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 he 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.