Ever since Freud created psychoanalysis over 100 years ago, it has been popular, especially in the USA. However, biological psychiatry is now at the forefront and the emphasis is on neurosciences and pharmacotherapy. Still, the question remains, what place is there for psychotherapy in psychiatric practice? We need to be aware of the need for psychotherapy for some patients. This has been scientifically demonstrated in the study of patients with moderate and severe major depression. It has been convincingly shown that there is a place for interpersonal therapy and for cognitive behavioral therapy. Moderately depressed patients may benefit from a regimen of psychotherapy. In contrast, those with severe depression also need antidepressant medication. Because people in the Pacific Rim countries are heterogeneous, their requirements may be diverse. Asian populations need emphasis on the family as a part of the treatment team. Biological and cultural issues also enter the picture. Using the example of the flushing response, 25% of Koreans versus 50% of the Han Chinese and Japanese have the flushing response. Confucius' teachings have influenced Chinese, Koreans and Japanese for over 2000 years. The need for therapy and education is great. One solution is in primary and secondary prevention with cognitive behavioral classes such as the depression prevention course.