SPECIAL GUEST PSYCHOTHERAPY SECTIONPsychotherapy and Its Role in Psychiatric Practice: A Position Paper. II. Objective, Subjective, and Intersubjective ScienceSHAPIRO, YAKOV MD; JOHN, NICHOLAS MD; SCOTT, ROWAN MD; TOMY, NADIA MDAuthor Information SHAPIRO, JOHN, SCOTT, and TOMY: Department of Psychiatry and Psychotherapy Supervisors’ Group, University of Alberta, Edmonton, AB, Canada The authors declare no conflicts of interest. Reprints: Yakov Shapiro, MD, Department of Psychiatry, University of Alberta, 2931-66 St., Edmonton, AB, Canada T6K 4C1 (e-mail: [email protected]). Journal of Psychiatric Practice: July 2016 - Volume 22 - Issue 4 - p 321-332 doi: 10.1097/PRA.0000000000000161 Buy Metrics Abstract In the first article in this 2-part series, we outlined a psychobiological model of psychiatric treatment and reviewed the evidence showing psychotherapy to be a form of biological intervention that induces lasting alterations in brain structure and function. In this second article, we focus on the adaptive model of psychopathology, the effectiveness of psychotherapeutic interventions, the synergistic effects of combined psychotherapy and psychopharmacology treatments, and attention to the patient’s subjective experience and the doctor-patient alliance to complement an “objective” case formulation. The evidence strongly suggests the need for an integrated treatment approach based on the objective, subjective, and intersubjective science that forms the foundation of psychiatry as a clinical discipline, in which psychotherapy and psychopharmacology are seen as complementary treatments within a systemic approach to psychiatric care and training. What emerges is the integrated psychobiological model of care with a complex treatment matrix unique to each patient-provider pair and comprised of biological, experiential, and relational domains of treatment which form the foundation of psychiatry as a science of attachment and meaning. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.