“Medication free treatment for people with psychosis," an international movement with national implementation, what is it all about?

Christine Henriksen Ødegaard from the Global Mental Health research group defends 20.6.2023 her PhD-thesis: “Medication free treatment for people with psychosis".

This research project is a collaboration between several departments at the University of Bergen, the Centre of International Health (CIH) at the department of Global Public Health and Primary Care, the Department of Clinical Psychology, and The Grieg Academy Music Therapy Research Centre (GAMUT).

Medication-free treatment for psychosis in Norway is the result of a joint initiative from several user organizations based on the debated use of anti-psychotic medication, and the wish for more person-centred care and greater self-determination. The study aimed to provide comprehensive insight into the user and provider experiences with the medication free treatment program in Bergen, Norway.

It was a qualitative study using in-depth interviews with people with psychosis, focus group discussions with staff from the mental health care institutions, and participatory observation in music therapy. Four experts by experience were invited as co-researchers. Patients described their relationship with therapists as improved and significant. Treatment was a learning process of their personal patterns of suffering, and motivation for self agency in the recovery process was important. The therapists were preoccupied with managing resources; their role in the therapy; and patient choices. Music therapy was described as a flexible, recovery-oriented treatment.

Medication-free treatment facilitated learning experiences regarding the choice of treatment, focusing on increased self-agency and motivation. It is supportive towards patient choices, and appears to improve the relationship between the patient and the caregiver. Democratization of treatment choices challenges the level of professional discretion when caregiver and patient have conflicting goals, possibly causing therapists to feel disempowered in and alienated from their work. Music therapy offers choices continuously, in collaboration with the therapist, but also contingent depending on circumstances. There is a potential for improved implementation.

Her trial lecture brought up autonomy and choices in psychosis treatment and brought in international and cultural dimensions of treatment and care.