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Martindale, B. (1993). The Future of Analytical Psychotherapy: What do We Profess?. Free Associations, 4(1):105-113.

(1993). Free Associations, 4(1):105-113

The Future of Analytical Psychotherapy: What do We Profess?

Brian Martindale

Psychotherapy and the NHS

Perhaps I could start my presentation by telling you about the setting in which I work, so that you will immediately see my bias.

I work part-time in the National Health Service as a consultant psychiatrist specializing in psychotherapy; most of this time is spent at an NHS out-patient psychotherapy clinic, but one day each week I work and teach in a psychiatric hospital. I also work as a psychoanalyst in private practice, and I am on the professional committee of the Lincoln Clinic and the Institute for Psychotherapy. I am therefore in both the independent and the public sectors, and have been for a number of years.

The hospital where I spend the one day each week is a 120-bed psychiatric unit, with day-hospital capacities for a further hundred patients and a large out-patient department. There are many more than a hundred staff working there; I am the only member employed as a psychotherapist, and — I emphasize — I work there only one day a week!

In many parts of the country, district health authorities have no psychotherapists at all. This is so even within a few miles of London. The North West Thames region has districts without a psychotherapist — medical or non-medical — and I am sure the same is true of the other regional health authorities around London.

Psychiatric Training and Psychotherapy

It is not necessary for a psychiatrist in training in Britain to gain any clinical training in psychotherapy, let alone basic counselling skills.

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