Suiting therapeutic intervention to the scientific models of aetiology

There appear to be three central themes: first, the contrast between quantitative knowledge and qualitative; second, the fact that biological factors are allowed for but psychosocial are neglected; and third that we have not come very far in matching treatment to aetiological theories. Psychotherapy is really the treatment side of the psychosocial model for aetiology (ecological, developmental and learning). We should not overlook the fact that a good therapist is really a teacher who opens up new options which the patient was not previously aware of, and which aid the patient in finding his or her own coping strategies that will provide 'natural healing'. The poorer therapist may, perhaps, lean too heavily on the phenothiazines alone believing that something must be 'done to' the patient who is nothing more than a mass of circuits and chemicals, rather than enlisting his or her help to try new strategies for coping. This could all be related to our plea that we not overlook the qualitative side of things. Perhaps, we will one day quantify the interactional aspects of patients and therapists so that we know why the same therapy, e.g. cognitive behavioural, works with one therapist and not another. Of course, too often we assume that it is poor matching between the type of therapy used and the particular patient, when, in fact, it may be a poor match between therapist and patient. This is again, another example of those intangible qualitative factors that are so important.