| Abstract: | We can understand the relevance of psychotherapy research for clinical practice only by considering the broader context of the psychotherapy service delivery system. Epidemiologic studies of the incidence and prevalence of emotional disturbance provide estimates of the need for services; surveys of providers and their practice patterns yield estimates of available resources to meet those needs; and studies of patient characteristics and patterns of psychotherapy utilization identify the constituencies served by the psychotherapy delivery system. From these data we know that each person in need of mental health services has available no more than an average of three treatment sessions from a mental health professional in any given year. Despite the fact that a small proportion of such individuals actually seek service, each such individual who consults the speciality mental health sector has available no more than an average of 10 treatment sessions. The most needy, particularly those lacking in education, are least likely to receive treatment in the psychotherapeutic service delivery system. Further, we argue for a clearer focus on service episodes and psychotherapy utilization through the tracking of the mental health “careers” of patients. |
