ABSTRACT
Unfortunately, in the two decades during which psychotherapy was relegated to secondary status by the ascendancy of psychotropic medication, the definition of what constitutes psychotherapy has been muddied and left in need of clarification. Primary care physicians have been dispensing 85 percent of the mental health in the United States, mostly through prescribed medication and occasionally through counseling that accompanies the prescription. It has been a stopgap necessitated by the shortage of psychiatrists, but this counseling by primary care physicians, no matter how skillful or even appropriate, falls far short of being psychotherapy. First of all, psychotherapy is a behavioral health procedure that is therapeutic. Many things are therapeutic, but they are not a procedure: a good night’s sleep, getting a job, reading a good book, making love, going out with friends, and even prayer (the latter shown to be therapeutic in summaries by Cooper, 1995 and Cummings & Cummings, 1997). The distinction between an intervention and a procedure is obvious in medicine, but it was not seen as a distinction until Manaster and Corsini (1982) defined a behavioral care procedure.
