The Practice and Roles of the Psychotherapies: A Discussion Paper

American Psychiatry Association. Position statement on medical psychotherapy. Am J Psychiatry 1995;152:11.

Royal College of Psychiatrists. Guidelines for psychotherapy training as part of general professional psychiatric training. Royal College of Psychiatrists; 1993.

Hohagen F Berger M . The new German specialist for psychiatry and psychotherapy and its consequences for advanced training programs. European Psychiatry 1994;9:265–71.

Cameron P Ennis J Deadman J . Development of the guidelines. In: Cameron P Ennis J Deadman , editors. Standards and Guidelines for the Psychotherapies. Toronto: University of Toronto Press; 1998. p xxiv–xxv.

Leszcz M . “Standards for Psychotherapy Training” Discussion Paper, Department of Psychiatry, University of Toronto. We acknowledge the background information provided in this document. 1994.

Katz P . The role of the psychotherapies in the practice of psychiatry. Can J Psychiatry 1986;31:458–65.

Copus P . Skills for a general psychiatrist. In: The Practice and Roles of the Psychotherapies in (Canadian) Psychiatry. Part of CPA discussion paper; CPA Annual Meeting; October 1996; Quebec City, QC.

Cameron PM . Improving psychiatrists' competence in the psychotherapies. CPA Bulletin 1997;29:5–7.

Clum GA Clum GA Surls R . A meta-analysis of treatments for panic disorder. J Consult Clin Psychol 1993;61:317–26.

van Balkom AJLM van Oppen P Vermeulen AWA van Dyck RV Nauta MCE Vorst HCM . A meta-analysis on the treatment of obsessive compulsive disorder: A comparison of antidepressants, behavior, and cognitive therapy. Clin Psychol Rev 1994;14:359–81.

Hollon SD Shelton RC Davis DD . Cognitive therapy for depression: Conceptual issues and clinical efficacy. J Consult Clin Psychol 1993;61:270–5.

Gloaquenu K Cotraux J Cucherat M Blackburn I.M. . A meta-analysis of the effects of cogniti ve therapy with depressed patients. J Affect Disord 1998;49:59–72.

Chambless DL Gillis MM . Cognitive therapy of anxiety disorders. J Consult Clin Psychol 1993;61:248–60.

Heimberg RG Juster HR . Cognitive-behavioral treatments: Literature review. In: Heimberg RG Liebowitz MR Hope DA Schneier FR , editors. Social phobia: Diagnosis, assessment, and treatment. New York: Guilford Press; 1995.

Abel JL . Exposure with response prevention and serotonergic antidepressants in the treatment of obsessive compulsive disorder: A review and implications for interdisciplinary treatment. Behav Res Ther 1993;31:463–78.

Cox BJ Swinson RP Morrison B Lee PS . Clomipramine, fluoxetine, and behavior therapy in the treatment of obsessive-compulsive disorder: A meta analysis. J Behav Ther Exp Psychiatry 1993;24:149–53.

Borkovec TD Roemer L . Cognitive behavioral treatment of generalized anxiety disorder. In: Ammerman RT Hersen M , editors. Handbook of prescriptive treatments for adults. New York: Plenum Press; 1995.

Emmelkamp PMG . Behavior therapy with adults. In: Bergin AE Garfield SL , editors. Handbook of psychotherapy and behavior change. 4th ed. New York: John Wiley & Sons; 1994.

Foa EB Rothbaum BO Riggs DS Murdock TB . Treatment of posttraumatic stress disorder in rape victims: A comparison between cognitive-behavioural procedures and counseling. J Consult Clin Psychol 1991;59:715–23.

Foa EB Herst-Ikeda D Perry KJ . Evaluation of a brief cognitive-behavioral program for the prevention of chronic PTSD in recent assault victims. J Consult Clin Psychol 1995;63:948–55.

Brenner HD . Cognitive therapy with schizophrenic patients: Conceptual basis, present state, future directions. Acta Psychiatr Scand 1994;90 Suppl 384: 108–15.

Perris C Skagerlind L . Cognitive therapy with schizophrenic patients. Acta Psychiatr Scand 1994;89 Suppl 382: 65–70.

Alford BA Correia CJ . Cognitive therapy for schizophrenia: Theory and empirical status. Behavior Therapy 1994;25:17–33.

Hogarty GE Anderson CM Reiss DJ Komblith SJ Greenwald DP , Javna CD, and others. Environmental/personal indicators in the course of schizophrenia research group: Family psychoeducation, social skills training, and chemotherapy in the aftercare treatment of schizophrenia: I. One year effects of a controlled study on relapse and expressed emotion. Arch Gen Psychiatry 1986;43:633–42.

Bentall RP Haddock G Slade PD . Cognitive therapy for persistent auditory hallucinations: From theory to therapy. Behavior Therapy 1994;25:51–66.

Kulpers E Garety P Fowler D Dunn G Bebbington P , Freeman D, and others. London-East Anglia randomized controlled trial of cognitive-behavioural therapy for psychosis. Br J Psychiatry 1997;171:319–27.

Wincze JP Carey MP . Sexual dysfunction: A guide for assessment and treatment. New York: Guilford Press; 1991.

Blanchard EB . Behavioral medicine and health psychology. In: Bergin AE Garfield SL , editors. Handbook of psychotherapy and behavior change. 4th ed. New York: John Wiley & Sons; 1994.

Hollon SD Beck AT . Cognitive and cognitive behavioral therapies. In: Bergin AE Garfield SL , editors. Handbook of psychotherapy and behavior change. 4th ed. New York: John Wiley & Sons; 1994.

Linehan MM Armstrong HE Suerez A Allmon D Heard HL . Cognitive-behavioral treatment of chronically parasuicidal borderline patients. Arch Gen Psychiatry 1991;48:1060–4.

Smith MH Glass GV Miller TI . The benefits of psychotherapy. Baltimore (MD): Johns Hopkins University Press; 1980.

Lambert MJ Bergin AE . The effectiveness of psychotherapy. In: Bergin AE Garfield SL , editors. Handbook of psychotherapy and behavior change. 4th ed. New York: John Wiley & Sons; 1994. p 143–89.

Robinson LA Berman JS Neimeyer RA . Psychotherapy for the treatment of depression: A comprehensive review of controlled outcome research. Psychol Bull 1990;108:30–42.

Luborsky L Diguer L Luborsky E Singer B Dicter D Schmidt KA . The efficacy of dynamic psychotherapies: Is it true that “Everyone has won and all must have prizes?” In: Miller NE Luborsky L Barber J Docherty JP , editors. Psychodynamic treatment research: A handbook for clinical practice. New York: Basic Books; 1993

Bednar RL Kaul TJ . Experiential group research: Can the canon fire? In: Bergin AE Garfield SL , editors. Handbook of psychotherapy and behaviour change. 4th ed. New York: John Wiley & Sons; 1994. p 631–63.

Toseland RW Siporin M . When to recommend group treatment: A review of the clinical and the research literature. Int J Group Psychother 1986;36:171–201.

Tillitski CJ . A meta-analysis of estimated effect sizes for group versus individual versus control treatments. Int J Group Psychother 1990;40:215–24.

Fuhriman A Burlingame GM . Group psychotherapy: Research and practice. In: Fuhriman A Burlingame GM , editors. Handbook of group psychotherapy. New York: John Wiley & Sons; 1994. p 3–40.

Gallagher DE Thompson LW . Treatment of major depressive disorder in older adult outpatients with brief psychotherapies. Psychotherapy: Theory, Research, and Practice 1982;19:482–90.

Beutler L Scogin F Kirkish P Schretlen D Corbishley A , Hamblin D, and others. Group cognitive therapy and alprazolam in the treatment of depression in older adults. J Consult Clin Psychol 1987;55:550–6.

Thompson LW Gantz F Florsheim M Delmaestro S Rodman J , Gallagher-Thompson D, and others. Cognitive-behavioral therapy in affective disorders in the elderly. In: Meyers WA , editor. New techniques in the psychotherapy of older patients. Washington (DC): American Psychiatric Press; 1991. p 3–19.

Lidren DM Watkins PL Gould RA Clum GA Asterino M Tulloch HC . A comparison of bibliotherapy and group therapy in the treatment of panic disorder. J Consult Clin Psychol 1994;62:865–9.

Teich MJ Lucas JA Schmidt NB Hanna HH Jaimez TL Lucas RA . Group cognitive-behavioral treatment, panic disorder. Behav Res Ther 1993;31:279–87.

Belfer PL Munoz LS Schacter J Levendusky PG . Cognitive-behavioral group psychotherapy for agoraphobia and panic disorder. Int J Group Psychother 1995;45:185–206.

Scholing A Emmelkamp PMG . Exposure with and without cognitive therapy for generalized social phobia: Effects of individual and group treatment. Behav Res Ther 1993;31:667–81.

Fals-Stewart W Marks AP Schafer J . A comparison of behavioral group therapy and individual behavior in treating obsessive-compulsive disorder. J Nerv Ment Dis 1993;181:189–93.

Osterheld JR McKenna MS Gould NB . Group psychotherapy in bulimia: A critical review. Int J Group Psychother 1987;37:163–84.

Wilfley DE Agras S Telch CF Rossiter EM Schneider JA , Golomb AG, and others. Group cognitive-behavioral therapy and group interpersonal psychotherapy for the non-purging bulimic individual: A controlled comparison. J Consult Clin Psychol 1993;61:296–305.

Leszcz M . Towards a model of integrated group therapy for the elderly. Int J Group Psychother 1990;42:379–98.

Roth BE Stone WN Kibel HD . The difficult patient in group psychotherapy. In: Roth BE Sone WN Kibel HD , editors. American Group Psychotherapy Association Monograph 6. Madison (CT): International University Press; 1990.

Marziali EA Munroe-Blum H . Interpersonal group psychotherapy for borderline personality disorder. New York: Basic Books; 1994.

Linehan MM Armstrong HE Suarez A Allmon D Heard HL . Cognitive-behavioural treatment of chronically parasuicidal borderline patients. Arch Gen Psychiatry 1991;48:1060–5.

Linehan MM . Cognitive behavioural treatment of borderline patients. New York: Guilford Press; 1993.

Budman SH Denby A Soldz S Merry J . Time-limited group psychotherapy for patients with personality disorders: Outcomes and drop-outs. Int J Group Psychother 1996;46:357–77.

Marmar CR Horowitz MJ Weiss DS Wilner NR Kaltreider NB . A controlled trial of brief psychotherapy and mutual-help group treatment of conjugal bereavement. Am J Psychiatry 1988;145:203–9.

Koller P Marmar CR Kanas N . Psychodynamic group treatment of posttraumatic stress disorder in Vietnam veterans. Int J Group Psychother 1992;42:225–46.

Van der Kolk B . Groups for patients with histories of catastrophic trauma. In: Alonso A Swiller HI , editors. Group therapy in clinical practice. Washington (DC): American Psychiatric Press; 1993. p 289–305.

Vanicelli M . Group therapy aftercare for alcoholic patients. Int J Group Psychother 1988;38:337–52.

Leszcz M Goodwin PJ . The rationale and foundations of group psychotherapy for women with metastatic breast cancer. Int J Group Psychother 1998;48:245–274.

Wesley S Waring EM . A critical review of marital therapy outcome research. Can J Psychiatry 1996;41:421–8.

Alexander JF Holtzworth-Monroe A Jameson P . The process and outcome of marital and family therapy: Research review and evaluation. In: Bergin AE Garfield SL , editors. Handbook of psychotherapy and behaviour change. 4th ed. New York: John Wiley & Sons; 1994.

Johnson SM Greenberg LS . Differential effects of experiential and problem-solving interventions in resolving marital conflict. J Consult Clin Psychol 1985;53:175–84.

Beach SRH O'Leary KD . Treating depression in the context of marital discord: Outcome and predictors of response for marital therapy vs. cognitive therapy. Behavior Therapy 1992;23:507–28.

Jacobson NS Dobson K Fruzzetti AE Schmaling KB Salusky S . Marital therapy as a treatment for depression. J Consult Clin Psychol 1991; 59:547–57.

O'Leary KD Beach SRH . Marital therapy: A viable treatment for depression and marital discord. Am J Psychiatry 1990;147:183–6.

Amow BA Taylor CB Agras WS Telch MJ . Enhancing agoraphobia treatment by changing couple communications patterns. Behavioural Therapy 1985;16:452–6.

Barlow DH O'Brien GT Last CG . Couples treatment of agoraphobia. Behavioural Therapy 1984;15:41–8.

O'Farrell TJ Cutter HSG Floyd FJ . Evaluating behavioural marital therapy for male alcoholics: Effects on marital adjustment and communication from before to after treatment. Behaviour Therapy 1985;16:147–67.

McCrady BS Stout R Noel N Abrams D Nelson HF . Effectiveness of three types of spouse-involved behavioural alcoholism treatment. British Journal of Addiction 1991;86:1415–24.

Hawton K Catalan J Fagg J . Low sexual desire: Sex therapy results and prognostic factors. Behav Res Ther 1991;29:217–44.

Anderson SA Atilano RB Bergen LP Russell CS Jurich AP . Dropping out of marriage and family therapy: Intervention strategies and spouses' perceptions. American Journal of Family Therapy 1985;13:39–54.

Allgood SM Crane DR . Predicting marital therapy dropouts. J Marital Fam Ther 1991;17:73–9.

Goldstein MJ Miklowitz DJ . Effectiveness of psychoeducational family therapy in the treatment of schizophrenic disorders. J Marital Fam Ther 1995;21:361–76.

Keitner G Miller IW Epstein NB Bishop DS Fruzzetti AE . Family functioning and the course of major depression. Compr Psychiatry 1987;28:54–64.

Clarkin JF Glick ID Haas CL Spencer JH Lewis AB , Peyser J, and others. A randomized clinical trial of inpatient family intervention, V: Results for affective disorders. J Affect Disord 1990;18:17–28.

Waring EM Patton D . Marital intimacy and depression. Br J Psychiatry 1984;145:641–4.

Russell GFM Szmukler GI Dare E Eisler I . An evaluation of family therapy in anorexia nervosa and bulimia nervosa. Arch Gen Psychiatry 1987;44:1047–56.

Robin AL Siegal PT Koepke T Moye AW Tice S . Family therapy versus individual therapy for adolescent females with anorexia nervosa. J Dev Behav Pediatr 1994;15:111–6.

Roy R Frankel H . How good is family therapy? A reassessment. Toronto: University of Toronto Press; 1995.

Pinsof WM Wynne LC . The efficacy of marital and family therapy: An empirical overview, conclusions and recommendations. J Marital Fam Ther 1995;21:585–610.

Henggeler SW Borduin CM Melton GB Mann BJ Smith LA . Effects of multisystemic therapy on drug use and abuse in serious juvenile offenders: A progress report from two outcome studies. Family Dynamics in Addictions Quarterly 1995;40–51.

Gurman AS Kniskern DP . Handbook of family therapy. New York: Brunner/Mazel; 1981.

Kaye NS Soreff SM . The psychiatrist's role, responses and responsibilities when a patient commits suicide. Am J Psychiatry 1991;148:739–43.

Brownstein M . Contacting the family after a suicide. Can J Psychiatry 1992;37:208–12.

Lebow J . Research on assessing outcome in couple and family therapy. American Family Therapy Academy Newsletter 1995;64:43–5.

Lebow J Gurman AS . Research assessing couple and family therapy. Annu Rev Psychol 1995;46:27–57.

Gurman AS Kniskern DP . Deterioration in marital and family therapy: Empirical, clinical and conceptual issues. Fam Process 1978;17:3–20.

Coleman S , editor. Failures in family therapy. New York: Guilford Press; 1985.

Edelbrock C Costello AJ . Structured psychiatric interviews for children. In: Rutter M Tuma AH Lann IS , editors. Assessment and diagnosis in child psychopathology. New York: Guilford Press; 1988.

Puig-Antich J Ryan N . The Schedule For Affective Disorders And Schizophrenia For School-Aged Children (Kiddie-SADS). 4th ed. Pittsburgh (PA): Western Psychiatric Institute and Clinic; 1986.

Kemberg PF Chazan SE . Children with conduct disorders: A psychotherapy manual. New York: Basic Books; 1991.

Alexander JF Parsons BV . Functional family therapy. Monterey (CA): Brooks/Cole; 1982.

Home AM Sayger TV . Treating conduct and oppositional disorders in children. Elmsford (NY): Pergamon Press; 1990.

Forehand R McMahon RJ . Helping the noncompliant child: A clinician's guide to parent training. New York: Guilford Press; 1981.

Michelson L Sugai DP Wood RP Kazdin AE . Social skills assessment and training with children. New York: Plenum Press; 1983.

Muir E . Watching, waiting, and wondering: Applying psychoanalytic principles to mother-infant intervention. Infant Mental Health Journal 1992;13:319–28.

Dulcan MK . Brief psychotherapy with children and their families: The state of the art. Journal of the American Academy of Child Psychiatry 1984;23:544–51.

Kazdin AE Bass D Ayers WA Rodgers A . Empirical and clinical focus of child and adolescent psychotherapy research. J Consult Clin Psychol 1990;58:729–40.

Fonagy P Target M . Predictors of outcome in child psychoanalysis: A retrospective study of 763 cases at the Anna Freud Centre. J Am Psychoanal Assoc 1996;44:27–77.

Brown J . A review of meta-analyses conducted on psychotherapy outcome research. Clin Psychol Rev 1987;7:1–23.

Casey RJ Berman JS . The outcome of psychotherapy with children. Psychol Bull 1985;98:388–400.

Weisz JR Weiss B Alicke MD Klotz ML . Effectiveness of psychotherapy with children and adolescents: Meta-analytic findings for clinicians. J Consult Clin Psychol 1987;55:542–9.

Weisz JR Weiss B . Assessing the effects of clinic-based psychotherapy with children and adolescents. J Consult Clin Psychol 1989;57:741–6.

Weisz JR Donenberg GR Han SS Weiss B . Bridging the gap between laboratory and clinic in child and adolescent psychotherapy. J Consult Clin Psychology 1995;63:688–701.

Patterson GR Reid JB Dishion TJ . Antisocial boys. Eugene (OR): Castalia; 1992.

Lewinsohn PM Clarke GN Hops H Andrews J . Cognitive-behavioral treatment for depressed adolescents. Behavior Therapy 1990;21:385–401.

Hazelrigg MD Cooper HM Borduin CM . Evaluating the effectiveness of family therapies: An integrative review and analysis. Psychol Bull 1987;101:4228–42.

Markus E Lange A Pettigrew TF . Effectiveness of family therapy: A metaanalysis. Journal of Family Therapy 1990;12:205–21.

Goldstein MJ Rodnick EH Evans JR Philip RA May RA Steinberg MR . Drug and family therapy in the aftercare of acute schizophrenics. Arch Gen Psychiatry 1978;35:1169–77.

Leff J Kuipers L Berkowitz R Eberlein-Vries R Sturgeon D . A controlled trial of social intervention in the families of schizophrenia patients. Br J Psychiatry 1982;141:121–34.

Russell GFM Szmukler G Dare C Eisler I . An evaluation of family therapy in anorexia nervosa and bulimia nervosa. Arch Gen Psychiatry 1987;44:1047–56.

Eisenstadt TH Eyberg S McNeil CB Newcomb K Funderburk B . Parent-child interaction therapy with behavior problem children: Relative effectiveness of two stages and overall treatment outcome. Journal of Clinical Child Psychology 1993;22:42–51.

McMahon R . Diagnosis, assessment, and treatment of externalizing problems in children: The role of longitudinal data. J Consult Clin Psychol 1994;62:901–17.

Alexander JF . Phases of family therapy process: A framework for clinicians and researchers. In: Wynne LC , editor. The state of the art in family therapy research. New York: Family Process Press; 1988.

Henggeler SW Borduin CM Melton GB Mann BJ Smith LA . Effects of multi-systemic therapy on drug use and abuse in serious juvenile offenders: A progress report from two outcome studies. Family Dynamics in Addictions Quarterly 1991;1:40–51.

Weisz JR Weiss B Han SS Granger DA Morton T . Effects of psychotherapy with children and adolescents revisited: A meta-analysis of treatment outcome studies. Psychol Bull 1995; 117:450–68.

Howard KI Kopta SM Krause MS Orlinsky DE . The dose-effect relationship in psychotherapy. Am Psychol 1986;41:159–64.

Kopta SM Howard KI Lowry JL Beutler LE . Patems of symptomatic recovery in psychotherapy. J Consult Clin Psychol 1994;62:1009–16.

Shefler G Dasberg H Ben-Shakhar G . A randomized controlled outcome and follow-up study of Mann's time-limited psychotherapy. J Consult Clin Psychol 1995;63:585–93.

Svartberg M Seltzer MH Stiles TC Khoo ST . Symptom improvement and its temporal course in short-term dynamic psychotherapy. J Nerv Ment Dis 1995;183:242–8.

Lambert MJ Bergin AE . The effectiveness of psychotherapy. In: Bergin AE Lambert MJ , editors. Handbook of psychotherapy and behaviour change. 4th ed. New York: John Wiley & Sons; 1994.

Robinson LA Bergan JS Neimeyer RA . Psychotherapy for the treatment of depression: A comprehensive review of controlled outcome research. Psychol Bull 1990;100:30–49.

Sloane RB Staples FR Cristol AH Yorkston NJ Whipple K . Short-term analytically oriented psychotherapy vs behaviour therapy. Cambridge (MA): Harvard University Press; 1975.

Elkin L Shea MT Watkins JT Imber SD Sotsky SM , Collins JF, and others. NIMH treatment of depression collaborative research program: General effectiveness of treatments. Arch Gen Psychiatry 1989;46:971–83.

Shapiro DA Barkham M Hardy GE Reynolds S Rees A Startup M . Effects of treatment duration and severity of depression on the effectiveness of cognitive/behavioral and psychodynamic/interpersonal psychotherapy. J Consult Clin Psychol 1994;62:522–34.

Smith ML Glass GV . Meta-analysis of psychotherapy outcome studies. Am Psychol 1977;32:752–60.

Crits-Christoph P . The efficacy of brief dynamic psychotherapy: A meta-analysis. Am J Psychiatry 1992;149:151–8.

Diguer L Luborsky L Singer B Luborsky E Dicter D Schmidt KA . The efficacy of dynamic psychotherapy vs other psychotherapies: A meta-analysis. Paper presented at the meeting of the Society for Psychotherapy Research. Pittsburg, PA. 1993.

Tasca G . Psychotherapy research: A review and current trends. Paper presentation. Research Day, Royal Ottawa Hospital. Ottawa, Ontario. 1996.

Crits-Christoph P Cooper A Luborsky L . The accuracy of therapists' interpretations and the outcome of dynamic psychotherapy. J Consult Clin Psychol 1988;56:490–5.

Strupp HH Hadley SW . Specific vs nonspecific factors in psychotherapy: A controlled study. Arch Gen Psychiatry 1979;36:1125–36

Piper WE McCallum M Azim HFA Joyce AS . Understanding the relationship between transference interpretation and outcome in the context of other variables. Am J Psychother 1993;47:479–93.

Piper WE Azim HFA Joyce AS McCallum M Nixon G Segal PS . Quality of object relations versus interpersonal functioning as predictors of therapeutic alliance and psychotherapy outcome. J Nerv Ment Dis 1991;179:432–8.

Luborsky L Crits-Christoph P . A relationship pattern measure: The core conflictual relationship theme. Psychiatry 1989;52:250–9.

Horowitz MJ . Relationship schema formulation: Role-relationship models and intrapsychic conflict. Psychiatry 1989;52:260–74.

Horowitz LM Rosenberg SE Bartholomew K . Interpersonal problems, attachment styles and outcome in brief dynamic psychotherapy. J Consult Clin Psychol 1993;61:549–60.

West M Sheldon A Reiffer L . Attachment theory and brief psychotherapy: Applying current research to clinical interventions. Can J Psychiatry 1989;34:369–74.

Banon E Perry JC Ianni F . The effectiveness of psychotherapy for personality disorders. Presented at the International Society for the Study of Personality Disorders. 1995. Dublin, Ireland.

Perry JC . Longitudinal studies of personality disorders. J Personality Disord 1993;Suppl Spring:63–85.

Linehan MM . Report for the use of the mental health work group. 1993. White House Task Force for National Health Reform.

Linehan MM . Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press; 1993.

Linehan MM Armstrong HE Suaraz A . Cognitive-behavioral treatment of chronically parasuicidal borderline patients. Arch Gen Psychiatry 1991;48:1060–4.

Monsen J Oldland T Fugi A Daae E Eilertsen DE . Personality disorders: Changes and stability after intensive psychotherapy focusing on affect consciousness. Psychotherapy 1995;5:33–48.

Luborsky L Diguer L Luborsky E Singer B Dickter D Schmidt KA . The efficacy of psychodynamic psychotherapy: Is it true that “everyone has won and all must have prizes”? In: Miller NE Luborsky L Barber JP Docherty JP , editors. Psychodynamic treatment research: A handbook for clinical practice. New York: Basic Books; 1993.

Stevenson J Meares R . An outcome study of psychotherapy for patients with borderline personality disorder. Am J Psychiatry 1992;149:358–62.

Monsen JT Oldland T Faugli A Daae E Eilersten DE . Personality disorders: Changes and stability after intensive psychotherapy focusing on affect consciousness. Psychotherapy Research 1995;5:33–48.

Shea T Elkin I Imber S Sotsky S Watkins J , Collins J, and others. Course of depressive symptoms over follow-up: Findings from the National Institute of Mental Health treatment of depression collaborative research program. Arch Gen Psychiatry 1992;49:782–7.

Klerman G Weissman M . The course, morbidity and costs of depression. Arch Gen Psychiatry 1992;49:831–4.

Horowitz M Mannar C Weiss D Kaltreider N Wilner N . Comprehensive analysis of change after brief dynamic psychotherapy. Am J Psychiatry 1986;143:582–9.

Blatt SJ Quinlan DM Pilkonis PA Shea MT . Impact of perfectionism and need for approval on the brief treatment of depression: The National Institute of Mental Health Treatment of Depression Collaborative Research Program revisited. J Consult Clin Psychol 1995;63:125–32.

Blatt SJ Ford R . Therapeutic change: An object relations perspective. New York: Plenum Press; 1994.

Selgiman MEP . The effectiveness of psychotherapy: The Consumer Reports study. Am Psychol 1995;50:965–74.

Gabbard G Lazar S Hornberger J Spiegel D . The economic impact of psychotherapy: A review. Am J Psychiatry 1997;154:147–55.

Verbosky LA Franco KN Zrull JP . The relationship between depression and length of stay in the general hospital patient. J Clin Psychiatry 1993;54:177–81.

Zients A . Chief of Utilization Review for the CHAMPUS Program. Report prepared for the use of the Mental Health Work Group, White House Task Force for National Health Care Reform. 1993.

Duehessen A Jorswiek E . An empirical and statistical inquiry into the therapeutic potential of psychoanalytic treatment. Nervenarzt 1965;36:166–9.

Andrews G . Private and public psychiatry: A comparison of two health care systems. Am J Psychiatry 1989;146:881–6.

Lieberman JA Rush AJ . Redefining the role of psychiatry in medicine. Am J Psychiatry 1996;153:1388–97.

Pardes H . A changing psychiatry for the future. Am J Psychiatry 1996;153:1383–7.

American Psychiatry Association. Position statement on medical psychotherapy. Am J Psychiatry 1995; 152:17.

Howard KI Orlinsky DE Lueger RJ . Clinically relevant outcome research in individual psychotherapy. New models guide for the researcher and clinician. Br J Psychiatry 1994;165:4–8.

Persons JB Gross JJ Etkin MS Madar SK . Psychodynamic therapists' reservations about cognitive behaviour therapy: Implications for training and practice. J Psychother Pract Res 1996;5:202–12.

Albeniz A Holmes JC . Psychotherapy integration: Its implications for psychiatry. Br J Psychiatry 1996;169:563–70.

Sturm R Wells KB . How can care for depression become more cost-effective? JAMA 1995;273:51–8.

Reynolds CF III Frank E Percel JM Mazumdar S Kupfer DJ . Maintenance therapies for late-life recurrent major depression: Research and review circa 1995. International Psychogeriatrics 1995;7(Suppl):27–39.

Norcross JC Goldfried MR . Handbook of psychotherapy integration. New York: Basic Books; 1992.

Barber JP . Efficacy of short-term dynamic psychotherapy. J Psychother Pract Res 1994;3:108–21.

Shea MT Elkin I Imber SD Sotsky SM Watkins JT , Collins JF, and others. Course of depressive symptoms over follow-up. Findings from the National Institute, Mental Health Treatment of Depression Collaborative Research Program. Arch Gen Psychiatry 1992;49:782–7.

Doidge N Simon B Gillies LA Ruskin R . Characteristics of psychoanalytic patients under a nationalized health plan: DSM-IIIR diagnoses, previous treatment and childhood trauma. Am J Psychiatry 1994;151:586–90.

Dies RR . Research on group psychotherapy: Overview and clinical applications. In: Alonso A Swiller HI , editors. Group therapy in clinical practice. Washington (DC): American Psychiatric Press; 1993. p 473–518.

Seligman MEP . The effectiveness of psychotherapy – The Consumer Reports Study. Am Psychol 1995;50:965–74.

Levy J . The borderline patient: Psychotherapeutic stalemates. In: Silver D Rosenbluth M , editors. Handbook of borderline disorders. Madison (CT): International University Press; 1994. p 307–34.

Gabbard GO . An overview of countertransference with borderline patients. J Psychother Pract Res 1993;2:7–18.

Cooper H Wittenberg E . The “bogged down” treatment: A remedy. Contemporary Psychoanalysis 1985;21:27–41.

Lambert MJ Bergin AE . The effectiveness of psychotherapy. In: Bergin AE Garfield SL , editors. Handbook of psychotherapy and behavior change. 4th ed. New York: John Wiley & Sons; 1994. p 143–89.

Krupnick JL Pincus HA . The cost-effectiveness of psychotherapy: A plan for research. Am J Psychiatry 1992;149:1295–305.

Kamlet MS Paul N Greenhouse J Kupfer D Frank E Wade M . Cost utility analysis of maintenance treatment for recurrent depression. Controlled Clinical Trials 1995;16:17–40.

Frank RG . Cost-benefit evaluations in mental health: Implications for financing policy. Advances in Health Economics and Health Services Research (JAI Press) 1993;14:1–16.