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The “20-minute Hour” revisited: A follow-up

Comprehensive Psychiatry
Publication Date
DOI: 10.1016/0010-440x(70)90153-7
  • Medicine


Abstract A questionnaire dealing with the use of psychotherapy by the non-psychiatrist was distributed to 50 internists who, during their residency, took part in a psychotherapy course for medical residents. Some questions addressed themselves at a retrospective evaluation of the course in which they had participated. Forty-one physicians, whose average age was 35 years and who had completed their training between 1960 and 1967, replied. The majority were in private practice. Noteworthy was a very broad spectrum of responses, indicating a considerable spread in the views and therapeutic approaches preferred by these physicians. Anywhere from 3–60 per cent of patients are seen as having a primarily psychiatric disorder, this wide range depending on the type of practice and, presumably, on the awareness and recognition by the physician of emotional factors. The majority of patients with emotional difficulties are treated by the physician himself and only a few are referred to psychiatrists. The consultative advice received from psychiatrists generally is regarded as satisfactory. Most of the emotionally upset patients treated by these internists are psychoneurotic and the most frequently employed treatment methods are psychotropic drugs with simple reassurance, or brief psychotherapy with drugs. Brief psychotherapy alone or long-term, non-intensive psychotherapy are used also, but much less often. The “20-minute Hour” is regarded as a useful approach to brief psychotherapy and approximately two-thirds of suitable patients are reported as showing a satisfactory response. Three-fourths (76%) of the physicians believe that psychotherapy is an effective form of treatment and most (85%) believe it has a useful place in the practice of internal medicine. Preference generally is for brief treatment and for a therapeutic approach emphasizing activity. Most would be interested in further postgraduate training, if readily available.

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