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April 1968

Subjective Change With Medical Student Therapists: I. Course of Relief in Psychoneurotic Outpatients

Author Affiliations

From the departments of Psychiatry and Behavioral Sciences (Dr. Uhlenhuth) and Statistics and Biostatistics (Dr. Duncan), Johns Hopkins University, Baltimore.

Arch Gen Psychiatry. 1968;18(4):428-438. doi:10.1001/archpsyc.1968.01740040044006

MOST PSYCHONEUROTIC patients coming for treatment are especially concerned about the distressing quality of their subjective experience in living. What counts most for the patient is the way he feels about himself and his situation, and the initiation, maintenance, and interruption of the treatment situation itself follows mainly from these feelings. Novey1 has emphasized that, with such patients, the psychiatrist, too, sets goals and evaluates progress largely in terms of the patient's inner experience, and quite properly so.

Psychoneurotic patients from the lower socioeconomic classes increasingly seek relief of distress through outpatient clinics associated with medical schools. Here they are usually assigned to trainees for their psychiatric care2(p273) which must be integrated with the requirements of the training program. The medical student's first attempts at psychotherapy perhaps offer the greatest potential for conflict with the patient's welfare.3(p153) What relief can patients ac

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