Treatment in the seventies: a decade of refinement

In the treatment of mental disorders, the 1970s was a decade of increasing refinement and specificity of existing treatments. There was increasing focus on the negative effects of various treatments, such as deinstitutionalization, and a stronger scientific basis for some treatments emerged. For instance, the field of somatic treatments saw a greater and more sophisticated use of lithium, accompanied by concern about possible side-effects of goiter and renal changes; greater specificity of the anti-depressants; more widespread monitoring of plasma levels; and growing attention to the tardive dyskinesias. In psychotherapy there was a change toward more eclectic and pragmatic approaches, as evidenced by the combining of behavioral and dynamic techniques and an increased use of short-term psychotherapies, plus a concern with efficacy. Ties between the mental health care and general health care fields became stronger, as evidenced by the growth of consultation-liaison programs, the often combined delivery of mental and physical health services, and advances in behavioral medicine. The authors expect such trends to continue in the 1980s, along with a greater rigor in diagnostic systems and an increased focus on prevention.