Psychotherapy is an art inl uenced by science. h e art involves develop-ing and maintaining rapport with clients; using clinical judgment in
applying therapeutic approaches supported by research, while incor-porating the therapist’s clinical knowledge and experience into treat-ment; respecting and using clients’ beliefs and intentions; and deciding
how to proceed when the research literature provides no, ambiguous, or
conl icting guidelines. h is text will review the psychotherapy research
and i ll in the gaps with personal experience to identify the factors
that contribute to change in psychotherapy and build on these fac-tors to identify an evidence-supported, theoretically eclectic approach
to psychotherapy.
Political and economic forces are dei ning psychotherapy in our soci-ety. Psychotherapy is expected to follow the medical model that dictates
that the therapist is responsible for diagnosing the patient and then
selecting and implementing “the treatment of choice” for the diagnosis.
h e patient’s primary role is to comply with the therapist’s directions.
h e treatment is expected to be evidence based, which means that several
studies using the highest standard of research (randomly assigned, dou-ble-blind, controlled clinical trials) have proved the intervention to be
ef ective for the client with that particular diagnosis