Psychotherapy in community mental health: a critical examination.

In this article I have argued that contemporary CMH practitioners have not clearly differentiated their own program goals from alternative objectives achievable through psychotherapeutic programming. The current bias toward defining treatment "success" in terms of stabilization, role performance, and maintenance in the community, obscures the fact that "mental health" is, after all, a quality of internal, emotional process as well as of behavior. I have argued that high-quality, comprehensive mental health care must therefore make optimal use of both community- and clinic-based treatment modalities, and that penetration into the system should be maintained at appropriate levels, regardless of depth or duration, as determined by a differentiated diagnostic assessment of the individual patient. Such an approach would leave the clinician freer to respond to the presenting needs of his patients than does an approach which considers it a virtue to reduce services to a minimum.