abuse).

Vol. no. 8 - August 2004 9 newsletter

The Danish National Schizophrenia project - DNS The Danish National Schizophrenia project is a large scale, prospective, comparative, longitudinal multi-centre study encompassing 16 centres (located in 9 out of 13 counties in Denmark) and covering almost half of the Danish population.1 ation Questionnaire)) suitable for The supportive psychodynamic psycho- following the changes through the therapy takes place in an atmosphere SWEDEN Brønderslev course of psychotherapy. The fourteen of empathy, trust and collaboration centres also decided more thoroughly with the patient, and it consist of a to investigate the “treatment as usual” blend of: giving insight and meaning DENMARK (TaU). The notion of TaU (or the no- to difficult emotions and repetitive tion of ‘standard treatment’) is often maladaptive patterns, establishing a Herning Århus used without specification of what it process thinking instead of adhering Hillerød really contains. Thus when reading a to the fixed pathological (and often Nykøbing Glostrup paper in a journal one seldom knows fragmented) thoughts, and creating Roskilde COPEN- what a specific intervention programme suggestions for testing oneself in diffe- Dianalund HAGEN Middelfart is compared with when it is set up rent social situations. The therapist’s Slagelse against treatment as usual. After two countertransference is of importance years of intake 563 patients were for this method. GERMANY included. The total sample could be OVERALL AIMS divided into three groups: After 2 1/2 years of preparation the The Psychodynamic Psychotherapy Already from the start it was decided 16 centres – including different types sample: 119 patients who were treated that the aims of the whole enterprise of treatment centres (small/big, urban/ with a manualised, scheduled 2–3 year should be broader than “just” research. rural, university/non-university) – treatment of supportive psychodyna- All centres had a wish to improve their agreed on assessing all patients with a mic psychotherapy (individual psycho- help to young psychotic patients, and first-episode psychosis of the schizo- therapy and/or group psychotherapy) thus the aims were specified as: phrenic spectrum disorders, consecu- in addition to treatment as usual; - establishing a network of psychiatric tively referred to either district psychia- The Integrated Psychosocial treatment services (including hospitals and dis- tric centres or psychiatric in-patient trict psychiatric centres), being inte- sample: 139 patients who were treated units. The intake of patients started rested in a systematic focus on early with a scheduled, two year long, inte- October 1997 and lasted 2 years. interventions towards persons with a grated psychosocial treatment pro- first episode schizophrenia The assessments were conducted by gramme consisting of assertive commu- members of trained, independent re- nity treatment, manualised psycho- - developing the quality of the research search teams. The assessment included educational multi-family treatment instruments and the forms of treat- demographic and socio-economic data, (a.m. McFarclane), social skills train- ment that can be offered to persons diagnoses according to ICD-10 rese- ing, weekly consultations for support with a first episode schizophrenia arch criteria and OPCRIT, and clinical and education, and antipsychotic – performing scientific research and status assessed by basic instruments as medication. This project is also known to investigate: GAF, PANSS, and the Strauss-Carpen- as the OPUS project; ter scale. The test-battery at inclusion a) The characteristics of patients with was repeated year 1 and 2, and is curr- The Treatment as Usual sample: first episode of schizophrenic psy- ently repeated year 5. 304 patients whose treatment consisted chosis, and of different treatment modalities – b) Whether different treatment Fourteen centres furthermore agreed psychoological methods, medication, to assess the patients with Rorschach methods eventually may lead to medical advice and treatment by the different outcomes a.m. Exner, WAIS and PAS, and other hospital milieu settings – administered instruments (SASB (Structural Analysis according to the patients’ needs and All three components were of great of Social Behavior), AES (Active En- the available resources of the clinic at importance to the DNS. Throughout gagement Scale), GEQ (Group Evalu- the moment of treatment. more than seven years members of the

1 The following centres participated: Brönderslev Psychiatric Hospital; Psychiatric unit Herning; The Psychiatric Hospital in Aarhus; The Psychiatric Hospital of Middelfart; Psychiatric Hospital Nykøbing Sj.; Psychiatric departments in Roskilde County; Slagelse Hospital department of Psychiatry; Holbäk Hospital Department and child and adolescence psychiatry; Sct Hans Hospital Roskilde department U7; Dianalund; Psychiatric Center Glostrup; Bispebjerg Hospital department Psychiatry U and E; Frederiksborg County Hospital Hilleröd. 10 Vol. no. 8 - August 2004 newsletter

WELCOME TO THE 15TH INTERNATIONAL SYMPOSIUM FOR THE PSYCHOLOGICAL TREATMENT OF SCHIZOPHRENIA AND OTHER PSYCHOSES – MADRID, SPAIN 13 – 16 JUNE 2006 research teams from the different cen- hospitals in Denmark. The National PRESENTATIONS tres have come together for theoretical Mental Health Service has 4.100 beds, and methodological discussions – e.g. approx. 105 community mental health AND PUBLICATIONS discussions of psychopathology and centres, and 125 private practising Previously the project has been pre- the content of manuals – and for con- specialists of psychiatry in the adult sented at the EIPA congresses in New ducting rating sessions. This has not psychiatry section. GPs and private York (2000) and Copenhagen (2002), only given each individual a sense of practicing specialists only care for a and some results will also be presented participating in a meaningful improve- small percentage of the patients treated in Vancouver (2004). Results from the ment of one’s own skills, but it has also for schizophrenia and related disor- comparison of the two forms of inter- helped each centre to raise the quality ders. Pathways to, and the quality of, ventions with the treatment as usual of the psychiatric service provided to psychiatric care of psychotic patients at year 1 and 2 are currently submitted the patients. can be considered similar in the to international journals or in prepa- A prospective, long-term multi-centre country. ration. Some of the results were pre- research project with sixteen centres It is more difficult to get publicly sented at the ISPS Congress in Mel- is a laborious effort with many pitfalls. financed psychotherapy in Denmark bourne, September 2003 (chaired and The strength of the model in our study than in the other Nordic countries, interestingly discussed by Courtney is: and the specialisation of psychotherapy Harding). We intend to present our 1) the quantity of consecutively is not widely spread. 5-year follow-up results in Madrid 2006. One research group in the DNS has referred patients; ORGANISATION 2) the inclusion of different types of published a scale measuring the suita- treatment centres (small/big, The data gathered at each centre in a bility for psychodynamic psychothe- urban/rural, university/non- specially designed computer programme rapy (Valbak et al. in Nord J Psychiatry, university) in all three groups which each centre has received. The 2004). being compared; local organiser and the secretary at For more information contact 3) the percentages of the Danish each centre are of the main persons Secretariate: responsible for getting all data at each population covered by the study; The National Schizophrenia Project, rating. The Steering Committee2 and Ledelsesgang N, Psykiatrisk Hospital 4) the comparison of two different different research teams work with the i Aarhus, 8240 Risskov treatment modalities with standard data to get them published. Each Tlf: 7789 2590 / Fax: 7789 2599 treatment of a supposedly good research team has chosen a specific quality; field of investigation, e.g.: [email protected] 5) the treatment con-ducted mainly 1. General demographic data and www.nationaleskizofreniprojekt.dk by average trained therapists and outcomes of treatment. or Bent Rosenbaum: not by master clinicians. We further- 2. Structural analysis and social [email protected] more hope that the sense of cohe- behaviour. sion between the centres will help Bent Rosenbaum in minimizing the number of drop- 3. Rorschach and Wais-R. DMSci., Associate clinical research professor outs of the study. 4. Treatment of relatives/families. Administrative research leader of the DNS BACKGROUND 5. Process research in individual psychotherapy. - a few words on the Danish Mental Health System: 6. Group psychotherapy and the ability to relate. The Danish National Mental Health Service has a long tradition for equal 7. Predictors for good outcome of access to and economically free treat- individual and group analytic ment for all inhabitants regardless of psychotherapy. their location of living, their income, 8. Treatment as usual. race or religion. The treatment is orga- 9. The group of adolescence patients. nised according to sectorized psychia- 10. Criminality and Schizophrenia. try and there are no private psychiatric From Nyhavn, Copenhagen

2 Susanne Harder, Per Knudsen, Anne Köster, Matilde Lajer, Anne Lindhardt, Bent Rosenbaum, Kristian Valbak, Gerda Winther Vol. no. 8 - August 2004 11 F R A N C E

newsletter L Madrid A

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T I N R S P A

O Annual Madrid Schizophrenia courses P Dr. Ignacio Garcia Cabeza

Professors of the highest world level fessionals and on Saturday morning, ince 1995, the Psychiatry Service I S in different fields of schizophrenia from other distinguished professors whose of the General University Hospital the most advanced investigation to native language is not Spanish parti- “Gregorio Marañón,” directed by Dr. famous therapists have come to the cipated. As every year, a large "biblio- Manuel González de Chávez, has orga- course, with one sure point in common: graphic dossier" with studies, lectures nised an Annual Course on Schizo- their interest and dedication during and publications of the Course phrenia. The course began with the their professional career to the world professors was distributed to all those intention of awakening interest among of psychosis. The most competent and attending. This year, in addition, the mental health professionals about avant-garde Spanish professionals and Spanish edition of the book by Alanen schizophrenia, overcoming the more an especially relevant group of foreign "Schizophrenia" was distributed. classical, academic and biological views guest professors who stand out in this that already had a wide training on field have come to the annual Schizo- The IX Course began with the inter- offer favored by the pharmaceutical phrenia Courses in Madrid. vention of Dr. Jorge Tizón, Doctor of industry. It had a more global, eclectic the Mental Health Unit of Sant Martí and integrating concept in which diffe- The last "IX Annual Course of Schizo- (Barcelona). He spoke at length on rent etiopatho-genic approaches, new phrenia" of Madrid took place on what we should understand by integra- health care models, more recent inves- November 28th and 29th, 2003 and tion in psychotherapy, beyond a simple tigations, but above all more innova- its subject was "Combined psychothera- mixture or combination, and the diffi- ting and complete therapies and inter- pies in schizophrenia and other culties that this entails due to the in- ventions were included. In addition, psychoses." Furthermore, it was held capacity that we still have to find the it aimed to be an open forum in which outside of the General University most useful elements in each psycho- discussion and personal experience Hospital “Gregorio Marañón” for the therapeutic approach. In any case, he predominated on the approach to this first time as its assembly room with 400 advocated the need for theoretically disease over the bibliographic revisions seats was insufficient for the number and technically integrated multidis- and dogmatisms of some theoretical of participants who were coming each ciplinary teams that make it possible positions predominated. year. It was held in the Lecture Room to offer the schizophrenic patient diffe- of the Hotel Melia Castilla, one of the rent responses according to their needs. Since that first year and Course I, in which there were hardly two hundred On behalf of the General University persons registered, the number of per- Hospital “Gregorio Marañón,” Dr. sons attending it has grown increasing- González de Chávez and Dr. Fernán- ly until more than seven hundred in dez Cuevas participated. Both have the IX Course in the year 2003. Those wide experience in the development attending, who initially came from Ma- of therapeutic programs based on a drid, now come from all Spain, even, predominantly group approach. since several years ago, from Portugal. Dr. González de Chávez explained the Not only has it grown in number but benefits of including schizophrenic also in interest, as is demonstrated by patients in group psychotherapy with an integrating orientation has and its the high degree of participation in the Hotel Melia Castilla, Madrid discussions and the loyalty of those perfect integration in a more global attending who come to the now usual most important in Madrid, although program as well as the advantages of appointment with schizophrenia it has maintained the same open to dia- the combination of psychotherapy and during the last weekend of November logue, reflexive and conciliating spirit. psycho-pharmacological treatment. year after year. On his part, Dr. Fernández Cuevas As in previous editions, the IX Course explained his experience in the treat- was divided into three large blocks: ment of bipolar disorder combining the first, usually on Friday morning, interpersonal orientation group in which Spanish professionals parti- therapy and psycho-drugs. cipate in order to know what we are The next presentations were those of doing and where we are going in our Rosa Rey and Marisol Filgueria, psych- country. Friday afternoon was dedi- ologists who work in the Day Hospital cated to other Spanish-speaking pro- and Psychiatry Unit of the Hospital 12 Vol. no. 8 - August 2004 newsletter

Marítimo de Oza in La Coruña re- ductive career in the Hospitals of Borda by him, although it was then implemen- spectively. Both were in charge of de- and Moyano in Buenos Aires, where ted largely in Finland and was characte- scribing the contribution of psycho- he initiated an original and innovating rized by an attempt to focus the pati- drama in psychotic patient treatment. treatment model as is multi-familial ent's treatment with an individual and The former, based on the theory of psychoanalysis, the center of an inter- familial psycho-therapeutic attitude, Rojas Bermúdez, gave a formal theori- vention that he sprinkled with practical centered in the community and deve- zation of psychodrama and its practical examples on applicability and utility. loping rehabilitating activities at all application. Marisol Filgueira reviewed times. Prof. Cullberg commented on the applicability of psychodrama tech- On Saturday morning, there was the the Parachute Project for the treatment niques in the improvement of commu- English presentation with simultane- of first episodes, presenting the good nication, sense of reality, social skills ous translation to Spanish of Profes- results obtained now at the end of five and rehabilitation of young and sors Yrjö Alanen and Johan Cullberg, years. Both coincided in presenting chronic schizophrenic patients in the two of the most important figures in an integrating and multifactorial mo- del of the etiopathogeny of schizophre- out-patient and in-patient setting. recent years in the psychotherapeutic treatment of schizophrenia and leaders nia where the biological aspects are Friday afternoon was dedicated to the in Finland and Sweden, respectively, not incompatible with dynamic or presentations of Prof. Dr. Shalom Lit- of combined therapy programs adap- psycho-social factors. man and Prof. Dr. Jorge García Bada- ted to the needs of schizophrenic After each session, a round of debates raco. Prof. Litman, native of Argentina, patients. Prof. Alanen described the was opened in which the public could ask questions, comment, give opinions described his experience as the respon- Turku Project, developed in that city sible person for the reform and de- and express whatever they wanted to, institutionalization process in Israel, not only on the specific presentations implementing a holistic model but also on their experience and thin- (psychotherapeutic, community and king regarding the combined therapies and, more globally, schizophrenia. This rehabilitating), implemented by multi- supplied enriching views that favored disciplinary teams and using the modu- the exchange between professionals lar group as psychotherapeutic treat- from sometimes very different theo- ment instrument, supported by another retical postures and at times from very one of the treatment mainstays of the far away places, facilitating knowledge schizophrenic patients: care continuity of a disease in which much still must and contiguity. Prof. García Badaraco, be described and that motivates us to a psychoanalyst from Argentina, has continue forward in the organization developed most of his long and pro- of future events.

The X Annual Madrid Schizophrenia course

26th and 27th November 2004 Madrid The X Course will be dedicated to Bent Rosenbaum, Copenhagen, “Psychotherapies and Early Interventions” and is Demark who will speak on “The Danish counting on the participation, as foreign invited professors, of National Schizophrenia Project: a prospective, comparative, longitudinal treatment study of first episode psychosis” Loren Mosher, California, USA with two lectures dedicated to and “Speech, thoughts and thinking in the psychotherapy with "Characteristics of Therapeutic Social Contexts for the treatment of Psychosis" and "Using Interpersonal Phenomenology with persons with schizophrenia: some semiotic reflections.” Unmedicated Psychosis - a case example", In addition, there will be other Spanish professors and some Jane Edwards from Melbourne, Australia who will speak on professionals from the General University Hospital “Gregorio “Developing First-episode psychosis Services: EPICC Service descrip- Marañón,” who organize the Course. Two thirds of the course will tion and global initiatives” and “Prolonged Recovery and Cannabis be presented in English, with simultaneous translation to Spanish, use in Early psychosis: data from two EPPIC RcTS”, and we aim to attract mental health professionals from all Jan Olav Johannessen, Stavanger, Norway, who will dedicate his countries who are interested in Psychotherapies and early lectures to the subjects "Early Intervention in First Episode Psychosis: interventions in schizophrenia and other psychoses. Rationale, Structure and Results from the Scandinavian TIPS-project" and "Mental Health literacy and Early detection strategies for untreated first-episode psychosis” and finally www.cursoesquizofreniamadrid.com

Vol. no. 8 - August 2004 13 L O P O R V A T S newsletter

Report from the 3rd Annual By Manager of ProPsy, Stavropol Conference “Society and Mental Health” Ekaterina Loskoutova profit organisations, public authorities, and the mass media. At this seminar two instruments were presented with the aim of forming The following issues were discussed at working groups of interested professio- the Conference: nals: to create a Russian version of • Modern Patterns and Methods of SWAP-200 and to develop and research a new self-report instrument with the Treating Patients tentative name of “Stavropol Checklist- • Patient and Social Milieu 33”. Two working groups were formed • Self-Concept and the Patient’s and cooperation between Kjell-Petter Inner World Bogwald and a group of clinicians/ re- searchers from Stavropol and Moscow • Mental Health Care in Society The Regional Museum, central square, Stavropol was started. The site dedicated to the Due to the variety of activities at the work of these groups has been created The 3rd Annual Conference “Society conference – plenary lectures, work- already and the next meetings of the and Mental Health” was held in Stavro- shops, seminars and round-table dis- specialists have been scheduled. pol, May, 27th – May, 28th. This time cussions – specialists could exchange • A seminar conducted by local pro- the motto of the event was “Ways of their experiences. fessionals took place too: “Various Integration”. That was due to the goal, Approaches to Work with Children set by the organisers – to promote the The plenary lectures embraced a very Suffering from Emotional Distur- development of comprehensive appro- wide range of issues. Specialists from bances in Development” ach to mental health care problems. Moscow, Russia delivered their reports – This seminar was conducted by child- The Conference was held by Stavropol during section-work at the Conference. specialists representing various orga- Regional Society for Psychotherapy of Before the Conference other satellite nisations from the sphere of mental Psychoses (SRSPP), together with activities took place, six of them being health care service, who presented Stavropol Regional Clinical Mental seminars, lasting from 4 to 18 hours; different views upon the problem, as Hospital (SRCMH), the non-profit • Clinical Cases Presentation and well as methods of work. Here the par- organisation “ProPsy”, the non-Profit ticipants had a chance to get a com- organisation “Stavropol Regional Discussion; Social Anxiety, Depressi- on, Disociations, Schizophrenia, prehensive idea concerning modern Psychoanalytical Association” (SRPA), approaches to work with children. The and with active support provided by Personality Disorders” (T. Huseby, MD, Oslo, Norway); seminar was led by T.F Esina, Psycho- Norwegian colleagues. The Conference logist, Methodologist at the Depar- was chaired by I.A. Bylim, PhD, Psycho- • Clinical Seminar “Modern Appro- tment of Infant School in the town of logy, Chief Psychiatrist of Stavropol aches to the Treatment of Severe Nevinnomyssk, T.N. Kosova, Child Region (Stavropol, Russia), and Vice- Mental Disorders” (Prof. A.O. Buk- Psychiatrist, Deputy-Chief Physician at Charman was Svein Haugsgjerd, MD, hanovsky, MD, Rostov-on-Dn, Russia; Stavropol Regional Clinical Mental Member of the Norwegian Psychoana- G.-R. Bloch Thorsen, MD, Stavanger, Hospital, N.V. Mitriashkina, Pedago- lytical Society (Oslo, Norway). The Norway; T. Huseby, MD, Oslo, gue-Psychologist at the Centre for programme committee of the Confe- Norway); Psychological-Pedagogical Aid, T.M. rence was headed by V.S. Chudnovsky, • Clinical Seminar on psychoanalytical Yartseva, Psychologist of the Depart- MD, Chief of the Department of psychotherapy (S. Haugsgjerd, MD, ment of Psychological Service at the Psychiatry at Stavropol State Medical Oslo, Norway); Regional Medical-Psychological-Peda- Academy (Stavropol, Russia). gogical Centre, Stavropol. • “Multifamily Groups for Patients with Schizophrenia (advanced seminar)” Both the structure and the content of ore than 400 people from 20 towns M (G.-R. Bloch Thorsen, MD, Stavan- the conference were designed so that and other localities of the Stavropol ger, Norway); it would not be just a scientific event, Region in Russia, and Norway, atten- • Modern evaluation instruments in but rather a public event. Apart from ded the conference and the related seminars, the conference was preceded activities and events. The delegates psychiatry: “SWAP-200: Shedler Wes- ten Assessment Procedure” and by open public lectures on the topic were specialists engaged in the sphere of mental health of the family and re- of mental health care, students, repre- “Stavropol Checklist-33” (K.-P. Bog- wald, MD, PhD, Oslo, Norway). searches in psychotherapy, which were sentatives of related professions, non- held on the premises of one of the 14 Vol. no. 8 - August 2004 newsletter

was not enough, and it should be con- tinued to develop into a constructive dialogue and shaping a common view upon the problem. In fact, this time it was possible just to present various viewpoints and express some parts of that complex issue. But there was an obvious interest both from the lectu- rers and the participants, which gives us every reason to believe the discussi- on will be continued. Mention should be made that this year drama-miniatures, performed by young actors, symphonic concert, and an exhi- bition of art-works executed by patients, were also included into the programme of the conference. All this, undoubtedly Kjell-Petter Bogwald (Oslo, Norway) and colleagues from Stavropol regional clinical mental made the atmosphere at the conference hospital - working group for the development of the Stavropol-33 symptom checklist. more exciting, encouraging people in their informal communication. local higher educational institutions; historic centre of the town. The organi- another open lecture was delivered sers tried to attract public attention, in- 3rd Stavropol Conference “Society for mental institution patients and forming people about the event ahead and Mental Health” was not only an their relatives, and a seminar for busi- through the mass-media, and advertise- event for professionals, but also evoked ness people was organised, where the ment boards, which bore its fruit. public interest to mental health care lecturer dwelled upon the problem of problems which, we believe, indicates “burn-out” syndrome. One of the most important and inte- they will be solved successfully. resting events at the conference was Just before the conference the Depart- the round-table discussion “Society We would like to express our deepest ment for First Psychotic Episode was and Mental Health: Ways of Integra- gratitude to the organisers and to the officially opened, and representatives tion”, which had been initially planned participants. We are especially thankful of various social groups – local parli- as the key event. to the lecturers and seminar-leaders. ment members, officials from Ministry The leading representatives of various The volume of the conference materi- of Health Care, drug-producing com- groups of the local society aired their als will be printed soon. To purchase panies employees, students – attended views – that opportunity had a priest, that, or to contribute your ideas and that. a local TV-programme editor, public suggestions concerning the next servants, members of non-profit or- conference, please contact us at The venue for the conference itself ganisations, as well as teachers and [email protected] was the building of the Stavropol State medical employees. It was obvious that or phone us: +7 (8652) 37 29 48. Philharmonic Society, located in the the time provided for the discussion How could I go about starting up a local group? There are two main ways; you can either find other like- 3. The local group must keep a reliable, up to date membership list minded people and get together to think about what you and send regular updates to ISPS. mightm like to get out of forming a local group, or you may already 4. The constitution of the ISPS must be accepted. be part of an existing group of people who meet from time to time Who can apply for a start-up grant from ISPS? (e.g. to discuss research or clinical material) and you may wish to give Usually we make a one-off grant of between $500 and $1000 to eligible the ISPS name to that group - there is no need to "reinvent the wheel" groups. A total of $5000 start-up money is available during the year 2004. where such a group already exists. Since the grant is intended to help groups that could not otherwise get What are the requirements for being a local group of ISPS? started, high income countries as defined by the World Bank are not 1. The primary aim of the network / group must be the promotion / eligible to apply. For the time being we will consider applications from development of psychological therapies for persons vulnerable to upper middle income countries, although this decision will be reviewed psychotic disorders. annually. World Bank classifications of countries can be viewed at 2. The local group must pay a yearly fee to ISPS. The fees to ISPS are http://iufro.boku.ac.at/iufro/secre/wb-categories-categories.htm kept to the absolute minimum to allow for a maximum growth See our website www.isps.org for further information or potential of local groups. email Antonia Svensson on [email protected]

Vol. no. 8 - August 2004 15 newsletter

What is your Your local ISPS group and its activites ? contribution Meetings, congresses or workshops ? to the next New approaches in psychological treatments of psychoses ? newsletter Research that you are involved in ? Questions that you would like to discuss ? Visit our Please send material for the ISPS newsletter and website: www.isps.org the ISPS website by e-mail to: [email protected]

How to become an ISPS member and enjoy membership rights

There are different APPLICATION FORM FOR INDIVIDUAL MEMBERSHIP IN ISPS ways to become a member of ISPS Send or fax to ISPS c/o SEPREP, Jernbarnetorget 4 A, N-0154 Oslo, Norway You may become a member of ISPS as a member of a local or Fax nr. +47 23 10 37 79 national ISPS group or net- work. Please contact our ISPS NAME secretariat for information on MEMBERSHIP: NEW RENEWAL local groups in your area. STREET/ADDRESS TITLE: MR DR (MED) PROF Members of such groups will receive the ISPS newsletter MS DR (PHD) through their group and have CITY/TOWN PROFESSION: reduced fees on ISPS congresses. MEDICAL DOCTOR PSYCHIATRIST ISPS encourage and support POSTAL CODE PSYCHOLOGIST NURSE members to form local groups. SOCIAL WORKER ARTS THERAPIST You may also join ISPS as an COUNTRY STUDENT IN: individual member using MEMBER OF USER ORG.: the form to the right. TELEPHONE OTHER:

The fee is NOK 250 ARE YOU A PSYCHOTHERAPIST IN YOUR COUNTRY? FAX (approx. 30 Euros or US$ 33) YES NO or NOK 625 for 3 years (approx. 75 Euros or US$ 81) . E-MAIL IF YES, PLEASE TICK UP TO THREE ORIENTATIONS:

As a member you will receive PSYCHOANALYTIC SYSTEMIC the ISPS newsletter and have COGNITIVE GROUP reduced fees on international INTEGRATIVE FAMILY ISPS congresses. VISA AM. EXPRESS DINERS CLUB MILIEU OTHER: MASTER CARD CREDIT CARD NUMBER: SEE YOU IN EXP / PLACE OF WORK: PRIVATE PRACTICE ONLY INSTITUTION/ORGANISATION PAYMENT BY ENCLOSED CHECK RETIRED FROM OTHER DATE (D/M/Y): MEMBERSHIP FOR SIGNATURE: ONE YEAR (NOK 250) JUNE 2006 THREE YEARS (NOK 625)

Vol. no. 8 - August 2004

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