Guidelines for Identifying Therapeutic Modalities

In 1980, the Medical Board of the Karen Horney Clinic established guidelines to delineate identifying features of the therapeutic modalities of psychoanalysis, psychoanalytic psychotherapy, supportive psychotherapy, and counseling. Because the Board felt that these guidelines might be of interest to the Journal's readership, it was decided to submit them for publication. Following a general discussion of the four modalities, each modality is considered in each of seven dimensions:

1. Theoretical principles

2. Environment

3. Quality of introspection

4. Frequency and duration of sessions

5. Aims of treatment

6. The therapist-patient relationship

7. Techniques

Three propositions underlie these guidelines. First, one-to-one psychotherapies, practically speaking, form a continuum: counseling, supportive psychotherapy, psychoanalytic psychotherapy, and psychoanalysis. Second, the therapeutic modality is defined by what is actually performed in treatment, not by the training of the therapist. Third, the approaches described below follow the tenets of the Karen Horney theory of neurosis as taught at the American Institute for Psychoanalysis. This in no way should be construed as a denial of the consistency and effectiveness of approaches taught elsewhere.