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September 1973

A Contraindication for Family TherapyThe Prepsychotic or Postpsychotic Young Adult and His Parents

Author Affiliations

From the Department of Psychiatry, Jewish General Hospital, Montreal.

Arch Gen Psychiatry. 1973;29(3):352-355. doi:10.1001/archpsyc.1973.04200030050007

Conjoint family therapy is not helpful and can be harmful in treating extremely anxious young patients who are on the verge of decompensating into or have scarcely recompensated from an acute psychotic breakdown. This is probably because the person's already overwhelming anxiety is increased and his ability to express his feelings is correspondingly decreased when he is made aware of his enormous ambivalent dependency on his parents and of their rejecting attitude.

It might be important to vary the type of therapy at different stages of treatment. Therapy should be more supportive and directive at times when the patient is about to decompensate and more insight and affect-oriented only at later stages of treatment, when the patient's defenses are sufficiently reconstituted and he has enough objectivity to tolerate this type of therapy.