ABSTRACT
The conventional wisdom, after May and Grinspoon, is that antipsychotics, alone or with supportive psychotherapy, are the ideal and most cost effective approach to treating schizophrenia. Gunderson highlights some of the difficulties in conducting psychotherapy research in schizophrenia. Although he found that reality-oriented, supportive psychotherapy was at least as effective as exploratory, insight-oriented psychotherapy with schizophrenics on high doses of antipsychotics over a two-year period, he leaves open the possibility that a longer time frame might be employed. In the United States, there has been a profound swing to the use of antipsychotic medication, supportive psychotherapy and psychiatric day care in the treatment of overtly psychotic patients. Perhaps in these countries a mix of social and supportive psychotherapies returns patients to home and the community in better shape than in the United States, where the art of psychotherapy is no longer taught or valued in psychiatric training programmes.
