Psychotherapy: Informed Consent

There are more kinds of psychotherapy than I can count. I trained most in family systems, but my residency exposed me to Jungian analysis, Freudian analysis, psychodynamic psychotherapy, cognitive behavior therapy and biofeedback. I stopped offering psychotherapy myself a couple years ago, so when I recommend that modality to a new patient at the end of an initial evaluation I find it difficult to omit a brief lecture on the differences among psychotherapies, especially the ones I recommend for that particular patient.

If you do psychotherapy yourself how far should you go to educate the patient, especially about alternatives you do not offer? If all your patients get whichever version you provide, whether or not it is the one most likely to succeed for that patient, how much should you tell about alternatives and advantages and disadvantages? Do you know enough about different kinds of psychotherapy to adequately describe the prime candidates? If you have reason to believe the patient will do better with a kind of psychotherapy that you cannot offer, will you admit as much and refer them out? Some items for consideration:

  • How it works
  • What determines duration of treatment
  • Likely frequency of sessions
  • Who will attend: individual, group, family
  • Cost
  • Availability
  • Risks
  • Benefits

What do you do if you know (or find out the hard way) that the kind of treatment you believe would best serve that patient cannot be found in your community?

Like so much of what we do a good starting point might involve considering what you would want a professional to tell you or your loved one if the roles were reversed. So you are the patient? Take these questions with you to that evaluation and ask a million questions.

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