Need-adapted treatment

Domain I · Psychodynamic & depth psychology · Yrjo Alanen · 1960 · Turku, Finland

What it is

NAT is an integrated, individualized and psychotherapeutically oriented way of treating first-episode schizophrenia-group psychoses inside a public service. It was built in stages at the Turku University Psychiatric Clinic from the 1960s to the 1990s. The stages were psychodynamic individual…

Format

• NAT has no formal named phases. Its course is set by repeated therapy meetings whose frequency follows need. The stages below are an operational way of organising what the sources describe. The timings come from the sources cited.
• Goals: meet the patient and the family or network quickly. Hear every party's account of what happened and why now. Get a first understanding of the crisis (the informative function) and of the network's needs and resources (the diagnostic function). Contain distress (the therapeutic function).…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• dropout around transitions.
• an ending decided only by the team.
• early group exposure making confusion worse.
• pushing a return before the patient is ready, or losing the network once symptoms settle.
• CBT running as a separate track with its own formulation that clashes with the team's shared image (see 4.11).

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.