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Operational Spectrum of Psychotherapeutic Process

HERBERT SPIEGEL, MD; NATALIE SHAINESS, MD
Arch Gen Psychiatry. 1963;9(5):477-488. doi:10.1001/archpsyc.1963.01720170051009.
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—Whoever aspires to understand man, must throw overboard all immobile concepts and learn to think in ever-shifting terms. —Ortega y Gasset

Problem  We start by focusing on four dissonant areas in the broad field of psychiatric therapy. (1) What is the meaning of the apparent effectiveness of the many and diverse therapeutic approaches, ranging from psychoanalysis to psychotherapy, to drug therapy, to biological therapy, to counseling, and to placebo effect? (2) Are therapy goals interchangeable with research goals? (3) Does classical nosology, which once structured the psychiatric discipline, still have the same usefulness today in the light of our expanded body of knowledge? (4) Does the tendency to therapeutic specialization permit the best selection from a wide range of therapies for the specific patient?

Proposal  In an effort to cope with these challenging issues, we propose a theoretical framework which (1) acknowledges that

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