Psychotherapy Assessment and Treatment Selection

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.