Determining Appropriate Treatments

The process of identifying appropriate treatments requires that interviewers consider the following information:

Client problem and empirical research: Depending on client problems and diagnosis, there may be published outcome research outlining effective treatment approaches. Unfortunately, in most cases, research does not definitively indicate which treatment approach is most effective with specific client problems (Castonguay, 2000; M. E. P. Seligman & Levant, 1998). Although some guidelines are available (e.g., cognitive therapy for bulimia and panic disorder; behavior therapy and medications for agoraphobia; interpersonal therapy, cognitive-behavioral therapy, and medications for unipolar depression), clear empirical treatment mandates have yet to be established for most mental disorders.

Clientproblem and treatment literature: Reputable scholarly journals and treatment books in clinical psychology, clinical social work, counseling, and psychiatry provide important treatment information in the form of case studies, short reports, outcome studies, and reasoned theoretical discussions regarding treatment choices. Therapist skill or expertise: The treatment plan must use an approach in which the therapist has education, training, experience, and previous or current supervision. For example, if the therapist has no training or experience in a particular treatment technique (e.g., hypnosis or eye movement desensitization reprocessing), that technique should not be employed.

Therapist preference: Mental health professionals vary in their theoretical orientations. Some adhere to psychoanalytic treatment formulations; others are behavioral in their approach to treatment. Although it may be inappropriate at times, clients are sometimes offered whatever treatment approach a given therapist prefers. Client preference: Given the choice, clients may prefer one form of treatment over another. For example, some clients struggling with maladaptive habits prefer short-term, specific behavioral therapy to successfully change the habit. Others prefer depth work, seeking understanding of the purpose the habit served in their lives, while still others prefer medication treatment. Client treatment preference can have a strong influence on client cooperation or compliance with treatment.

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