A Comparative Study of Results in Neurotic Patients Treated by Two Different Methods

Abstract

In the outpatient department of the Maudsley Hospital, patients are seen in the first instance by members of the medical staff of consultant status at the diagnostic clinics, to which they are referred from a variety of sources, by far the greater number coming from general practitioners. From the diagnostic clinics there are several possible disposals, one of which is referral for outpatient treatment of a more prolonged and elaborate type, as opposed to treatment at a purely supportive level with brief interviews concerned with environmental factors and immediate practical problems. The more prolonged and elaborate outpatient treatment is under the supervision of a physician of consultant status with a Freudian analytical training and strong interest in psychotherapeutic methods. It is carried out by registrars under his guidance and may consist either of individual or group sessions, or of a mixture of the two, as he directs. His general outlook is well known (Foulkes, 1948). It has been a constant source of difficulty that the number of patients referred for this type of outpatient treatment has been greater than the resources of the hospital could manage, with the consequent development of long waiting lists and of the necessity for making awkward decisions with regard to priorities.