Goals in Therapy

The function of the psychiatrist differs in many ways from that of any other medical specialist. With the exception of the psychiatrist in mental institutions, he does not see the most serious cases and those most in need of psychiatric help. As a rule, it is not the severity of the condition which prompts therapy, but the patient's decision to do something about it.

Furthermore, in many instances those who come for treatment do so for reasons other than to get well. Psychiatrically speaking, even the term “getting well” is ambiguous and full of complexities since the disappearance of symptoms does not necessarily imply cure.

We cannot assume either that the goal of psychiatric therapy is to satisfy the purpose for which the patient came. Almost every patient believes that he is seeking help, that he wants to get well. This may not be true. The patient may not believe that he ever will get well. Seeking psychiatric treatment is merely a demonstration of his willingness to do everything possible; but while outwardly cooperative, he is bent on proving that even the best doctor cannot help him. Or he may look for sympathy; or may wish to put somebody in his service, to solve his problems and make decisions for him. Some may seek support in their fight against others and hope that the psychiatrist will be their ally. It is obvious that the satisfaction of such demands cannot be the goal of therapy.

Differences of opinion about the nature of the therapeutic process itself confuse the issue even further. The goal of psychotherapy will vary according to the postulations of a particular school of thought. All dynamic schools consider a change in the personality structure as essential. However, no agreement has been reached, as yet, about the nature of the pathological mechanisms and, consequently, of the kind of changes which are necessary to produce mental health and cure. It is the purpose of this paper to present the Adlerian point of view, the dynamic processes interpreted