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May 1981

No Treatment as the Prescription of Choice

Author Affiliations

From the Department of Psychiatry, Cornell University Medical College, New York (Drs Frances and Clarkin); the Payne Whitney Clinic, New York (Dr Frances); and the Westchester Division, New York Hospital, White Plains, (Dr Clarkin).

Arch Gen Psychiatry. 1981;38(5):542-545. doi:10.1001/archpsyc.1980.01780300054006

• As part of each evaluation, the clinician must decide whether or not a psychiatric treatment is indicated. It is unfortunate that there is little available research to aid in this decision, and it has not received much attention in the clinical literature. In actual practice, therapists tend to recommend treatment almost automatically and without a careful consideration of its necessity or possible harmful effects. The research methodology and problems in defining those patients who are better off without psychiatric treatment is discussed. This group is categorized into negative responders and nonresponders and spontaneous improvers. A set of preliminary criteria for no treatment and clinical examples are provided.