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History and Psychiatry's Present State of Transition

David F. Musto, MD
Arch Gen Psychiatry. 1970;23(5):385-392. doi:10.1001/archpsyc.1970.01750050001001.
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AMERICAN psychiatrists are losing a clear sense of their professional role. No longer is it as evident that the most valued role is psychoanalytically oriented psychotherapy with individual patients. Concern with the individual is now shared with the behavior of groups. Psychotherapy both with individuals and with groups has moved toward crisis intervention and correction of behavior styles in the "here and now" as opposed to the establishment of cause and effect relationships through a study of the patient's past history.

The emergence of the mental health center is an added step away from past orientation. By its very nature, such a form of "community psychiatry" makes necessary a departure from prolonged one-to-one therapy, at least as practiced by lengthily trained specialists, to briefer encounters with one or many persons. It frequently places the psychiatrist in an administrative role, substantially removed from individual psychotherapy.


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