‘Psychotherapy’

Abstract

For many the experience of going to a psychiatrist will be one that concludes with ‘Do you want treatment with medication or do you want psychotherapy?’ It may appear odd that these are presented as clear alternatives, considering how different they are. If there were clear reasons for identifying medical treatment as best for certain mental health difficulties and psychotherapy as best for others, then it would be reasonable to expect a psychiatrist to be able to be clear which might be most helpful in any one case. As it is, formal recommendations concerning the treatment of most forms of mental health difficulties refer in differing ways to both medical and psychotherapeutic interventions.¹ Chapters 3 and 4 clarify why it is that psychiatric drug treatments are not and cannot be as precisely targeted and applied as might be expected, and why it is that what comes to be prescribed is as much determined by the detailed specifics of the individual and the difficulties they are in, as it is by ‘diagnosis’ or the scientific underpinnings of psychopharmacology. Much the same is true for psychological therapies. Some have reputations for greater efficacy in certain situations but all are claimed, by some, to be effective in all conditions, and all prove ineffective in some people, regardless of the situation. This chapter provides an outline of the psychotherapies as they are presented in standard textbooks and in conventional psychiatric settings.