Duration of treatment under a clinical or counseling psychologist is similar to that of a social work counselor. The best way to proceed is to ask prospective therapists how long they believe it will be necessary to see them. Most professionals will be open and candid; if the client's goals are specific and lend themselves to "brief" therapy, a psychologist will make this clear. And, as we have already observed, much depends on the type of therapy practiced by the psychologist. Behavioral therapies tend to be of shorter duration; psychoanalysis is longer-term. In between these there are, as we will see, many therapies that have different emphases, methods, and goals. PSYCHIATRISTS ORIENTATION AND TRAINING Before they specialize in psychiatry, psychiatrists receive the {45} training required of any physician. After this, there is specialized course work followed by a period of psychiatric internship. The educational background of psychiatrists enables them sometimes to identify physical bases for emotional difficulties. A later chapter discusses this growing area of awareness. Until fairly recently, the therapeutic training of psychiatrists emphasized almost exclusively the approach of psychoanalysis. Psychoanalysis developed within a medical context: Freud was a physician, and his outlook was influenced by his medical orientation. His approach was therefore felt to be the special province of psychiatric medicine. Eventually, as we have already noticed, the methods of psychoanalysis came to be used by psychologists and some social workers. But for a long period, analysis was the primary and exclusive focus of medical psychiatry. The psychoanalytical orientation still dominates much psychiatry, and many psychiatrists in private practice use psychoanalysis as their therapy of choice. However, there has been a general broadening of the perspective of psychiatrists. Other approaches to psychotherapy are increasingly being used by psychiatrists. Cognitive therapy is important among these; we will discuss its purpose and methods later. Psychiatrists are the only therapists who may prescribe medication, and some of the most important recent advances in psychiatry have come in this area. Many emotional problems appear to have a biochemical basis. Many forms of anxiety, panic disorders, and depression respond well to the growing family of psychopharmaceutical drugs. Other emotional difficulties, including alcohol and drug abuse, can be moderated by pharmaceutical therapy. Psychiatrists, then, can be especially helpful in these ways: * to provide a medical evaluation for complaints that sometimes have a physical basis * to give assistance especially by means of psychoanalysis and by means of an increasing number of alternative therapies * to help patients with medication to acquire a degree of emotional equilibrium that will allow them to begin to solve personal problems so that, in time, they may no longer require medication