Philosophical issues in psychotherapy

This article aims to demonstrate the importance and inevitability of nonscientific issues in psychotherapy and psychopathology by addressing four closely related topics: the presence of a priori factors such as tacit assumptions and narrative forms; the inescapable presence of values; the way in which psychotherapy and psychopathology are partly defined by, and in turn shape, current societal and cultural outlooks; and the status of clients as agents independent of their status as objects of scientifically based healing. The way in which these factors operate is illustrated in the care of a 45-year-old woman suffering from depression, physical illnesses, and family problems. Implications for quantitative and qualitative research are suggested.