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Psychotherapy Assessment and Treatment Selection

Published online by Cambridge University Press:  02 January 2018

Richard Tillett
Richard Tillett*
Affiliation:
Wonford House Hospital, Dryden Road, Won ford, Exeter EX2 5AF
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Abstract

Background

Current acceptance of the need for a wide range of treatments and growing pressure for cost-effectiveness suggest the need for a more discriminating approach to assessment of psychotherapy.

Method

Medline and manual literature searches, and personal experience of over 1000 assessments in a district psychotherapy service.

Results

There is substantial evidence for the general efficacy of psychotherapy; differential benefits are beginning to be identified. Short-term treatments are appropriate in a wide variety of situations and can be surprisingly effective. Chronic/complex psychopathology is likely to need longer term therapy.

Conclusions

Effective use of scarce psychotherapy resources requires knowledge of the research evidence of treatment effectiveness, careful assessment of the patient and a logical and collaborative approach to treatment planning.

Type
Review Article
Information
The British Journal of Psychiatry , Volume 168 , Issue 1 , January 1996 , pp. 10 - 15
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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References

Andrews, G. (1993) The essential psychotherapies. British Journal of Psychiatry, 162, 447–451.CrossRefGoogle ScholarPubMed
Aveline, M. (1980) Making a psychodynamic formulation. Bulletin of The Royal College of Psychiatrists, 192–193.Google Scholar
Barker, P. (1986) Basic Family Therapy (2nd edn). London: Collins.Google Scholar
Beutler, L. E. (1989) Differential treatment selection: the role of diagnosis in psychotherapy. Psychotherapy, 26, 271–281.CrossRefGoogle Scholar
Beutler, L. E. (1991) Selective treatment matching: systematic eclectic psychotherapy. Psychotherapy, 28, 457–462.CrossRefGoogle Scholar
Bloch, S. (1979) Assessment of patients for psychotherapy. British Journal of Psychiatry, 135, 193–208.CrossRefGoogle ScholarPubMed
Brown, D. & Skynner, R. (1981) Referral of patients for psychotherapy. British Medical Journal, 262, 1952–1955.Google Scholar
Brown, D. & Pedder, J. (1991) Introduction to Psychotherapy (2nd edn). London: Routledge.Google Scholar
Chase, J. & Holmes, J. (1990) A two-year audit of a family therapy clinic in adult psychiatry. Journal of Family Therapy, 12, 229–241.CrossRefGoogle Scholar
Clarkin, J., Frances, A. & Moody, J. (1979) Selection criteria for family therapy. Family Process, 18, 391–403.CrossRefGoogle ScholarPubMed
Clarkin, J. & Frances, A. (1982) Selection criteria for the brief psychotherapies. American Journal of Psychotherapy, 34, 166–180.CrossRefGoogle Scholar
Clementel-Jones, C., Malan, D. & Trauer, T. (1990) A retrospective follow up study of 84 patients treated with individual psycho-analytic psychotherapy: outcome and predictive factors. British Journal of Psychotherapy, 6, 363–374.CrossRefGoogle Scholar
Coltart, N. (1987) Diagnosis and assessment for suitability for psycho-analytic psychotherapy. British Journal of Psychotherapy, 6, 127–134.CrossRefGoogle Scholar
Crits-Christoph, P. (1992) The efficacy of brief dynamic psychotherapy: a meta-analysis. American Journal of Psychiatry, 149, 151–158.Google ScholarPubMed
Crown, S. (1983) Contra-indications and dangers of psychotherapy. British Journal of Psychiatry, 143, 436–441.CrossRefGoogle Scholar
Dare, C. (1991) Anorexia nervosa: In Text Book of Psychotherapy and Psychiatric Practice, (ed Holmes, J.), pp. 395–419. London: Churchill Livingstone.Google Scholar
Fahy, T. & Wessely, S. (1993) Should purchasers pay for psychotherapy? British Medical Journal, 307, 576–577.CrossRefGoogle ScholarPubMed
Frances, A., Clarkin, J. & Marachi, J. (1980) Selection criteria for out-patient group psychotherapy. Hospital and Community Psychiatry, 31, 245–250.Google Scholar
Frances, A. & Clarkin, J. (1981) No treatment as the prescription of choice. Archives of General Psychiatry, 38, 542–545.CrossRefGoogle ScholarPubMed
Grant, S., Margison, F. & Powell, A. (1991) (Working Party, Royal College of Psychiatrists' Psychotherapy Specialist Section). The future of psychotherapy services. Psychiatric Bulletin, 15, 174–179.Google Scholar
Guthrie, E., Creed, F., Dawson, D., et al (1993) A randomised controlled trial of psychotherapy in patients with refractory irritable bowel syndrome. British Journal of Psychiatry, 163, 315–321.CrossRefGoogle ScholarPubMed
Hartmann, A., Herzog, T. & Drinkmann, A. (1992) Psychotherapy of bulimia nervosa: what is effective? A meta-analysis. Journal of Psychosomatic Research, 36, 159–167.CrossRefGoogle ScholarPubMed
Hawton, K., Salkowskis, P., Kirk, J., et al (1989) Cognitive Behaviour Therapy for Psychiatric Problems: A Practical Guide. Oxford: Oxford University Press.Google Scholar
Higgit, A. & Fonagy, P. (1992) Psychotherapy in borderline and narcissistic personality disorder. British Journal of Psychiatry, 161, 23–43.CrossRefGoogle Scholar
Hinshelwood, R. (1991) Psycho-dynamic formulation in assessment for psychotherapy. British Journal of Psychotherapy, 8, 166–174.CrossRefGoogle Scholar
Hoglend, P., Guldberg, C. & Perry, C. (1992) Scientific approaches to making psycho-dynamic formulations. Nordic Journal of Psychiatry 46, 41–48.CrossRefGoogle Scholar
Holmes, J. (1994) Brief dynamic psychotherapy. Advances in Psychiatric Treatment 1, 9–15.CrossRefGoogle Scholar
Holmes, J. & Mark, I. (1994) Psychotherapy – a luxury the NHS cannot afford? British Medical Journal, 309, 1070–1072.CrossRefGoogle ScholarPubMed
Howard, K. I., Orlinsky, D. E. & Lueger, R. J. (1994) Clinically relevant outcome research in individual psychotherapy. British Journal of Psychiatry, 165, 4–8.CrossRefGoogle ScholarPubMed
Hyde, K. (1988) Analytic group psychotherapies. In Group Therapy in Britain (eds Aveline, M. & Dryden, W.), pp. 13–43. Milton Keynes: Open University.Google Scholar
Karasu, T. B. (1986) The psychotherapies: benefit and limitations. American Journal of Psychotherapy, 40, 324–342.CrossRefGoogle ScholarPubMed
Kingdon, D., Turkington, D. & John, C. (1994) Cognitive-behaviour therapy of schizophrenia. British Journal of Psychiatry, 164, 581–588.CrossRefGoogle ScholarPubMed
Kissane, D. W. & Bloch, S. (1994) Family grief. British Journal of Psychiatry, 164, 728–740.CrossRefGoogle ScholarPubMed
Lam, D. (1991) Psycho-social family interventions in schizophrenia: a review of empirical studies. Psychological Medicine, 21, 423–441.CrossRefGoogle Scholar
Leff, J. (1985) Family treatment of schizophrenia. In Recent Advances in Clinical Psychiatry 5 (ed. Granville-Grossman, K.), pp. 23–43. London: Churchill Livingstone.Google Scholar
Lipsey, M. & Wilson, D. (1993) The efficacy of psychological, educational and behavioural treatment: confirmation from meta-analysis. American Psychologist, 48, 1181–1209.CrossRefGoogle ScholarPubMed
Malan, D. (1976) The frontiers of brief psychotherapy. London: Hutchinson.CrossRefGoogle Scholar
Malan, D. (1979) Individual psychotherapy and the science of psychodynamics. London: Butterworths.Google Scholar
Marks, I. (1981) Cure and care of neuroses. Chichester: Wiley. McGrath, G. (1994) Economic aspects of psychotherapy. Current Opinion in Psychiatry, 7, 241–244.Google Scholar
Menzies, D., Bolan, B. & Norton, K. (1993) Are short-term savings worth long-term costs? Funding treatment for personality disorders. Psychiatric Bulletin, 17, 517–519.CrossRefGoogle Scholar
Orlinsky, D. & Howard, K. (1986) Process and outcome in psychotherapy. In Handbook of Psychotherapy and Behaviour Change (eds Garfield, S. & Bergin, A.), pp. 311–381. New York: Wiley.Google Scholar
Parry, G. (1992) Improving psychotherapy services: applications of research, audit and evaluation. British Journal of Clinical Psychology, 31, 3–19.CrossRefGoogle ScholarPubMed
Perry, S., Cooper, A. & Michels, R. (1987) The psycho-dynamic formulation: its purpose, structure and clinical application. American Journal of Psychiatry, 144, 543–550.Google Scholar
Rosser, R. M., Birch, S. & Bond, H. (1987) Five year follow-up of patients treated with in-patient psychotherapy at the Cassel Hospital for Nervous Diseases. Journal of the Royal Society of Medicine, 80, 549–555.CrossRefGoogle Scholar
Ratigan, B. & Aveline, M. (1988) Inter-personal group therapy. In Group Therapy in Britain (eds Aveline, M. & Dryden, W.), pp. 43–65. Milton Keynes: Open University Press.Google Scholar
Ryle, A. (1990) Cognitive Analytic Therapy: Active Participation in Change. Chichester: Wiley.Google Scholar
Shapiro, D. A. & Shapiro, D. (1982) Meta-analysis of comparative outcome studies: a replication and refinement. Psychological Bulletin, 92, 581–605.CrossRefGoogle ScholarPubMed
Smith, M. L. & Glass, G. V. (1977) Meta-analysis of psychotherapy outcome studies. American Psychologist, 32, 752–760.CrossRefGoogle ScholarPubMed
Smith, M. L., Glass, G. V. & Miller, T. (1980) The Benefits of Psychotherapy. Baltimore: Johns Hopkins University Press.Google Scholar
Sifneos, P. (1972) Short-term Psychotherapy and Emotional Crisis. Cambridge, Massachusetts: Harvard University Press.Google Scholar
Solomon, S., Gerrity, E. & Muff, A. (1992) Efficacy of treatments for post-traumatic stress disorder: an empirical review. Journal of the American Medical Association, 268, 633–638.CrossRefGoogle ScholarPubMed
Stern, R. & Drummond, L. (1991) The Practice of Behavioural and Cognitive Psychotherapy. Cambridge: Cambridge University Press.Google Scholar
Stevenson, J. & Meases, R. (1992) An outcome study of psychotherapy for patients with borderline personality disorder. American Journal of Psychiatry, 149, 358–362.Google ScholarPubMed
Svartbero, M. & Stiles, T. (1991) Comparative effects of short-term psycho-dynamic psychotherapy: a meta-analysis. Journal of Consulting and Clinical Psychology, 59, 704–714.CrossRefGoogle Scholar
Tillett, R. I. L. (1993) Assessment and outcome in psychotherapy. Current Opinion in Psychiatry, 6, 353–357.CrossRefGoogle Scholar
Tillett, R. I. L. (1994) Activity in a district psychotherapy service. Psychiatric Bulletin, 18, 544–547.CrossRefGoogle Scholar
Tyson, R. & Sandler, J. (1971) Problems in the selection of patients for psycho-analysis. British Journal of Medical Psychology, 44, 211–228.CrossRefGoogle Scholar
Williams, J. M. G. (1992) The Psychological Treatment of Depression (2nd edn). London: Routledge.Google Scholar
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