Collaboration in Psychopharmacotherapy Gregoris Simos University of Macedonia Collaboration in pharmacotherapy implies a professional willing to prescribe an effective medication and a patient willing to adhere to the therapeutic regimen in order for both to achieve their common goal. This relationship requires trust in the relationship, collaboration in goal setting, and effective means for promoting and restoring mental health. Variables like illness insight and patients’ attitudes towards medication should be dealt within a collaborative relationship. Several methods of shared decision making, culled from the research literature and clinical experience, promote such prescriber- patient collaboration and, even more specifically, medication adherence. Detailed physician-patient interactions in 2 cases, one of a depressed patient and one of a patient suffering from schizophrenia, serve to highlight common difficulties in the management of pharmacotherapy in the context of a collaborative relationship. C  2012 Wiley Periodicals, Inc. J. Clin. Psychol: In Session 68:198–208, 2012. Keywords: collaboration; pharmacotherapy; decision making; collaborative decision making; medication adherence Pharmacotherapy is among the first treatment options for serious and/or chronic mental disor- ders like schizophrenia, bipolar disorder, and some anxiety disorders. Psychotherapy is another first treatment option for a variety of mental disorders, either as an alternative to or in combi- nation with medication. The focus of this article will be on those cases when pharmacotherapy is combined with psychotherapy, no matter whether these two treatments are provided by the same clinician or by different professionals. In this article, I begin by tracking the demise of the paternalistic medical model and then addressing the rise of collaboration in prescriber-patient relationships. Several evidence-based means of promoting shared or collaborative decision making are then reviewed. I present ver- batim physician-patient exchanges from two cases of pharmacotherapy to illustrate several key points. The article concludes with a review of the recommended practices to foster collaboration in pharmacotherapy for the mental disorder. Rise and Fall of a Paternalistic Medical Model Although the medical model in psychiatry relates to the organic etiology of mental illnesses, it also incorporates therapeutic knowledge of a scientifically valid nature. Accordingly, it is grounded in the therapeutic relationship (Shagass, 1975). The medical model also implies that doctors are given by society the authority to probe bodies and minds in ways permitted to no one else, and patients, without protest, permit themselves to be subjected to unpleasant, frightening, and even humiliating experiences. Special knowledge about medicine, the belief that a physician functions for the good of the patient, and faith in a doctor’s knowledge are three kinds of authority. Despite the abuses and misuses of the medical authority model, it adheres persistently to a value system centered around the benefit of the individual patient. The model also follows the medical tradition of applying the test of pragmatic relevance to new ideas and procedures. When they achieve desirable purposes they are adopted, even though this means changing previous explanations (Shagass, 1975). Please address correspondence to: Gregoris Simos, Department of Educational and Social Policy, University of Macedonia, 156 Egnatia Ave., P.O. Box 1591, 540 06 Thessaloniki, Greece. E-mail: simos@med.auth.gr and gsimos@uom.gr JOURNAL OF CLINICAL PSYCHOLOGY: IN SESSION, Vol. 68(2), 198–208 (2012) C  2012 Wiley Periodicals, Inc. Published online in Wiley Online Library (wileyonlinelibrary.com/journal/jclp). DOI: 10.1002/jclp.21836