ISPS Newsletter September 2002

Vol. 6 no.1 - September 2002 www.isps.org

Reconciliation reform and recovery: Creating a future for psychological interventions in psychosis 14th International Symposium for the Psychological Treatment of Schizophrenia and Other Psychoses 22 – 25 September 2003 / Melbourne Convention Centre

Patrick McGorry: Message from the ISPS Convenor, Melbourne 2003

for psychological and psychosocial interven- The International Symposium for the tions in psychosis, and progressive service Psychological Treatment of Schizophrenia reform. and Other Psychoses is the oldest conference ISPS has evolved into a formal organization on schizophrenia, being held for the first time in 1956 in Lausanne, Switzerland, convened promoting all of these positive developments. by Professor Gaetano Benedetti and Christian ISPS aims to protect and expand the place Muller. At that time, psychotherapy had been of psychological interventions in the care of the treatment of choice for schizophrenia for people with psychosis, recognising the need decades, and biological treatments were in to be inclusive of all forms of psychotherapy their infancy and not yet widely accepted. and psychological intervention and to advo- The ensuing decades have witnessed a cate effectively for resources and support for dramatic swing of the pendulum such that a renaissance of psychological intervention. psychotherapy, particularly of the psycho- ISPS advocates a non-reductionistic stance, analytic variety, became discredited as the inclusiveness, recognition of common factors biological psychiatry paradigm became domi- across approaches, respect for and comfort nant, especially in North America and other with appropriate use of novel antipsychotic Anglophone Countries. This led to a great and other drug therapies, and commitment neglect of the therapeutic relationship with to an evidence-based approach. the patient and a death of therapeutic skills These principles are reflected in the themes and techniques due to the absence of an of the 2003 conference, “reconciliation, accepted theoretical basis for psychothera- reform and recovery”. We expect our confe- peutic work. rence, the first time the ISPS has been held The problem with both extreme swings of in the southern hemisphere, to be a watershed the pendulum is that they involve reductio- in evolving and guaranteeing a future for nism, which is not only inappropriate given psychological interventions in psychosis. the complex biopychosocial nature and im- The complexion of psychological approaches pact of psychotic disorders, but also inade- will need to be different, more sophisticated quate to bring about a good recovery and and more effective then what has been on quality of life for patients and their families. offer in previous eras if it is to prosper. In recent years there has finally been an We look forward to welcoming you to increasing recognition of the need for better Melbourne on this auspicious occasion and utilisation of drug and psychosocial treatment, can promise you a stimulating, challenging the overdue development of an evidence-base and fulfilling experience.

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A special newsletter Objectives of ISPS ISPS secretariat The ISPS secretariat is a link ISPS is increasingly becoming a true international network of local groups, as Promote the appropriate use of between members and the executive the overview of European groups and other psychotherapy and psychological committee, updates the website, reports in this issue shows. Both the UK and treatments for persons with schizo- prints and distributes the newsletter, the US chapters are also distributing their phrenias and other psychoses keeps a database of ISPS members own newsletters and have ongoing Promote the integration of psycho- and local networks, and helps the discussions via e-mail, and there is an society and the members with increasing number of ISPS meetings logical treatments in treatment plans arranged in different countries. and comprehensive treatment for information and other services. all persons with schizophrenias and Mail to the ISPS and the executive The next international ISPS congress other psychoses committee may be sent to the being held only a year from now, we also secretariat, who will forward it need to make this congress in Melbourne Promote the appropriate use of well known and encourage friends and psychological understanding and to the right persons. colleages to meet there, – as well as making psychotherapeutic approaches in The secretariat is hosted by Centre plans to be there ourselves. You will also all phases of the disorders including for Psychotherapy and Psychosocial find information about the congress in both early in the onset and in longer Rehabilitation of Psychoses SEPREP, Melbourne in this issue. lasting disorders which is a non-commercial foundation and a network of We are printing this newsletter in colour Promote research into individual, and with a much higher number of copies clinicians and researchers promoting than usual. Thanks to Ellen Jepson in family, group psychological therapies, preventive measures and other psychological treatment of psychoses Stavanger you will also see a new and in Norway. professional layout, but still with enough psychosocial programmes for those of the old to be recognised as a new issue with psychotic disorders Address to the ISPS secretariat of the ISPS newsletter. This is like in good treatment where the patient moves Support treatments that include ISPS c/o SEPREP forward and changes, with an identity that individual, family, group and net- Jernbanetorget 4 A includes and integrates the past. work approaches and treatment N-0154 Oslo methods that are derived from Norway But as in treatment, the most important, psychoanalysis, cognitive- Tel +47 23 10 37 77 of course, is the content! This issue contains behavioural, systemic and psycho- Fax +47 23 10 37 79 information on the next great international educational approaches ISPS congress, on the growing number of E-mail: [email protected] local groups and networks, and on Advance education, training and Website: www.isps.org examples of how ISPS members work to knowledge of mental health make psychological treatments for professionals in the psychological Bank account 5005 06 56648 psychoses more available. We hope this will therapies Den norske Bank, Oslo, Norway contribute to the recruitment of new members and new local groups, and that these will meet at the ISPS congress in ISPS honorary life time members Melbourne next year. The ISPS Yrjö Alanen, Finland We encourage you to use this newsletter executive committee in spreading information about the ISPS Gaetano Benedetti, Switzerland and about psychological treatments for Jan Olav Johannessen, Stephen Fleck, USA psychoses. More free copies of the Norway (chairman) Murray Jackson, UK newsletter can be ordered from the ISPS secretariat. Johan Cullberg, Sweden Jarl Jørstad, Norway Courtenay Harding, USA Christian Müller, Switzerland And once again I want to remind you and encourage you to submit material to the Brian Martindale, UK Barbro Sandin, Sweden newsletter and to the ISPS website Patrick McGorry, Australia Helm Stierlin, Germany www.isps.org. Torleif Ruud Franz Resch, Germany Lyman Wynne, USA Torleif Ruud, Norway Ann-Louise Silver, USA

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letter from the chairman

It is also a goal for this board to de- and supported by Ronald Turco,MD, velop the co-operation with other major President of the American Academy organisations that work close to the of Psychoanalysis, and Professor John ideas of the ISPS, such as the WAPR Cox, President of the Royal College of Dear members (World association for psychosocial Psychiatrists, UK. and friends of the ISPS rehabilitation), and IEPA (International The PORT-report task force, chaired association for early psychosis). In some by Dr TK Larsen, has now concluded. The board finds that the ISPS is now countries, it is being discussed whether The work of the group will be published in a period of very positive develop- one should co-operate in offering in a special issue of the Journal of the ment. New local chapters are develop- combined membership and co-ordinate American Academy of Psychoanalysis. ing in many areas around the world. the work with local conferences. The board has decided to buy a certain Details about this are given on other For the ISPS it is also an established number of copies to be distributed for pages in this issue. You may remember goal to try to contribute to the develop- free to selected target groups. Hope- that the board made establishment of ment of strategies for implementing fully it will also be published as part of new local chapters one of its major task psychological treatment modalities the ISPS book series. The board wants for this three-year period (2000–2003) around the world through specific pro- to express its sincere thank to the task with the explicit goal to be represented jects aimed at this. In Russia (Stavropol) force for their dedication to the work, on all continents. there is a growing co-operation between and we are sure that their work will It is also a great pleasure to tell you the psychiatric milieu in Stavropol and have a big influence on the future de- that the ISPS now has become an some milieus in Norway, supported velopment of psychological treatments affiliated organisation with the World financially by the ISPS. The board want as part of a comprehensive treatment Psychiatric Organisation (WPA). This to support three similar projects other programme for psychotic patients. is important both as a symbolic act, and places, and also want to establish this Well, as you can see, the board has in practice by representing the psycho- as a joint effort between for example been busy pursuing the goals of the logical treatments for psychosis in one the WHO, WPA, WAPR and ISPS. ISPS. The board will meet next time of the most important psychiatric We are also very proud to inform our in Copenhagen in the end of September organisations in the world. The board members and sympathisers that the at the third International conference wants to express its gratitude towards ISPS has been nominated for the Prize of early psychosis. Look forward to the WPA for accepting the ISPS as an of Geneva for human rights in psychia- meeting many of our members and affiliated organisation, and thereby also try. The nominations has been proposed friends there, and next: Melbourne for their recognition of the importance by Mr Gunnar Berge, Chairman of the 2003! of our organisation and its objectives. Norwegian Noble Prize Committee, Jan Olav Johannessen

CFNCR - Feinsilver Fund David B. Feinsilver, M.D., a long-time staff member at Chestnut Lodge Hospital and a president of ISPS, established a fund which would grant a scholarship to fund the travel expenses to the 2003 upcoming ISPS meeting, for the best research or clinical paper on the psychotherapeutic treatment of the severely disturbed. The applicants will be those who would not otherwise be able to fund their transportation and accommodations. Those submitting abstracts to the ISPS-Melbourne meeting should indicate on their submission that they wish T R A L to be considered for the award. They should also send their abstracts and papers U S I A A by e-mail to Ann-Louise S. Silver, M.D. ([email protected]) and Brian Koehler, Ph.D. ([email protected]) as soon as possible.

Ann-Louise S. Silver, M.D., 4966 Reedy Brook Lane, Columbia, MD 21044-1514 410-997-1751 / fax: 410-730-0507 / [email protected] Melbourne

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PRELIMINARY PLENARY PROGRAM INCLUDES Ian Falloon Integrating Neurobiology and Psychotherapy in the Management of Psychosis Prof Jim van Os The Dimensions and Boundaries of Psychosis Prof Richard Bentall VENUE & The Conceptual Basis of Psychotic Disorder ACCOMMODATION The Melbourne Dr John Read Convention Centre Child Abuse as a Risk Factor for Psychotic Illness is Australia's finest, fully Dr Jeremy Holmes integrated, purpose-built The role of psychodynamic theory and practice in the management of psychosis convention andexhibition centre. Situated on the Dr T.K. Larsen banks of the picturesque Systematic Review of the Evidence for Psychosocial Interventions in Psychosis Yarra River within Melbourne's central Dr Frank Margison business district, the Integrating Approaches to Psychotherapy in Psychosis Melbourne Convention Centre provides excellent facilities. MAIN ANNOUNCEMENT AND REGISTRATION Accommodation has been Please complete and return the attached "Intent to Attend" form to ensure you are on booked at a range of hotels to ensure all delegates the mailing list to receive the main announcement and registration details. needs are catered for. The main announcement and registration brochure will be distributed in October 2002. Location, facilities and costs will be outlined in detail in the main announcement. PLEASE FAX YOUR NOTICE OF INTENTION TO ATTEND/SUBMIT AN ABSTRACT TO: The Melbourne 14th International Symposium for the Psychological treatment of Schizophrenia and other psychoses Convention Centre c/- Conference Strategy Pty Ltd, PO Box 1127 Sandringham Vic 3191 Australia Cnr Flinders & Spencer Facsimile: +61 3 9521 8889 Streets, Melbourne Victoria Australia Yes, i am interested to receive the main announcement tel: +61 3 9205 6400 Prof/Dr/Mr/Mrs/Miss/Ms Family name: Given name/s: 22 – 25 SEPTEMBER2003 Address: City/suburb: Country: Postcode: T R A L U S I A A Email: YES NO YES NO I would like to receive the Main Announcement I intend to submit an abstract Melbourne

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CALL FOR ABSTRACTS Authors wishing to submit a paper should follow these instructions: 1. Provide your typed abstract by 1 March 2003 and send via e-mail to the Symposium Secretariat. 2. Abstract should include presenter's name, title, position, organisation, address, telephone, fax number, e-mail address and title of abstract. 3. Indicate the topic of the abstract (see list of topics below). 4. If the author is different from the presenter their name/s must be included. 5. Abstracts must be on a single page, typed, double-spaced, maximum 250 words. MELBOURNE - 6. The abstract should describe original work not previously presented or published. The Host City 7. All abstracts and presentations must be in English. Extensive parklands and 8. All poster presenters must be in attendance during Poster sessions at the designated times. Botanic gardens of world class standards grace 9. You must register for the Symposium as a delegate for your paper to be presented. Melbourne, the capital city Authors will be notified of the acceptance of your paper or poster May 2003. The decision regarding of Victoria, Australia's the acceptance of your paper or poster is at the discretion of the Symposium Programme Committee. Garden State. It is a thriving cosmopolitan city with a ABSTRACT TOPICS DEADLINE FOR ABSTRACTS: unique balance of graceful 1 MARCH 2003 old and new buildings. FOR INCLUSION Melbourne has a wealth The Symposium Program Committee of culture and is Australia's The Symposium Programme Committee invites will notify all persons submitting for leader in the arts, sport and the submission of papers or posters to be presentations in writing. The decision of fashion whist boasting considered for presentation at the Symposium acceptance of abstracts is at the discretion some of the finest restaurants in the country. in September 2003. Topics for inclusion cover of the committee. A copy of all abstracts Melbourne's weather during a wide range of options which can be broadly accepted for presentation will be made September is delightful grouped as follows: available at the Symposium. with temperatures ranging from 10 degrees Celsius to Individual psychological treatments 25 degrees Celsius. Integration of treatment modalities SYMPOSIUM PROGRAMME COMMITTEE The experience of psychosis Ms Kerryn Pennell Comorbidity in psychosis Dr John Gleeson Family interventions Professor Henry Jackson Group interventions Dr Andrew Chanen Dr David Kavanagh

INVITATION TO SPONSOR The Symposium offers a range of exciting possibilities for both Sponsorship and Trade Display. SOCIAL HIGHLIGHTS If you wish to participate please direct your enquiries to Marg Scarlett, ISPS Secretariat, The Welcome Reception Conference Strategy on +61 3 9521 8881 or email: [email protected] will provide an excellent We look forward to ensuring that the ISPS Symposium is a successful event for all involved. opportunity for delegates to get to know each other in a relaxed atmosphere. FURTHER INFORMATION: Contact Marg Scarlett, ISPS Secretariat, The Symposium Dinner Conference Strategy Pty Ltd PO Box 1127, Sandringham Vic 3191 Australia. will be a social highlight. Telephone: +61 3 9521 8881 / Facsimile: +61 3 9521 8889 The evening promises to be Email: [email protected] memorable with Australian wine, food and dancing. Website: http://www.conferencestrategy.com.au

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Starting a local LAPLAND Archangelsk group of ISPS? MAP: ELLEN JEPSON MAP: For assistance and guidelines on how Sweden Finland to start a local group Norway of ISPS in your country or area, Baltic Estonia please order the Sea information package Denmark Copenhagen sept. 2002 Russia on local groups from United ISPS by e-mail to: Kingdom [email protected] Netherland Poland Belgium Germany Czech Republic Stavropol

Portugal Spain Bulgaria

ISPS Local networks in Europe Here is a summary of local Bulgaria ISPS networks in Europe. ISPS European network representatives Assist Prof Maya Mladenova at meeting Copenhagen September 2002 the new Bulgarian University I would encourage any The Bulgarian Institute of Hu- reader to let me know of A meeting for all those involved in developing ISPS networks man Relations is very interested any additions or corrections. in Europe is being planned for Thursday September 26th at in starting up a ISPS group there as a multidisciplinary group of 17.35 pm in room 203–205 at the International Congress on clinicians working with persons Brian Martindale Early Psychosis. (Please contact Dr. Brian Martindale on with serious and persistent drbmartindale@blueyonder. beforehand if you plan to attend). mental illnesses. Contact co.uk details: Dr. Maja Mladenova Facilitator and Co-ordinator The ISPS will reimburse a part of the registration fees for one person from each country. Institute for Human Relations of ISPS European networks. Gk. Hypodrim Bl. III, eubr V, Please contact me if you need further information. apt 66,1612 Sofia, Bulgaria Brian Martindale 011-359-2-65-39-06, 011-359- [email protected] 2-65-75-49 Facilitator and Co-ordinator of ISPS European networks. [email protected] & [email protected]

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Czech Republic advising mostly family centered Poland Manuel Gonzalez De Chavez Contact details: methods. The Estonian group is There are a number of persons Menendez, Chief of Psychiatric active in early intervention Service, General University David Holub, M.D., Private in Poland who have been methods. Contact persons: Hospital "Gregorio Marañón" Practice, Bezrucova 187 connected with ISPS and wish Harri Küünarpuu Psychologist C/ Ibiza nº 43. 28009 Madrid, 276 01 Melnik, Czech Republic to develop a network. They are Tallinn Psychiatric Hospital particularly interested in Spain. Tel. +34 91 5868132 Tel.: 0042-0-206-624343 (+Fax) Paldiski mnt. 52, 10614 Tallinn developing links with Nordic Fax +34 91 426 51 10 0042-0-603-921192 [email protected] countries and have a historical [email protected] [email protected] GSM +372 56 496884 ISPS link with Finland. The "Institute for Complex Contact persons: Contact person Portugal: Germany Therapy of Schizophrenia" (in Krzysztof Walczewski Dr.Cesar Vieira Dinis cooperation with British collea- A new German ISPS group was [email protected] Dr.Isaura Manso Neto gues: Paul O'Halloran, Max founded in March 2001in Slawomir Murtawiec Rua Ruben A Leitao nº 4 4º D Birchwood.) has been founded. Munich during an international [email protected] 1200 -392 Lisboa, Portugal Director of the Institute is: conference. Further meetings Professor Namyslowska Phone + 35 1 21 727 67 82 Martin Jarolimek, M.D. took place in Heidelberg in Sep- [email protected] Fax + 35 1 21 727 67 83 Nad Ondrejovem 36, 140 00 tember 2001 at the opening of [email protected] Prague 4, Czech Republic the "Prinzhorn Exhibition and Russia and Stavropol Sweden E-mail: [email protected] in March 2002. It is hoped that Four persons from Stavropol in this new network will create links Russia participated in the ISPS In April 2002, a group of 35 The 1Vth Conference on with a number of well established conference in Stavanger in persons met for two days and Psychotherapy of Psychosis in German groups. Contact details: February 2002. Svein Haugsgjerd laid the foundations for an ISPS Jachymov Spa is being prepared. Professor Franz Resch, Ruprecht- and some other Norwegian Swedish network. The meeting The title of the Summer 2002 Karls Universität Heidelberg, psychotherapists have had con- took the form of both brain- issue of the "Review of Psycho- Psychiatrische Klinik, Abt. Für tact with the group in Stavropol storming sessions and lectures. analytical Psychotherapy" is Kinder- und Jugendpsychiatrie, earlier, teaching and giving A five person ‘board’ agreed to supervision in psychotherapy of "The Role of Psychoanalytic Blumenstraße 8, 69115 meet and form structures and psychosis. There is preparations guidelines for further develop- Concepts and Psychotherapy Heidelberg, Germany [email protected] to start a local ISPS group in ment (see separate article in this in the Treatment of Severely Stavropol. See report from a Disturbed and Psychotic heidelberg.de Newsletter). Contact person: seminar in Stavropol in June Sonja Levander Patients" (Editor David Holub). Fax + 49-6221 9704 41 2002 elsewhere in this issue of Tel + 49 6221 97 04 15/17 [email protected] Denmark the ISPS newsletter. Contact person: United Kingdom Contact person: Susanne Harder Netherlands / Belgium Alexey Koryoukin The UK network was formed as [email protected] ISPS Network Nederland- Vlaanderen, This group has had mailto:[email protected] a result of the 1997 ISPS Inter- Finland a first successful network confe- Ekaterina Loskoutova national conference held in [email protected] London. It has now had two large Contact persons: rence in March 2002, in Eind- hoven with 60 participants from national residential conferences Dr. Jaakko Seikkula, Flanders – the northern, dutch Spain and Portugal (300 attending), an active Department of Psychology speaking part of Belgium – and In November 2002 there is the committee covering a full range University of Jyväskylä 40 from the Netherlands. "Course on Schizophrenia of of therapies, and professions as P.O.Box 35, FIN-40351, Jyväskylä well as users and carers and an Contact person: Jan Leijten the hospital "Gregorio Fax +358 (14) 26 02 841 active email discussion group. It [email protected] Marañón" which will be held tel +358 (14) 26 02 842 in Madrid and will attract more has developed subsections eg a [email protected] Norway than 400 persons. It is hoped London group and an analytic that this forum will be an oppor- section and an ISPS UK After a meeting during the ISPS Dr Klaus Lehtinen tunity to publicise ISPS and newsletter. The activities are [email protected] conference in Stavanger in clarify how many persons may now such that we have a paid February 2002 a group of persons be interested in forming an ISPS ‘organiser’ and secretarial help Estonia interested in working to esta- Spanish-Portugese network. for our 180 paid up members. blish a local chapter of ISPS in The Estonian informal network Jorge Tizon has a team in Barcel- Contact person: Norway is formed. There will be meets at least once in every ona and also has contacts in Dr Brian Martindale Chair ISPS information from the group early three months and has done so Girona and Granada. UK, C/O ISPS UK organiser, in the autumn of 2002 regarding for more than three years. The Contact persons Spain: Antonia Svensson, Addison how the group suggest to move psychiatric association has been House, Flat 219, Grove End on in starting ISPS Norway. Dr.. Jorge L. Tizón, Director influenced to adopt treatment [email protected] Road, London NW8 9EJ guidelines that include psycho- Contact person: Torleif Ruud [email protected] [email protected] Sant Martí Mental Health Unity logical treatment as a must in Pza. de la Infància s/n Tel + 44 208 354 8941 an integrated treatment model 08037 Barcelona, Spain Fax + 44 208 354 8054

vol.6 no.1 - September 2002 7 isps newsletter

Researchers gather at International Symposium on „Psychological Interventions in Schizophrenia“ in Heidelberg

geneity of the group of patients called n a scientific symposium devoted I schizophrenic urges an individually to „Psychological Interventions in tailored treatment programme with Schizophrenia: Future Challenges“ an attention to interactional factors. Thus, international group of researchers and the TIPS-programme in Norway focus- clinicians gathered on May 24th in sing on early intervention in psychosis Heidelberg to share their findings, out- Y offers a wide variety as well of different N line common interests and challenges, A M forms of interventions as of different and explore areas for future scientific R E intensity levels, according to the needs and organizational work. Invited by the G Heidelberg of the patient. International Society for the Psycho- logical Treatment in Psychosis (ISPS), Patrick McGorry, M. D. (Aus) con- about 100 attendees followed the tinued in the specification of organiza- Brian Martindale, M. D., (UK) meeting that presented speakers from tional and individual requirements to opened the session with a presentation Australia, England, Germany, Norway meet patients needs. Early intervention on „Psychodynamics and the Family in and Sweden. The symposium to foster programmes in Melbourne use adapted Contemporary Practice”. Based on two collaboration and scientific exchange psychosocial interventions, according case presentations, the influence of between widely separated clinical and to the rationale for early recognition psychotherapeutic reflections on health research centers was organized by Franz and optimal treatment of psychotic dis- care teams as well as on individual Resch, M. D., and Romuald Brunner, orders. The still underestimated impact therapy progress was illustrated. M.D., of Heidelberg University Hospi- of the duration of untreated psychosis tal, Department of Child- and Adole- Johan Cullberg, M. D, of Stockholm (DUP) on outcome in schizophrenia scent Psychiatry, and was sponsored by (S) Center for Psychosis Research pro- underlines the necessity of preventive Janssen Pharmaceutica. vided data on the „Parachute Project: interventions. Need adapted treatment for first episode ISPS representatives and board mem- A very lively discussion followed each psychosis“. In this programme with early bers included Jan Olav Johannessen presentation, and a scientific debate on intervention and easy access, the psycho- (President) (Stavanger, Norway), the use and implications of the presen- therapeutic orientation is reflected for Patrick McGorry (Melbourne, ted findings lead to new collaborations example in low-stimulus, non-institutio- Australia), Brian Martindale (UK), and exchanges of ideas. This international „crisis homes“. Comparing a group Johan Cullberg (S) and Franz Resch nal echo was particularly important for of patients treated in this programme (D). Also present was the honorary the psychiatric team in Heidelberg, with a historical and a prospective con- board member Helm Stierlin, as well because of the new Early Intervention trol group, major 3-year conclusions as the Chair of the Department of Center named HEART („Heidelberg comprised good symptomatic recovery General Psychiatry, Christoph Mundt. Early Adolescent and Adult Recogni- with very low neuroleptic consumation tion and Treatment Center“) that was The session was opened by a presiden- and lowered number of days in inpatient established in a cooperation between tial adress from Jan Olav Johannessen care, a reduced suicidality and a high the department of child and adolescent underlining the relevance of new know- subjective satis-faction with the pro- psychiatry and the department of ledge in the field of treatment of psyc- vided care. general psychiatry. Within the next hosis. Although the prognosis for a large year, this center will be opened in new amount of schizophrenic patients is Jan Olav Johannessen, M. D., (N) facilities, covering all psychiatric crisis well, there is a growing body of evidence highlighted possibilities of phase- interventions for patients aged 12–25. for a better outcome by using combined specific psychological interventions in This center will offer low-threshold, treatment plans including phase-specific the treatment of psychosis. Based on need-adapted multidimensional thera- and adequate psychological interven- psychopathological insights into the peutic approaches with a special focus tions. The work of the ISPS is devoted development of psychosis, specific needs on psychotherapeutic interventions. to promoting this knowledge in of the patients and possible therapeutic research, practice and public health. actions can be described. The hetero- Andreas Richterich, M. D.

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STAVROPOL Report on the Russian-Norwegian seminar for mental health service specialists

report. The leaders of the discussion n June 3rd to 7th, The Russian- O groups were the participants of the Norwegian Seminar 2002 for mental Russian-Scandinavian training program health specialists, was held in the Stav- of teachers and psychoanalytical ropol regional clinical mental hospital psychotherapy supervisors, and also (SRCMH). The seminar was devoted leading psychiatrists and psychologists to the 95th anniversary of SRCMH of the hospital. And there were a lot of and was held in collaboration of the questions, ideas and opinions. The Stavropol regional psychoanalytical Seminar was a place where different association (SRPA). points of view on mental disorders and The fact that the organizers of the Program of the Seminar includes approaches to patient treatment met. seminar consisted of two organizations, lectures, discussion groups and master- Sometimes it caused hard debates, and namely the non-profitable professional classes. it was clear that it was only the be- organization SRPA and the public insti- Every morning began with the outline ginning of an uneasy process of finding tution SRCMH, did obviously contri- lecture of one of the teachers. a common language within the profess- bute to the achievement of the main • Svein Haugsgjerd (Norway, Oslo) ional community of mental health goal of the seminar. This goal was to “Psychoanalytical and psychotherapeutic specialists, and that common language improve the mental health service in perspectives on psychotic states” is a must for more effective treatment the Stavropol region, and in particular, of patients. to rally the psychologists, psychiatrists, • Igor Anatolievich Bylim (Russia, social workers into the united profes- Stavropol) “Perspectives of mental In the second half of the day the sional community. health service improvement in Russia participants visited master-classes hold and in Stavropol region” by the specialists from Norway. The This seminar was not the first step in topic of a master-class went along with cooperation of Stavropol and Norwe- • Gerd-Ragna Bloch Thorsen the plenary lecture that had been de- gian specialists. The idea of co-operative (Norway, Stavanger) “Modern livered by the leader during one of the work appeared more than 4 years ago, psychosocial treatment approach to days of the Seminar. During the three during the collaborative work of the schizophrenia” days the participants of the master- mental health specialists from Norway • Jorge Bustos (Norway, Oslo) “Modern classes were studying the topic been and the members of SRPA on the psychopharmacological treatment of chosen and were assimilating working conference held in Saint-Petersburg. different diagnostic groups of patients techniques of the Norwegian colleagues. Then it was developed when the Nor- in Norway” In particular, during the master-classes wegian colleagues took part in the they presented a project of the rehabili- Festival on psychotherapy and applied • Helen Christie (Norway, Oslo) tation program for schizophrenia pati- psychology “Christmas-tide meetings” “Traumatic stress disorder on children” ents and their relatives, the four-level and when the delegations of our psychia- • Alf Lund (Norway, Oslo) method of psychological trauma after- trists and psychologists were invited to “Transformation of institutional effects correction, an experience on participate in the Congress and then psychiatry and trans-cultural anthro- organization of psychiatric treatment in the Conference of International pological psychiatry” service in Europe, a modern approach Society of Psychotherapy of Schizo- to psychopharmacological treatment phrenia in Norway in February 2002. • Galina Petrovna Bylim (Russia, with discussion of social outcome of Stavropol) “Basis of effective psychopharmacology. 133 people from 12 different places interaction” of Russia and Norway took part in the The Seminar ended in general dis- seminar in Stavropol, among them After the lectures discussion groups cussion. The speakers talked about the there were psychiatrists, psychologists, were held during which there was an necessity of joining the efforts of psychi- social workers, psychotherapists, high opportunity to share opinions and atrists, psychologists and psychothera- school teachers, students. discuss questions appeared during the pists in order to achieve the common

vol.6 no.1 - September 2002 9 isps newsletter goal – the improvement of the patient between the work of the Russian collea- on carrying out in the hospital in welfare. The Russian-Norwegian gues and their own experience and Stavropol an educational program for seminar was the starting point of the showed their willingness to support the training of the group leaders (coaches) dialogue. It revealed many problems of incoming positive changes. for schizophrenia patients and their interaction, but also it let us see the relatives. The program will involve The Russian-Norwegian seminar has perspectives on further development of psychiatrists, psychotherapists, psycho- come to the end, but the cooperation professional community of mental logists of the Stavropol region public between Russian and western specialists health specialists. health service. The first section of the is not over. Negotiations have been held program is planned for March 2003. During the Seminar the guests from with the representatives of the Inter- Norway got acquainted with the history national Society of Psychotherapy of And for the beginning of summer of the hospital, visited some wards and Schizophrenia (ISPS) and the develop- 2003 the Second Annual Russian- met with psychiatrists and medical staff. ment of the first local group of this Norwegian Seminar for mental health organization in Russia has been planned. service specialists is planned. We hope Reorganization work that had begun Also there were negotiations with Gerd- that active cooperation with Scandi- in the hospital and had been planned Ragna Bloch Thorsen, the director of navian colleagues will help to improve for the nearest future, made a good the Psychiatric Educational Fund the quality of the mental health service impression on the guests. They found (Norway, Stavanger), as a result of in our region. that there were a lot of common things which an agreement has been reached

Network for developing the treatment of psychosis

Representatives of the units share an In need-adapted approach, both the ince 1996 about 25 different S interest on having the voice of the patient and the family are always in- psychiatric units from Norway, Sweden, patient and the voice of the family more cluded in meetings, where the problems Finland, Germany, Estonia, Latvia, heard in treatment processes. Many of are analyzed and the treatment plans Lithuania and Russia have organized them have been working as family conducted. Examination of the problem annual conferences to develop the therapists and especially focusing on and the treatment is dominated by psychotherapeutic treatment of psych- language and dialogue in treatment psychotherapeutic attitude throughout osis. The common aspect in these units meetings. The focus is not so much on the process. are that (1) all the units have a total changing the family system or the pati- responsibility of the psychiatric care in ent, but on generating dialogue and one geographic catchment area and reflective processes between the partici- that (2) they all share an interest on pants in every meeting. The Need- developing family centered treatment Adapted approach developed by for psychotic patients. In this network professor emeritus Yrjö Alanen and his the aim has not become to conduct group in Finland is one background and some specific project with some specific its further development in the Finnish psychotherapeutic method, but instead Western Lapland, named as open dia- to initiate the development of the entire logue treatment. Many of the encoura- state psychiatric system in each catch- ging research findings on the treatment ment area. Last year in the meeting in of first episode psychotic patients in Tromsø in Norway it was decided to Western Lapland are an inspiring aspect organize the first preliminary research for the co-operation of these units. project to compare the outcomes of new Another background forms the idea of psychotic and schizophrenia patients. reflective processes first originated by 12 units from 4 countries decided to Norwegian professor Tom Andersen at join this study. the university of Tromsø.

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Across the Baltic Sea educational level of the staff. In many patient in the meetings. The entire One interesting aspect of the meeting of the Eastern European countries the psychiatric staff (including also some is the enormous differences in the wor- psychiatric organization almost entirely part of child and youth psychiatry and king context. Some units of the Nordic was based on having only psychiatrist social care in the cities) has the possibi- countries already try to organize the as therapeutic staff. This has been well lity for a three years family therapy psychiatric system based on psycho- illustrated in a four year training project training (or individual psychotherapy), therapeutic attitude. But, on the other in Archanglesk in Russia, where new which forms a basis for the new hand, the units in the Baltic countries psychiatrist were trained in open dia- psychotherapeutic practice. logue and reflective processes. During have previously started to practice to Many problems all the time occur in the period, the Medical University use the term ”psychological treatment” the treatment of severe crisis. And the started the training of clinical psycho- of psychosis as a whole new idea. The context in Nordic and Baltic countries logists and social workers. Also the organization of treatment, too, seems differs quite a lot. The annual confe- specialization into psychiatric nursing very different. From Estonia, all the rences have provided a possibility to has started. The multi professional team psychiatric hospitals have participated share experiences in treatment of work is becoming possible. in the meetings. For the whole country, psychosis (1) in case descriptions, and, three psychiatric districts exist, each Nordic Health care system what is most interesting, in the “failure having its own psychiatric hospital. In the Nordic countries, especially in case” seminar each time, (2) epistemo- The biggest psychiatric hospital is Finland, Norway and Sweden, an active logical and other philosophical aspects located in Tallinn, having 350 beds for history exists for developing the psycho- of treatment and (3) research interests 700 000 inhabitants. They have started therapeutic treatment of schizophrenia both in the form of statistical and a project for first episode psychotic pa- and other severe psychiatric problems. qualitative analysis. The content of our tients, aiming, for instance, at psychosis Here the psychiatric system, as well as annual meetings is always open, it is team approach within the hospital and the entire state social and health care not planned in advance, but on the at a special ward for first episode pati- system, provides possibilities for organi- place for every meeting. By this way it ents. In Tallinn, as in Estonia on the zing a treatment system for the entire is tried to avoid any hierarchical whole, family therapy has a quite strong population. Each psychiatric unit is structure for the co-operation and to position. Tallinn working on a specified geographical guarantee so much as possible flexibility catchment area having a total responsi- to answer the actual needs of every bility for entire population. The system units working in different contexts. includes both inpatient and outpatient In every meeting also an “Open Day” care, although during the last decade is organized to have the possibility for administrative changes have challenged bigger audience in every conference the cohenrence of the system in each city to listen the ideas shared in this country. network. This year the meeting took place in Kaunas Lithuania at the end The Nordic system makes it possible of August having the Open Day 29th In the Tartu University Hospital for to plan a coherent treatment organi- of August. 150 000 inhabitants, 140 beds are orga- zation, not only as one treatment Financing this type of co-operation nized. They already have had different method that is tried to develop in some is always a big problem. The meetings types of psychotherapeutic approaches, project for a specified diagnostic cate- are organized by the principle that each starting from group therapy. At the gory. This is seen in the Need-Adapted participating units have to take care of moment, a lively family therapy training approach, where one central element its costs, also in the study project. For program is organized. In the third dis- has been to organize psychosis teams increasing possibilities for the units in trict, in Viljandi, the Jämejala psychi- for the catchment area and integrate Baltic countries and Russia, the Swedish atric hospital include 400 beds for the inpatient-outpatient process. In Östeuropakomiten and the Institute of 400 000 inhabitants. In Latvia, Open Dialogue idea applied especially Community Medicine in the University Lithuania and Archangelsk in Russia, in the Finnish Western Lapland it has of Tromso Norway have provided the process towards psychotherapeutic become possible to guarantee the economical support. treatment is in its origins. psychological continuity and organize Jaakko Seikkula, Ph.D. One big problem for the future deve- immediate help in every case and to Finland lopment will probably be the low mobilize the social network of the

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The ISPS task force on psychotherapy of psychosis

psychiatrists want them to and the risk most EBM-standard studies, as clini- here is no doubt that many people T for having new episodes is in general cians we cannot ignore them. who suffer from schizophrenia have high. The ISPS task force was established neurophysiological changes such as As clinicians working with people as a reaction to the treatment reco- ventricular enlargement or decreased who suffer from schizophrenia over time, mmendations published in 1998 in cerebral volume, and some have subtle we see that social dysfunction, lack of Schizophrenia Bulletin by the Schizo- neorocognitive dysfunctions prior to work, conflict with friends or family, phrenia Patient Outcome Research onset of psychosis. Many also have chronic psychotic symptoms, powerty Team (PORT) of The U.S. National poorer premorbid functioning than etc. very often develops into problems Institute of Mental Health. The PORT “healthy” controls, and most people that are long lasting and clearly not is a solid and thorough study of evidence have great benefit from the use of anti- treatable with medication alone. In a based treatment of schizophrenia and psychotic medication. These findings recent review as many as 11 % of home- gives detailed recommendations on how have lead many clinicians from different less people around the world suffer from to treat schizophrenia with medication, schools and traditions to look at schizo- schizophrenia and only a minority of but the study does not discuss psycho- phrenia as a biological or genetic dis- these people receive any treatment at logical treatments in a pragmatic and order. Some clinicians have almost all. Even though evidence based medi- clinical orientated manner. stopped talking to the patients because cine (EBM) has advantages as a way to There are only two recommendations “it is a biological disease that needs make sure that the treatment we give dealing with the psychodynamic biological treatment only”. This ten- is the best, EBM also have limitations therapies: dency is for the time being very strong regarding the generalisability. The fact Recommendation 22: Individual and in both USA and Europe. Insurance that few studies with randomized con- group psychotherapies adhering to a companies challenge the need for long trol design comparing psychotherapy psychodynamic model (defined as lasting psychotherapies, and in some with medication have been carried out, therapies that use interpretation of countries it has become very difficult is probably due to both lack of funding unconscious material and focus on to give people who suffer from schizo- (research-funds within psychiatry are transference and regression) should not phrenia the multileveled treatment that mostly used to develop and study the be used in the treatment of persons they are in need of. effect of medication) and to metho- with schizophrenia. The fact is that we still do not know dological difficulties. It is in general Recommendation 26: Family therapies the cause of the disorder in each indi- easier to have a randomized controlled based on the premise that family dys- vidual case. No neurobiological findings study with pills than with talks. Some function is the etiology of the patient’s have high predictive power, and cannot studies have however, been carried out, schizophrenic disorder should not be be used neither in preventing the dis- and they show that adding psychothera- used. order nor verifying the diagnosis. Most py to other treatment modalities in The ISPS felt that these recommen- people who suffer from schizophrenia general has a benefit on outcome. dation do not explore the field of do not have a close relative with the A highly significant problem with psychological therapies in a proper way. same disorder and detailed studies on this kind of research is informed con- They also gives the impression that premorbid functioning show that almost sent. We must assume that randomized psychological treatment should not be 25% have normal development in both control studies to a large degree select given and could be harmful. Actually school and social functioning. Even patients that have insight and cooperate the PORT dose not tell us how to carry though antipsychotic medication is clear- with the treatment i.e. exclude the out psychological therapy at all, but ly effective in making positive symptoms “difficult cases” that do not agree with tells us how we should not do it. Both such as auditive hallucinations and our use of diagnosis or the psychiatric recommendation 22 and 26 are negative delusions disappear or weakened, as treatment. These people are, however, formulated. This is in strong contrast many as 15–25% still have none or the ones that is the greatest challenge to the clinical experience that igno- inadequate effect of medication and in clinical practice. It is also a fact that rance of psychological aspects related many patients suffer from side effects almost 50% of first episode psychosis to psychosis, might be very harmful for such as weight gain, tiredness or car- cases use drugs regularly and that he patients and families. In 2001 the diovascular problems. Many patients approximately 1/3 have severe drug ISPS asked a group of clinicians and do not take their medication as the abuse. These are also excluded from researchers to look critically at the

12 vol.6 no.1 - September 2002 isps newsletter biological paradigm and to seek scientific and clinical proof and arguments for Journal of the American Academy of Psychoanalysis, Vol 31, No 1 (Spring, 03) psychological treatment of schizophrenia. SPECIAL ISSUE: The Schizophrenic Person and The ISPS task force consists of clini- the Benefits of the Psychotherapies – Seeking a PORT in the Storm cians and researchers from the whole world: Silke Bachman from Germany, Guest Edited by Ann-Louise S. Silver and Tor K. Larsen John Gleeson from Australia, William Gottdiener from the US, Tor K Larsen FRONTLINE by Silver and Larsen from Norway (chairman), Frank Margi- Ver Eecke, Wilfried: “The Role of Psychoanalytic Theory and Practice in son from the UK, John Read from New Understanding and Treating Schizophrenia: A Rejoinder to the PORT Report’s Zealand and Colin Ross from the US. Condemnation of Psychoanalysis” The group has been working together for almost a year and several scientific Karon, Bertram P.: “The Tragedy of Schizophrenia Without Psychotherapy” papers are accepted for publication in the Journal of the American Academy Garfield, David: "The Mask of Psychotic Diagnoses" of Psychoanalysis in a forthcoming special issue on Psychosis and Psycho- Prouty, Garry: "Pre-Therapy: A Newer Development in the Psychotherapy therapy. The special issue are guest of Schizophrenia” edited by Drs. Ann Louise Silver and O’Connor, Siobhan: “Violent Behaviour in Chronic Schizophrenia and Tor K Larsen. Inpatient Psychiatry” This process culminated in a seminar supported by the ISPS held in Stavan- Bechgaard, Birgitte: “Lessons in How to Ruin a Study in Psychotherapy ger, Norway, in February 2002, in which Effectiveness: A Critical Review of the Follow-up Study from Chestnut Lodge” most of the research was presented. Most members of the task force gave Koehler, Brian: “Interview with Gaetano Benedetti, M.D.” presentations at the seminar together with Wayne Fenton (USA), Richard Lehman, Anthony F. and Steinwachs, Donald M.: “Evidence-based Psychosocial Bentall (UK) and Lars Thorgaard Treatment Practices in Schizophrenia: Lessons from the Patient Outcomes (Denmark). The seminar was called Research Team (PORT) Project “Psychological treatment of psychosis; what is good practice?” and gathered Bachmann, Silke, et. al: “Psychological Treatments for Psychosis: History and 150 clinicians from Scandinavian Overview” Countries and even some people from Margison, Frank: “Evidence-based medicine in the psychological treatment Russia. The seminar was a great success of schizophrenia” and put renewed focus on psychological treatment. Gottdiener, William H. and Haslam, Nick: “A Critique of the Methods and Tor K Larsen, Conclusions in the Patient Outcome Research Team (PORT) Report on Norway Psychological Treatments for Schizophrenia” INVITATION Psychological treatment Larsen, T.K., et al: “The Concept of Schizophrenia and Phase Specific of psychosis; what is Treatment. Psychological Treatment in Pre-psychosis and in Non-responders” good practice? Gleeson, John, et al:: “Psychological Treatment in Pre- and Early Psychosis”

Read, John and Ross, Colin A.: “Trauma and Psychosis: the Need to Offer Psychological Therapies to People Experiencing Psychosis”

Book Reviews edited by Joseph P. Merlino, MD

“Mad in America” by Robert Whitaker, Reviewed by Clare E. Mundell “Phenomenology and Lacan on Schizophrenia, After the Decade of the Brain” by Alphonse De Waelhens and Wilfried Ver eecke, Reviewed by Scott Gemell

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A language for psychosis. Psychoanalysis of Psychotic States.

Paul Williams, Editor. The ten chapters are written by well Whurr Series on Psychoanalysis. known psychoanalysts with long experi- BOOK Whurr Publishers Ltd., London 2001. ence in treatment of persons with ISBN 1 86156 166 0. 207 pages. psychosis and with long experience in expressing their thoughtful reflections This book is a collection of challenging in writing. reviev and inspiring chapters on how to apply Most chapters are new, and some psychoanalytic understanding in a prac- chapters have earlier been published as tical way in multidisciplinary treatment articles in journals. A few chapters dis- teams in mental health services, where cuss case material, and all chapters are important in improving treatment skills and approaches of several profess- relevant for clinical practice. Some approaches, but also in making bridges ional groups are needed to give a chapters discuss important and necess- between professional groups and show- comprehensive understanding and ary components of treatment seen from ing how psychotherapy can bei ntegrated treatment. The book argues that psycho- a psychoanalytic perspective, and others in clinical work based on multidiscipli- analytic theory still makes important describe how psychoanalytic under- nary knowledge and approaches. and necessary contributions in this standing can be used in clinical practice. Brian Martindale reminds us in his multidisciplinary work. The introductory text by the editor is chapter that we now know much about well written and places the chapters the dynamics of psychoses and the in the context of the present challenges for clinicians and teams mental health services. engaged in treatment of the person with In a chapter on a rationale psychosis, but that this knowledge in for the psychoanalytically the present situation often is forgotten informed psychotherapy of or not taken into account. Neglect of schizophrenia and other this knowledge about the powerful psychoses, James S Grotstein forces that may influence the contact first discusses the emergence and interaction between the patient of current diagnostic division and the staff, may severely deteriorate between state and trait, the treatment and the effect of treat- changes in use of diagnostic ment. He discusses experiences that categories and the concept show the importance of training the of psychoses, and some multidisciplinary staff in the mental recent contributions health services in psychological to psychotherapy of understanding of psychosis and of the psychoses. He deve- related interpersonal dynamics. lops the discussion towards a concept of In his chapter on psychoanalysis and psychoanalytically in- the treatment of psychosis, Murray formed rehabilitative Jackson argues for a charter of the rights psychotherapy for for psychotic patients. This includes schizophrenia, -which the right to have a treatment team that also has to be a neuro- communicates and share an unders- psychologically infor- tanding that psychotic experiences have med psychotherapy meaning, the right to be listened to, taking into account the right to have a psychoanalytic recent research on the assessment, and the right to try psycho- brain. This way of analytically informed psychotherapy thinking is both until evidence emerges to the contrary.

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He then describes how several psycho- applying a psychoanalytic understanding analytic concepts can contribute to under- of these experiences, they discuss how Have you read the standing of psychosis and gives clinical this may be helpful in the treatment of examples. At the end he describes how the both groups. Johan Cullberg first book from ISPS? different approaches can be achieved describes how the stress-vulnerability Martindale B, Bateman A, Crowe M, in interdisciplinary convergence, model, a dynamic crisis model and Margison F: Psychosis (editors): exemplified by psychodynamic and need-adapted care in different phases Psychological Approaches cognitive-behavioural psychotherapy. have been used in treating and studying and their Effectiveness. It is impossible in a short book review first episode psychosis in the Swedish Gaskell, London. 2000. Paperback. £ 25. ISBN 1 901242 49 8. to give full justice to all the chapters “parachute project”. Results after one More information and ordering form at in this book, so some has to be mentio- year follow-up indicate that it is possible the ISPS website. ned more briefly. to work with this group of patients with Order from: Book Sales, Royal College Thomas Freeman share from his a combined psychodynamic and of Psychiatrists, 17 Belgrave Square, personal experience of treating and biological frame of reference using less London SW1X 8PG, United Kingdom. Telephone +44 20 7235 2351. studying persons with schizophrenia in restriction and medication and still Fax +44 20 7245 1231. multidisciplinary treatment teams in achieve very good results. psychiatric departments influenced by The last three chapters are case studies As the chapters are addressing diffe- the development for treatment appro- with theoretical discussions. Luiz rent topics, obviously different readers aches in the international professional Eduardo Prado de Oliveira discusses will experience the chapters and the community. Franco de Masi presents a autism, schizophrenia and paranoia in book differently. Those with a psycho- discussion on the unconscious and children based on treatment of a boy analytic background and interest for psychosis, distinguishing between the over several years, including contact treatment of psychosis will find most repressive dynamic unconscious and with his parents. In a chapter on or all these chapters stimulating and the emotional unconscious of that which psychotic addiction to video games useful. But also clinicians without such we are not aware. He illustrates his David Rosenfeld describes and discusses training will find several chapters useful. thoughts by case stories, and argues that the treatment of a 17 year old boy. There are few books addressing the restoring the function of the emotional Communicating about and understan- challenge of using psychoanalytic unconscious is an important part of ding the characters and the world in understanding within multidisciplinary helping the psychotic patient regain the video games became an important treatment teams, and this book is self-perceptions and personal identity. part of learning how the patient experi- needed and welcome. Hopefully books Andrzej Werbart and Marika Lindbom- enced the real world and in communi- such as this one may also inspire some Jakobson compare similarities and diffe- cating with him. In the last chapter the clinicians to write books also aimed rences between the experiences of torture editor Paul Williams discusses the primarily at helping other professional survivors and persons with schizophrenia, psychotic developments and treatment groups learn more about the language where both groups can feel “living dead” of a woman with borderline psychopath- of psychosis when working in other and “end of the world “catastrophes. ology who had been sexually abused in roles than as psychotherapists. Comparing experiences of torture and her childhood and adolescence by her psychotic breakdown as trauma and father. Torleif Ruud, Norway

The Journal of the American Academy of Psychoanalysis 22 – 25 SEPTEMBER Special offer/discount for ISPS members 2003 Guilford Publications would like to offer a one year, four issue subscription to JAAP for $70, which includes $28 for airmail (unfortunately we are not able to T R A L U S I discount postage). The regular one year subscription price, including airmail, A A is $88. You can can subscribe directly, just let us know that you are an ISPSmember to receive the special rate of $70. Melbourne Orders by MasterCard, Visa or American Express can be placed by: Phone at 800-365-7006, ext. 3, Fax 212-966-6708, or E-mail: [email protected] SEE YOU IN Inform that you are a member of ISPS to get the special rate of $70. MELBOURNE 2003

vol.6 no.1 - September 2002 15 isps 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 to the ISPS newsletter and website: www.isps.org the ISPS website by e-mail to: [email protected]

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