PubMed · 7928529
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G Gustafsson, A Larsson, B Magnusson. 1994. [Aurora].. https://pubmed.ncbi.nlm.nih.gov/7928529/
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This paper outlines five different forms of dialogue, which are often confused: A conversation is a conventional and not formalized dialogue between two persons on equal terms, both talking and listening to each other. An interview is a formalized (perhaps schematic) exploration with the specific aim of assessing the interviewee. A counselling and/or a consultation does not interfere with the traditional doctor-patient relationship. Counselling can be an independent profession focusing on delimited problem areas. Psychotherapy is- or should be-qualified, specific and systematic, i.e. the application of a psychological theory with the specific aim of treating a psychological disorder/disease. The therapist is in a well-defined professional role. The dialogue is subject to the primary therapeutic goal. Psychoanalysis is research of the unconscious in particular, as well as a special kind of psychological treatment. The dialogue is specifically accommodated to the psychoanalytic process.
Current services for those with mental disorders show two trends. Psychiatric services are becoming concentrated on the care of those with "severe mental illness," largely (but unjustifiably) synonymous with chronic psychosis. The retreat of psychiatry from the care of those with non-psychotic mental disorders has helped the growth of counselling services for these patients. However, there is no evidence that non-directive counselling is effective for such disorders, in contrast to the evidence for the effectiveness of other treatments that are usually delivered by psychologists or community psychiatric nurses. By retreating from the concerns of general practice and general medicine, psychiatry is returning to the days of alienism: in Victorian terms, the care of "the mad." Possible consequences include increasing expectations of psychiatric services that cannot be met, a loss of skills within psychiatry, and increased demoralisation in the mental health services.
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