In today's New York Times, there is a story by Benedict Carey on whether psychotherapy methods should be subject to scientific research. The Times treats this as news, but the debate has been going on for decades. It is fair to say that the debate has intensified during the last twenty years, however, because of the advent of managed care and the increased use of antidepressant medications.

It makes sense to require that a psychotherapist know which methods have successfully cured certain disorders in most people. It also makes sense that new treatments or combinations of treatments be tracked to determine their efficacy.

But, as Carey's article points out, is isn't that simple. For example, cognitive/behavioral therapy is all the rage for the treatment of most depressive disorders and most anxiety disorders, but it is sometimes not enough to use thought- and behavior-changing methods. Psychodynamic therapy--treatment that seeks to heal early psychological wounds--is needed before some people can get better. Such treatment may also prevent relapse.

And the old-fashioned concepts of validation and unconditional positive regard are major components in psychological healing. Sometimes people just need to be heard.

There are people quoted in the Times article who call for a middle ground: the continued use of research tempered by acceptance that psychotherapy is an art as much as it is a science. A therapist who is accepting and caring but has few skills will do some good, but will be lost when it comes to diagnosing and treating disorders. A highly skilled therapist who cannot feel empathy or cannot see the client's "big picture" may be able to remove symptoms, but she probably cannot heal.

I have been pondering this issue for many years; I am a psychotherapist.