Psychotherapy Standards Of Care

I was pleased to be asked to do a series on Standards of Care. This is the first of series of columns on suggested Standards in Psychotherapy in Primary Care Medicine. I hope you enjoy the column and find it interesting.

My overall objective is to open up, and contribute to, an ongoing discussion and development of possible Standards of Care for medical professionals practicing psychotherapy. My interest in this area comes from multiple sources. As someone trained in various forms of psychotherapy (psychoanalytic, interpersonal, and group psychotherapy), I have always sought the true essence of therapy. As a mentor and a trained supervisor in Balint group work, my central interest has been to learn the core skills, roles, and therapeutic

The standard of care could be described as the qualities and conditions that exist (or should exist) in a particular mental health service that a reasonable and prudent practitioner follows. The standard of care, therefore, guides physicians who provide professional psychotherapy services by specifying and requiring a minimum standard of practice. Thus, it is defined by what our professional peers would do and consequently determined by professional consensus. The standard is based on community and professional [practicesevidence . As such, professionals are held to the same expectations as others of the same profession or discipline who hold comparable qualification in similar localities (Zur,

The standard is determined by a variety of factors, such as: the setting in which therapy takes place ; the psychotherapeutic modality that is employed; the stage of psychotherapy; the history of the problem; cultural factors ;and so on. Of course, patient factors such as chief complaints or presenting problems must also be taken into consideration. But even though the standard is an “ideal”, it is not an ideal of perfection; rather, it is what a regular, prudent and reasonable practitioner would do. Hence, as one of the core ideas of “standard of care”, simply making an error in judgment or making a mistake does not necessarily () put a psychotherapist below the standard of