Long-term psychotherapy and informed consent.

Many long-term psychotherapies begin without sufficient attention to an informed-consent process. Failure to obtain informed consent may leave patients ill prepared to question the recommendation for long-term psychotherapy or to make alternate treatment choices. The author presents a model for informed consent to stimulate debate on ethical approaches to this type of treatment. The approach covers six areas therapists should discuss with candidates for long-term psychotherapy: the diagnostic model used and the recommendation for treatment, potential risks and benefits of treatment, availability of less expensive short-term interventions, clarification of the necessity for psychotherapy, limits of insurance coverage, and plans for measuring the patient's response to treatment. The decision to recommend long-term psychotherapy should be made through careful analysis of indications and contraindications for such treatment and in the context of informed consent.