Psychiatric Medical Service

Head of Service: Dr. Sara Fumagalli

The Psychiatric Medical Service of the Santa Croce Clinic deals with the first clinical evaluation of the patient through an initial interview. The theoretical model of reference is the bio-psycho-social one.
This means that the person is taken into consideration in its complexity and individual particularity: in addition to biological aspects, the psychological and socio-environmental functioning (also work or school) is also understood and evaluated.
This type of approach allows for the formulation, in complete agreement with the patient, of a therapeutic project which defines the main psychic disorders of importance, the treatment strategies and the therapeutic figures who will therefore be involved, as well as any social-environmental interventions useful for a good social and work reintegration.
The psychiatrist investigates and monitors the clinical and biological variables: it is now scientifically proven that many of the psychiatric symptoms can be related to neurotransmitter dysfunctions (dopamine, serotonin, noradrenaline).
The origin of these dysfunctions is variable: genetic factors come into play, any concomitant somatic pathologies, trauma, et al. The approach can be pharmacological when the symptom becomes strongly dysfunctional and disabling for the subject. Pharmacological treatments aim to re-establish these dysfunctions through an individualised choice of specific molecules, which must be constantly monitored over time by a specialist.

  • ACT

    ACT is an acronym for Acceptance and Commitment Therapy is a form of cognitive-behavioral psychotherapy of the so-called “third wave” (i.e. the set of the most modern theories) that has proven effective in the treatment of different areas of psychological distress such as anxiety, depression, relationship problems, addictions, problems related to chronic pain.

    The results of research in this area suggest that often the efforts and strategies that people use to try to solve problems leads into a trap that creates suffering. ACT addresses and overturns some of the notions and approaches that are conventionally used and promoted to treat psychological distress, suggesting that psychological distress is important and is not in itself a sign of pathology.

    In fact, pain and suffering are two different states, the former inevitable, the latter induced by our strategies to avoid pain. A new focus on what matters (or values), rather than on what we want to avoid, can give a new direction to our lives. To do this, ACT teaches people about perspective shifting, using three basic techniques:

    • Mindfulness a technique to achieve awareness and contact with the here and now
    • Accettazione or vital contact with pain and engagement strategies
    • Behavioral change toward what the person considers to be their direction (or values).

    The desirable outcome is so-called psychological flexibility, allowing us to lead an existence that is not pain-free, but vital and towards what we really want. It is a treatment that has a good empirical support that to date is clear in particular for chronic pain, depression and anxiety, with evidence is growing and also for addictions and substance abuse.

    For further information please refer to ACT Italia or Contextual Science websites or consult texts such as “Acceptance and Commitment Therapy, Second Edition: The Process and Practice of Mindful Change” (Kelly G. Wilson, Kirk D. Strosahl, Steven C. Hayes).

    ACT is supported by the research of more than 60 RCTs (Randomized Control Trials, the golden standard for research) and a meta-analysis published in 2006 is a summary of it: meta-analysis, Hayes, Luoma, Bond, Masuda, & Lillis, 2006, Behaviour Research and Therapy in January 2006.

    Source: ACT Italia

  • GET® Method

    The GET® Method is a psychotherapeutic method which aims to restore a better quality of life to the borderline personality disorder. It is the first evidence-based method for the treatment of borderline personality disorders, created and developed entirely in Italy.

    The treatment provides an equal experience in groups focused on the main psychopathological problems of Borderline Disorder. In the groups a homogeneous setting is established in which participants learn new knowledge about their emotions and crisis management through a greater understanding of their inner world.

    The Therapeutic Experiential Groups (GET ®) led by a facilitator are in fact the tool to act on the core of the borderline disorder that we can identify in:

    • Emotional dysregulation is an atypical way of perceiving emotions, which are therefore too strong and difficult to manage, often resulting in emotional overload.

    • Impulsivity, that is, behaviour impulsively adapted to manage emotional suffering that often becomes harmful to the person: self-injurious behaviour, sexual promiscuity, drug use, eating disorders.

    • Loneliness, emptiness and a sense of abandonment, or the perception of oneself as unworthy of society and therefore a tendency to isolate and to constantly fear abandonment by those around.

    More info on GET® Method