ABSTRACT
This chapter identifies a series of factors that therapists should consider to determine whether a patient should begin a combined treatment, and shows how to help patients understand the value of having both medication and therapy. It describes how to address certain negative reactions to the recommendations. If a decision is made to pursue medication treatment in addition to psychotherapy, the clinician discusses the patient whether he will be prescribing it or whether the patient will go to another clinician for additional evaluation and potential medication treatment. Once medication is effective, it can diminish feelings of humiliation that are part of the depressive disorder. In this diagnostic process, therapists will be applying the two-illness and interactional models and make use of "shifting gears" in their assessment and their discussion of their recommendations with the patient. Kelly described two views of the psychoanalyst treating a patient with medication: the abstinent and the interventionist models.
