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Domains of Discussion in Psychotherapy: What Do Patients Really Want?

Little quantitative data exist on what the content of non-manualized psychotherapy in contemporary clinical settings actually is, and what patients and clinicians think it ought to be. This descriptive pilot study identified potential content areas to address in psychotherapy, quantified the relative importance of these domains of discussion to patients vs. clinicians, and attempted to measure the frequency with which these domains are actually addressed in current clinical practice at two academic, urban hospitals. The content areas assessed included health habits, avocations, work, family, friendships, community involvement, spirituality/religion, finance, sexuality, political activities, educational and cultural pursuits, and ethnicity/race. Overall, clinicians and patients agreed about the relative personal importance and importance to treatment of these content areas, and they rated work, family, friends, and sexuality as the most important domains of discussion for psychotherapy. Also, this sample of patients did not feel that clinicians undervalue the importance of religion and spirituality.