Dozens of different psychotherapies address innumerable different patient problems (1). With the possible exception of a few specific behavioral and cognitive-behavioral methods applied to several discrete problems, rigorous proof of psychotherapy’s effectiveness does not exist. However, much nonrigorous but very compelling experience indicates that various psychotherapies can help many patients—almost every therapist educates, gets patients to voice their concerns, encourages them to try out new behaviors, etc. Unfortunately, specific indications for specific therapies generally are not available. Some experts argue that many supposedly different psychotherapeutic methods are actually quite similar in practice (2). Other experts suggest that trained therapists using specific techniques may be less important for the patient’s improvement than the therapist’s personal characteristics of accurate empathy, nonpossessive warmth, and genuineness. Studies comparing the effectiveness of empathic trainees with that of experienced therapists have often found only modest differences in outcome (3).

Psychotherapy is a field without a high level of scientific objectivity. However, it is clear that some patients benefit from such care and that an essential ingredient to that care is a good patient-therapist relationship built on trust and genuine interest. Psychotherapy is an art, and a good therapist does make a difference. In general, one needs to find a therapy that is a “good fit” for the patient (i.e., the patient is comfortable with the therapist and the type of therapy). Patients resist psychotherapy unless they feel that it is both tolerable and likely to be of benefit; the dropout rate from therapy can be quite high. Individual treatment is the most common form of psychotherapy and comes in endless variations; group, family, and marital therapy are in widespread use as well (4).