What is a Mental Health Care Navigator?


A mental health care navigator is an individual who assists patients and families to find appropriate mental health caregivers, facilities and services. Individuals who are care navigators are often also trained therapists and doctors.


The need for mental health care navigators arises from the fragmentation of the mental health industry, which can often leave patients with more questions than answers. Care navigators work closely with patients and families through discussion and collaboration to provide information on best options and referrals to healthcare professionals, facilities, and organisations specialising in the patients’ needs. The difference between other mental health professionals and a care navigator is that a care navigator provides information and directs a patient to the best help rather than offering treatment. Still, care navigators may provide diagnosis and treatment planning.

Mental health care navigation is also sometimes provided by self-help books. Lloyd I. Sederer, M.D.’s The Family Guide to Mental Healthcare (W. W. Norton & Company, 2013) is a resource for patients and families searching for guidance in the mental health industry. Publishers Weekly called it a “thoughtful, compassionate, and fact-packed guide for recognizing illness and getting help.” It provides information to patients and families about recognising symptoms of mental illness, how to get diagnosis and how to choose the right therapists and treatments.


Many mental health organisations use “navigator” and “navigation” to describe the service of providing guidance through the health care industry. Care navigators are also sometimes referred to as “system navigators.”. One type of care navigator is an “educational consultant.”


Models for mental health care navigation can involve many scenarios from a brief consultation to an extended process with follow-up. They offer referrals, assistance with insurance and other financial matters and general support. A highly detailed method of care navigation with long-term follow up was developed in 2011 by San Francisco-based psychiatrist and mental health expert Eli Merritt, M.D. His model involves what he calls the “3 R’s” of mental health care: “Research, Resources, and Referrals.” It involves four steps:

  • Assessment & Needs Identification:
    • In this preliminary, exploratory phase, care navigators meet with the individual or family seeking help. Patient history and needs are identified.
    • Both the patient and the care navigator think through short- and long-term goals and levels of treatment sought.
  • Dialogue & Plan Formation:
    • Through discussion and collaboration, both the patient and care navigator brainstorm next steps, establishing a plan that is specific to the patient’s needs.
  • Care Coordination:
    • After information gathering and brainstorming, doctors, therapists, and other mental health options are provided to the patient.
    • Questions of affordability arise, and patients are advised toward the best solutions for their conditions and circumstances.
  • Continuity:
    • After guiding patients to healthcare providers, care navigators maintain communication and continuity with patients, offering assistance with any future obstacles that might arise.

What is a Therapeutic Relationship?


The therapeutic relationship refers to the relationship between a healthcare professional and a client or patient. It is the means by which a therapist and a client hope to engage with each other and effect beneficial change in the client.

In psychoanalysis the therapeutic relationship has been theorised to consist of three parts: the working alliance, transference/countertransference, and the real relationship. Evidence on each component’s unique contribution to the outcome has been gathered, as well as evidence on the interaction between components. In contrast to a social relationship, the focus of the therapeutic relationship is on the client’s needs and goals.

Therapeutic/Working Alliance

The therapeutic alliance, or the working alliance may be defined as the joining of a client’s reasonable side with a therapist’s working or analysing side. Bordin (1979) conceptualised the working alliance as consisting of three parts: tasks, goals and bond. Tasks are what the therapist and client agree need to be done to reach the client’s goals. Goals are what the client hopes to gain from therapy, based on their presenting concerns. The bond forms from trust and confidence that the tasks will bring the client closer to their goals.

Research on the working alliance suggests that it is a strong predictor of psychotherapy or counselling client outcome. Also, the way in which the working alliance unfolds has been found to be related to client outcomes. Generally, an alliance that experiences a rupture that is repaired is related to better outcomes than an alliance with no ruptures, or an alliance with a rupture that is not repaired. Also, in successful cases of brief therapy, the working alliance has been found to follow a high-low-high pattern over the course of the therapy. Therapeutic alliance has been found to be effective in treating adolescents suffering from PTSD, with the strongest alliances were associated with the greatest improvement in PTSD symptoms. Regardless of other treatment procedures, studies have shown that the degree to which traumatised adolescents feel a connection with their therapist greatly affects how well they do during treatment.

Necessary and Sufficient Conditions

In the Humanistic approach, Carl Rogers identified a number of necessary and sufficient conditions that are required for therapeutic change to take place. These include the three core conditions: congruence, unconditional positive regard, and empathy. Rogers (1957; 1959) stated that there are six necessary and sufficient conditions required for therapeutic change:

  1. Therapist–client psychological contact: a relationship between client and therapist must exist, and it must be a relationship in which each person’s perception of the other is important.
  2. Client incongruence: that incongruence exists between the client’s experience and awareness.
  3. Therapist congruence, or genuineness: the therapist is congruent within the therapeutic relationship. The therapist is deeply involved, they are not ‘acting’ and they can draw on their own experiences (self-disclosure) to facilitate the relationship.
  4. Therapist unconditional positive regard: the therapist accepts the client unconditionally, without judgment, disapproval or approval. This facilitates increased self-regard in the client, as they can begin to become aware of experiences in which their view of self-worth was distorted or denied.
  5. Therapist empathic understanding: the therapist experiences an empathic understanding of the client’s internal frame of reference. Accurate empathy on the part of the therapist helps the client believe the therapist’s unconditional regard for them.
  6. Client perception: that the client perceives, to at least a minimal degree, the therapist’s unconditional positive regard and empathic understanding.

Transference and Counter-Transference

The concept of therapeutic relationship was described by Freud (1912) as “friendly affectionate feeling” in the form of a positive transference. However, transferences, or more correctly here, the therapist’s ‘counter-transferences’ can also be negative. Today transference (from the client) and counter-transference (from the therapist), is understood as subconsciously associating a person in the present, with a person from a past relationship. For example, you meet a new client who reminds you of a former lover. This would be a counter-transference, in that the therapist is responding to the client with thoughts and feelings attached to a person in a past relationship. Ideally, the therapeutic relationship will start with a positive transference for the therapy to have a good chance of effecting positive therapeutic change.

Operationalisation and Measurement

Several scales have been developed to assess the patient-professional relationship in therapy, including:


Bordin, E.S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research & Practice. 16(3), pp.252-260.

On This Day … 24 April

People (Births)

People (Deaths)

  • 1924 – G. Stanley Hall, American psychologist and academic (b. 1844).
  • 1983 – Erol Güngör, Turkish sociologist, psychologist, and academic (b. 1938).

Eliana Gil

Eliana Gil RPT-S, ATR (born 24 April 1948), is a lecturer, writer, and clinician of marriage, family and child. She is on the board of a number of professional counselling organisations that use play and art therapies, and she is the former president of the Association for Play Therapy (APT).

Dr. Gil is the senior partner of the Gil Institute for Trauma Recovery and Education in Fairfax, Virginia. She is also the director of Starbright Training Institute for Child and Family Play Therapy based in northern Virginia.

G. Stanley Hall

Granville Stanley Hall (01 February 1846 to 24 April 1924) was a pioneering American psychologist and educator. His interests focused on childhood development and evolutionary theory.

Hall was the first president of the American Psychological Association and the first president of Clark University.

Review of General Psychology survey, published in 2002, ranked Hall as the 72nd most cited psychologist of the 20th century, in a tie with Lewis Terman.

Erol Gungor

Erol Güngör (25 November 1938 to 24 April 1983) was a Turkish sociologist, psychologist, and writer.

After spending a period in the Faculty of Law, Güngör graduated from the Faculty of Literature and Social Sciences of Istanbul University in 1961. He received his Ph.D. in 1965 with a thesis titled “Kelâmî (Verbal) Yapılarda Estetik Organizasyon”. Kenneth Hammond invited him to visit the University of Colorado. He became an associate professor with his thesis titled “Şahıslar arası Ihtilafların Çözümünde Lisanın Rolü” in 1970. He became an academic in the Faculty of Literature and Social Sciences of Istanbul University in 1975. He eventually became the president of Selçuk University in 1982.

He mostly studied culture, personality, customs, people and religion. He focused on the identity and cultural problems which Turkish people have faced in the last 150 years.

What is Functional Analytic Psychotherapy?


Functional analytic psychotherapy (FAP) is a psychotherapeutic approach based on clinical behaviour analysis (CBA) that focuses on the therapeutic relationship as a means to maximise client change. Specifically, FAP suggests that in-session contingent responding to client target behaviours leads to significant therapeutic improvements.

FAP was first conceptualised in the 1980s by psychologists Robert Kohlenberg and Mavis Tsai who, after noticing a clinically significant association between client outcomes and the quality of the therapeutic relationship, set out to develop a theoretical and psychodynamic model of behavioural psychotherapy based on these concepts. Behavioural principles (e.g. reinforcement, generalisation) form the basis of FAP (See The five rules below).

FAP is an idiographic (as opposed to nomothetic) approach to psychotherapy. This means that FAP therapists focus on the function of a client’s behaviour instead of the form. The aim is to change a broad class of behaviours that might look different on the surface but all serve the same function. It is idiographic in that the client and therapist work together to form a unique clinical formulation of the client’s therapeutic goals, rather than one therapeutic target for every client who enters therapy.

The Basics

FAP posits that client behaviours that occur in their out-of-session interpersonal relationships (i.e. in the “real world”) will, if clients are given a therapeutic relationship of sufficiently high quality, occur in the therapy session as well. Based on these in-session behaviours, FAP therapists, in collaboration with their client, develop a case formulation that includes classes of behaviours (based on their function not their form) that the client wishes to increase and decrease.

In-session occurrence of a client’s problematic behaviour is called clinically relevant behaviour 1 (CRB1). In-session occurrence of improvements is called clinically relevant behaviour 2 (CRB2). The goal of FAP therapy is to decrease the frequency of CRB1s and increase the frequency of CRB2s.

The FAP therapist evokes (i.e. sets the context for) CRB1s and in response gradually shapes CRB2s.

The five Rules

“The five rules” operationalise the FAP therapist’s behaviour with respect to this goal. It is important to note that the five rules are not rules in the traditional sense of the word, but instead a set of guidelines for the FAP therapist.

  • Rule 1 – Watch for CRBs:
    • Therapists focus their attention on the occurrence of CRBs that are in-session problems (CRB1s) and improvements (CRB2s).
  • Rule 2 – Evoke CRBs:
    • Therapists set a context which evoke the client’s CRBs.
  • Rule 3 – Reinforce CRB2s naturally:
    • Therapists reinforce the occurrence of CRB2s (in-session improvements), increasing the probability that these behaviours will occur more frequently.
  • Rule 4 – Observe therapist impact in relation to client CRBs:
    • Therapists assess the degree to which they actually reinforced behavioural improvements by noting the client’s behaviour subsequent behaviour after Rule 3.
    • This is similar to the behaviour analytic concept of performing a functional analysis.
  • Rule 5 – Provide functional interpretations and generalise:
    • Therapists work with the client to generalise in-session behavioural improvements to the client’s out-of-session relationships.
    • This can include, but is not limited to, providing homework assignments.

The ACL Model

Researchers at the Centre for the Science of Social Connection at the University of Washington are developing a model of social connection that they believe is relevant to FAP. This model – called the ACL model – delineates behaviours relevant to social connection based on decades of scientific research.

  • Awareness (A):
    • Behaviours include paying attention to your own and the other’s needs and values within an interpersonal relationship.
  • Courage (C):
    • Behaviours include experiencing emotion in the presence of another person, asking for what you need, and sharing deep, vulnerable experiences with another person in the service of improving the relationship.
  • Love (L):
    • Behaviours involve responding to another’s courage behaviours with attunement to what that person needs in the moment. These include providing safety and acceptance in response to a client’s vulnerability.

FAP has the potential to target awareness, courage, and love behaviours as they occur in session as described by the five rules above. More research is needed to confirm the utility of the ACL model.

Research Support

Radical behaviourism and the field of clinical behaviour analysis have strong scientific support. Additionally, researchers have conducted a number of case studies, component process analyses, a study with non-randomised design on FAP-enhanced cognitive therapy for depression, and a randomised controlled trial on FAP-enhanced acceptance and commitment therapy for smoking cessation.

Third Generation behaviour Therapy

FAP belongs to a group of therapies referred to as third-generation behaviour therapies (or third-wave behaviour therapies) that includes dialectical behaviour therapy (DBT), acceptance and commitment therapy (ACT), behavioural activation (BA), and integrative behavioural couples therapy (IBCT).


FAP has been criticised for “being ahead of the data”, i.e. having not enough empirical support to justify its widespread use. Challenges encountered by FAP researchers are widely discussed There is also criticism of using the ACL model as it detracts from the idiographic nature of FAP.

Book: Relaxation and Stress Reduction Workbook

Book Title:

Relaxation and Stress Reduction Workbook.

Author(s): Matthew McKay (PhD).

Year: 2019.

Edition: Seventh (7th).

Publisher: New Harbinger.

Type(s): Paperback and Kindle.


The Relaxation and Stress Reduction Workbook broke new ground when it was first published in 1980, detailing easy, step-by-step techniques for calming the body and mind in an increasingly overstimulated world. Now in its seventh edition, this fully revised and updated workbook-highly regarded by therapists and their clients-offers the latest stress reduction techniques to combat the effects of stress and integrate healthy relaxation habits into every aspect of daily life.

This new edition also includes powerful self-compassion practices, fully updated chapters on the most effective tools for coping with anxiety, fear, and panic-such as worry delay and diffusion, two techniques grounded in acceptance and commitment therapy (ACT)-as well as a new section focused on body scan.

In the workbook, you will explore your own stress triggers and symptoms, and learn how to create a personal action plan for stress reduction. Each chapter features a different method for relaxation, explains why the method works, and provides on-the-spot exercises you can do when you feel stressed out. The result is a comprehensive yet accessible workbook that will help you to curb stress and cultivate a more peaceful life.

Book: Assessment Procedures for Counsellors and Helping Professionals

Book Title:

Assessment Procedures for Counsellors and Helping Professionals.

Author(s): Carl Sheperis, Robert Drummond, and Karyn Jones.

Year: 2019.

Edition: Ninth (9th).

Publisher: Pearson.

Type(s): Paperback.


A classic textbook for aspiring counsellors, now updated and expanded to improve its usefulness and relevance for practicing counsellors.

Since its first publication in 1988, Assessment Procedures for Counsellors and Helping Professionals has become a classic among assessment textbooks designed specifically for aspiring counsellors. Now in its 9th Edition, the text includes extensive changes to content and updating throughout, while maintaining its popular, easy-to-read format and continuing emphasis on assessment information that is most useful and relevant for school counsellors, marriage and family therapists, mental health counsellors, and other helping professionals. Throughout the text, readers get invaluable information and examples about widely used assessment instruments in order to become familiar with these well-known tests.


Before purchasing, check with your instructor to ensure you select the correct ISBN. Several versions of the MyLab(TM) and Mastering(TM) platforms exist for each title, and registrations are not transferable. To register for and use MyLab or Mastering, you may also need a Course ID, which your instructor will provide.

Used books, rentals, and purchases made outside of Pearson

If purchasing or renting from companies other than Pearson, the access codes for the MyLab or Mastering platform may not be included, may be incorrect, or may be previously redeemed. Check with the seller before completing your purchase.

On This Day … 07 February

People (Births)

People (Deaths)

  • 2015 – Marshall Rosenberg, American psychologist and author (b. 1934).

Alfred Adler

Alfred Adler (07 February 1870 to 28 May 1937) was an Austrian medical doctor, psychotherapist, and founder of the school of individual psychology. His emphasis on the importance of feelings of inferiority, the inferiority complex, is recognised as an isolating element which plays a key role in personality development. Alfred Adler considered a human being as an individual whole, therefore he called his psychology “Individual Psychology” (Orgler 1976).

Adler was the first to emphasize the importance of the social element in the re-adjustment process of the individual and who carried psychiatry into the community. A Review of General Psychology survey, published in 2002, ranked Adler as the 67th most eminent psychologist of the 20th century.

Marshall Rosenberg

Marshall Bertram Rosenberg (06 October 1934 to 07 February 2015) was an American psychologist, mediator, author and teacher. Starting in the early 1960s he developed Nonviolent Communication, a process for supporting partnership and resolving conflict within people, in relationships, and in society. He worked worldwide as a peacemaker and in 1984 founded the Centre for Nonviolent Communication, an international non-profit organisation for which he served as Director of Educational Services.

On This Day … 17 January

People (Deaths)

  • 1881 – Harry Price, English psychologist and author (d. 1948).
  • 1887 – Ola Raknes, Norwegian psychoanalyst and philologist (d. 1975).
  • 1945 – Anne Cutler, Australian psychologist and academic.

Harry Price

Harry Price (17 January 1881 to 29 March 1948) was a British psychic researcher and author, who gained public prominence for his investigations into psychical phenomena and his exposing fraudulent spiritualist mediums. He is best known for his well-publicised investigation of the purportedly haunted Borley Rectory in Essex, England.

Ola Raknes

Ola Raknes (17 January 1887 to 28 January 1975) was a Norwegian psychologist, philologist and non-fiction writer. Born in Bergen, Norway, he was internationally known as a psychoanalyst in the Reichian tradition. He has been described as someone who spent his entire life working with the conveying of ideas through many languages and between different epistemological systems of reference, science and religion (Dannevig, 1975). For large portions of his life he was actively contributing to the public discourse in Norway. He has also been credited for his contributions to strengthening and enriching the Nynorsk language and its use in the public sphere.

Raknes was known as a thorough philologist and a controversial therapist. Internationally he was known as one of Wilhelm Reich’s closest students and defenders.

Anne Cutler

(Elizabeth) Anne Cutler (1945 to Present) FRS is a Research Professor at the MARCS Institute for Brain, Behaviour and Development, Western Sydney University and Emeritus Director of the Max Planck Institute for Psycholinguistics in Nijmegen.

What is Therapy?


A therapy or medical treatment (often abbreviated tx, Tx, or Tx) is the attempted remediation of a health problem, usually following a medical diagnosis.

As a rule, each therapy has indications and contraindications. There are many different types of therapy. Not all therapies are effective. Many therapies can produce unwanted adverse effects.

Treatment and therapy are generally considered synonyms. However, in the context of mental health, the term therapy may refer specifically to psychotherapy.

Semantic Field

The words care, therapy, treatment, and intervention overlap in a semantic field, and thus they can be synonymous depending on context. Moving rightward through that order, the connotative level of holism decreases and the level of specificity (to concrete instances) increases. Thus, in health care contexts (where its senses are always noncount), the word care tends to imply a broad idea of everything done to protect or improve someone’s health (for example, as in the terms preventive care and primary care, which connote ongoing action), although it sometimes implies a narrower idea (for example, in the simplest cases of wound care or post-anaesthesia care, a few particular steps are sufficient, and the patient’s interaction with that provider is soon finished).

In contrast, the word intervention tends to be specific and concrete, and thus the word is often countable; for example, one instance of cardiac catheterisation is one intervention performed, and coronary care (noncount) can require a series of interventions (count). At the extreme, the piling on of such countable interventions amounts to interventionism, a flawed model of care lacking holistic circumspection – merely treating discrete problems (in billable increments) rather than maintaining health. Therapy and treatment, in the middle of the semantic field, can connote either the holism of care or the discreteness of intervention, with context conveying the intent in each use. Accordingly, they can be used in both noncount and count senses (for example, therapy for chronic kidney disease can involve several dialysis treatments per week).

The words aceology and iamatology are obscure and obsolete synonyms referring to the study of therapies.

The English word therapy comes via Latin therapīa from Greek: θεραπεία and literally means “curing” or “healing”.

Types of Therapies

By Chronology, Priority, or Intensity

Levels of Care

Levels of care classify health care into categories of chronology, priority, or intensity, as follows:

  • Emergency care handles medical emergencies and is a first point of contact or intake for less serious problems, which can be referred to other levels of care as appropriate.
  • Intensive care, also called critical care, is care for extremely ill or injured patients.
    • It thus requires high resource intensity, knowledge, and skill, as well as quick decision making.
  • Ambulatory care is care provided on an outpatient basis.
    • Typically patients can walk into and out of the clinic under their own power (hence “ambulatory”), usually on the same day.
  • Home care is care at home, including care from providers (such as physicians, nurses, and home health aides) making house calls, care from caregivers such as family members, and patient self-care.
  • Primary care is meant to be the main kind of care in general, and ideally a medical home that unifies care across referred providers.
  • Secondary care is care provided by medical specialists and other health professionals who generally do not have first contact with patients, for example, cardiologists, urologists and dermatologists.
    • A patient reaches secondary care as a next step from primary care, typically by provider referral although sometimes by patient self-initiative.
  • Tertiary care is specialised consultative care, usually for inpatients and on referral from a primary or secondary health professional, in a facility that has personnel and facilities for advanced medical investigation and treatment, such as a tertiary referral hospital.
  • Follow-up care is additional care during or after convalescence.
    • Aftercare is generally synonymous with follow-up care.
  • End-of-life care is care near the end of one’s life. It often includes the following:
    • Palliative care is supportive care, most especially (but not necessarily) near the end of life.
    • Hospice care is palliative care very near the end of life when cure is very unlikely.
      • Its main goal is comfort, both physical and mental.

Lines of Therapy

Treatment decisions often follow formal or informal algorithmic guidelines. Treatment options can often be ranked or prioritised into lines of therapy: first-line therapy, second-line therapy, third-line therapy, and so on.

First-line therapy (sometimes called induction therapy, primary therapy, or front-line therapy) is the first therapy that will be tried. Its priority over other options is usually either:

  • Formally recommended on the basis of clinical trial evidence for its best-available combination of efficacy, safety, and tolerability; or
  • Chosen based on the clinical experience of the physician.

If a first-line therapy either fails to resolve the issue or produces intolerable side effects, additional (second-line) therapies may be substituted or added to the treatment regimen, followed by third-line therapies, and so on.

An example of a context in which the formalisation of treatment algorithms and the ranking of lines of therapy is very extensive is chemotherapy regimens. Because of the great difficulty in successfully treating some forms of cancer, one line after another may be tried. In oncology the count of therapy lines may reach 10 or even 20.

Often multiple therapies may be tried simultaneously (combination therapy or polytherapy). Thus combination chemotherapy is also called polychemotherapy, whereas chemotherapy with one agent at a time is called single-agent therapy or monotherapy.

Adjuvant therapy is therapy given in addition to the primary, main, or initial treatment, but simultaneously (as opposed to second-line therapy). Neoadjuvant therapy is therapy that is begun before the main therapy. Thus one can consider surgical excision of a tumour as the first-line therapy for a certain type and stage of cancer even though radiotherapy is used before it; the radiotherapy is neoadjuvant (chronologically first but not primary in the sense of the main event). Premedication is conceptually not far from this, but the words are not interchangeable; cytotoxic drugs to put a tumour “on the ropes” before surgery delivers the “knockout punch” are called neoadjuvant chemotherapy, not premedication, whereas things like anaesthetics or prophylactic antibiotics before dental surgery are called premedication.

Step therapy or stepladder therapy is a specific type of prioritisation by lines of therapy. It is controversial in American health care because unlike conventional decision-making about what constitutes first-line, second-line, and third-line therapy, which in the US reflects safety and efficacy first and cost only according to the patient’s wishes, step therapy attempts to mix cost containment by someone other than the patient (third-party payers) into the algorithm. Therapy freedom and the negotiation between individual and group rights are involved.

By Intent

Therapy TypeDescription
Abortive Therapy1. A therapy that is intended to stop a medical condition from progressing any further.
2. A medication taken at the earliest signs of a disease, such as an analgesic taken at the very first symptoms of a migraine headache to prevent it from getting worse, is an abortive therapy.
3. Compare abortifacients, which abort a pregnancy.
Bridge Therapy1. A therapy that figuratively provides a bridge to another step or phase, crossing over some immediate chasm (challenge).
2. In contrast with destination therapy (see below), which is the final therapy in cases where clinically appropriate.
Consolidation Therapy1. A therapy given to consolidate the gains from induction therapy. In cancer, this means chasing after any malignant cells that may be left.
Curative Therapy1. A therapy with curative intent, that is, one that seeks to cure the root cause of a disorder.
2. Also known as etiotropic therapy.
Definitive Therapy1. A therapy that may be final, superior to others, curative, or all of those.
Destination Therapy1. A therapy that is the final destination rather than a bridge to another therapy.
2. Usually refers to ventricular assist devices to keep the existing heart going, not just until a heart transplant can occur, but for the rest of the patient’s life expectancy.
Empiric Therapy1. A therapy given on an empiric basis; that is, one given according to a clinician’s educated guess despite uncertainty about the illness’s causative factors.
2. For example, empiric antibiotic therapy administers a broad-spectrum antibiotic immediately on the basis of a good chance (given the history, physical examination findings, and risk factors present) that the illness is bacterial and will respond to that drug (even though the bacterial species or variant is not yet known).
Gold Standard Therapy1. A therapy that is definitive, just as a gold standard diagnostic test is a definitive test.
Investigational Therapy1. An experimental therapy. Use of experimental therapies must be ethically justified, because by definition they raise the question of standard of care.
2. Physicians have autonomy to provide empirical care (such as off-label care) according to their experience and clinical judgment, but the autonomy has limits that preclude quackery.
3. Thus it may be necessary to design a clinical trial around the new therapy and to use the therapy only per a formal protocol.
4. Sometimes shorthand phrases such as “treated on protocol” imply not just “treated according to a plan” but specifically “treated with investigational therapy”.
Maintenance Therapy1. A therapy taken during disease remission to prevent relapse.
Palliative TherapySee supportive therapy (below) for connotative distinctions.
Preventive Therapy (Prophylactic Therapy)1. A therapy that is intended to prevent a medical condition from occurring (also known as prophylaxis).
2. For example, many vaccines prevent infectious diseases.
Salvage Therapy (Rescue Therapy)1. A therapy tried after others have failed; it may be a “last-line” therapy.
Stepdown Therapy1. Therapy that tapers the dosage gradually rather than abruptly cutting it off.
2. For example, a switch from intravenous to oral antibiotics as an infection is brought under control steps down the intensity of therapy.
Supportive Therapy1. A therapy that does not treat or improve the underlying condition, but instead increases the patient’s comfort, also called symptomatic treatment (see there for more information).
2. For example, supportive care for flu, colds, or gastrointestinal upset can include rest, fluids, and over the counter pain relievers; those things do not treat the cause, but they treat the symptoms and thus provide relief.
3. Supportive therapy may be palliative therapy (palliative care).
4. The two terms are sometimes synonymous, but palliative care often specifically refers to serious illness and end-of-life care.
5. Therapy may be categorised as having curative intent (when it is possible to eliminate the disease) or palliative intent (when eliminating the disease is impossible and the focus shifts to minimizing the distress that it causes).
6. The two are often contradistinguished (mutually exclusive) in some contexts (such as the management of some cancers), but they are not inherently mutually exclusive; often a therapy can be both curative and palliative simultaneously.
7. Supportive psychotherapy aims to support the patient by alleviating the worst of the symptoms, with the expectation that definitive therapy can follow later if possible.
Systemic Therapy1. A therapy that is systemic.
2. In the physiological sense, this means affecting the whole body (rather than being local or locoregional), whether via systemic administration, systemic effect, or both.
3. Systemic therapy in the psychotherapeutic sense seeks to address people not only on the individual level but also as people in relationships, dealing with the interactions of groups.

By Therapy Composition

Treatments can be classified according to the method of treatment:

  • By Matter:
    • By drugs: pharmacotherapy, chemotherapy (also, medical therapy often means specifically pharmacotherapy).
    • By medical devices: implantation.
      • Cardiac resynchronisation therapy.
    • By specific molecules: molecular therapy (although most drugs are specific molecules, molecular medicine refers in particular to medicine relying on molecular biology).
      • By specific biomolecular targets: targeted therapy.
        • Molecular chaperone therapy.
      • By chelation: chelation therapy
    • By specific chemical elements:
      • By metals:
        • By heavy metals:
        • By gold: chrysotherapy (aurotherapy).
        • By platinum-containing drugs: platin therapy.
        • By biometals:
          • By lithium: lithium therapy.
          • By potassium: potassium supplementation.
          • By magnesium: magnesium supplementation.
          • By chromium: chromium supplementation; phonemic neurological hypochromium therapy.
          • By copper: copper supplementation.
      • By non-metals:
        • By diatomic oxygen: oxygen therapy, hyperbaric oxygen therapy (hyperbaric medicine).
        • Transdermal continuous oxygen therapy.
        • By triatomic oxygen (ozone): ozone therapy.
        • By fluoride: fluoride therapy.
        • By other gases: medical gas therapy.
    • By water:
      • Hydrotherapy.
      • Aquatic therapy.
      • Rehydration therapy.
        • Oral rehydration therapy.
      • Water cure (therapy).
    • By biological materials (biogenic substances, biomolecules, biotic materials, natural products), including their synthetic equivalents: biotherapy.
      • By whole organisms.
        • By viruses: virotherapy.
        • By bacteriophages: phage therapy.
        • By animal interaction: see animal interaction section.
      • By constituents or products of organisms.
        • By plant parts or extracts (but many drugs are derived from plants, even when the term phytotherapy is not used).
          • Scientific type: phytotherapy.
          • Traditional (prescientific) type: herbalism.
        • By animal parts: quackery involving shark fins, tiger parts, and so on, often driving threat or endangerment of species.
        • By genes: gene therapy.
          • Gene therapy for epilepsy.
          • Gene therapy for osteoarthritis.
          • Gene therapy for colour blindness.
          • Gene therapy of the human retina.
          • Gene therapy in Parkinson’s disease.
        • By epigenetics: epigenetic therapy.
        • By proteins: protein therapy (but many drugs are proteins despite not being called protein therapy).
        • By enzymes: enzyme replacement therapy.
        • By hormones: hormone therapy.
          • Hormonal therapy (oncology).
          • Hormone replacement therapy.
            • Oestrogen replacement therapy.
            • Androgen replacement therapy.
            • Hormone replacement therapy (menopause).
            • Hormone replacement therapy (transgender).
              • Hormone replacement therapy (male-to-female).
              • Hormone replacement therapy (female-to-male).
          • Antihormone therapy.
            • Androgen deprivation therapy.
        • By whole cells: cell therapy (cytotherapy).
          • By stem cells: stem cell therapy.
          • By immune cells: see immune system products below.
        • By immune system products: immunotherapy, host modulatory therapy.
          • By immune cells:
            • T-cell vaccination.
            • Cell transfer therapy.
            • Autologous immune enhancement therapy.
            • TK cell therapy.
          • By humoral immune factors: antibody therapy.
            • By whole serum: serotherapy, including antiserum therapy.
            • By immunoglobulins: immunoglobulin therapy.
              • By monoclonal antibodies: monoclonal antibody therapy.
      • By urine: urine therapy (some scientific forms; many prescientific or pseudoscientific forms).
      • By food and dietary choices:
        • Medical nutrition therapy.
        • Grape therapy (quackery).
    • By salts (but many drugs are the salts of organic acids, even when drug therapy is not called by names reflecting that).
      • By salts in the air.
        • By natural dry salt air: “taking the cure” in desert locales (especially common in prescientific medicine; for example, one 19th-century way to treat tuberculosis).
        • By artificial dry salt air:
          • Low-humidity forms of speleotherapy.
          • Negative air ionisation therapy.
        • By moist salt air:
          • By natural moist salt air: seaside cure (especially common in prescientific medicine).
          • By artificial moist salt air: water vapor forms of speleotherapy.
        • By salts in the water.
          • By mineral water: spa cure (“taking the waters”) (especially common in prescientific medicine).
          • By seawater: seaside cure (especially common in prescientific medicine).
    • By aroma: aromatherapy.
    • By other materials with mechanism of action unknown.
      • By occlusion with duct tape: duct tape occlusion therapy.
  • By Energy:
    • By electric energy as electric current: electrotherapy, electroconvulsive therapy:
      • Transcranial magnetic stimulation.
    • By magnetic energy:
      • Magnet therapy.
      • Pulsed electromagnetic field therapy.
      • Magnetic resonance therapy.
    • By electromagnetic radiation (EMR):
      • By light: light therapy (phototherapy).
        • Ultraviolet light therapy.
          • PUVA therapy.
        • Photodynamic therapy.
          • Photothermal therapy.
          • Cytoluminescent therapy.
        • Blood irradiation therapy.
        • By darkness: dark therapy.
        • By lasers: laser therapy.
          • Low level laser therapy.
      • By gamma rays: radiosurgery.
        • Gamma Knife radiosurgery.
        • Stereotactic radiation therapy.
        • Cobalt therapy.
      • By radiation generally: radiation therapy (radiotherapy).
        • Intraoperative radiation therapy.
        • By EMR particles:
          • Particle therapy.
            • Proton therapy.
            • Electron therapy.
              • Intraoperative electron radiation therapy.
              • Auger therapy.
            • Neutron therapy.
              • Fast neutron therapy.
              • Neutron capture therapy of cancer.
        • By radioisotopes emitting EMR:
          • By nuclear medicine.
          • By brachytherapy.
      • Quackery type: electromagnetic therapy (alternative medicine).
    • By mechanical: manual therapy as massotherapy and therapy by exercise as in physiotherapy and exercise therapy.
      • Inversion therapy.
    • By sound:
      • By ultrasound:
        • Ultrasonic lithotripsy.
          • Extracorporeal shock wave lithotripsy.
          • Extracorporeal shockwave therapy.
        • Sonodynamic therapy.
      • By music: music therapy.
        • Neurologic music therapy.
    • By temperature.
      • By heat: heat therapy (thermotherapy).
        • By moderately elevated ambient temperatures: hyperthermia therapy.
          • By dry warm surroundings: Waon therapy.
          • By dry or humid warm surroundings: sauna, including infrared sauna, for sweat therapy
      • By cold:
        • By extreme cold to specific tissue volumes: cryotherapy.
        • By ice and compression: cold compression therapy.
        • By ambient cold: hypothermia therapy for neonatal encephalopathy.
      • By hot and cold alternation: contrast bath therapy.
  • By Procedure and Human Interaction:
    • Surgery.
    • By counselling, such as psychotherapy (refer to list of psychotherapies).
      • Systemic therapy.
      • By group psychotherapy.
    • By cognitive behavioural therapy.
      • By cognitive therapy.
      • By behaviour therapy.
        • By dialectical behaviour therapy.
      • By cognitive emotional behavioural therapy.
    • By cognitive rehabilitation therapy.
    • By family therapy.
    • By education.
      • By psychoeducation.
      • By information therapy.
    • By physical therapy/occupational therapy, vision therapy, massage therapy, chiropractic or acupuncture.
    • By lifestyle modifications, such as avoiding unhealthy food or maintaining a predictable sleep schedule.
    • By coaching.
  • By Animal Interaction:
    • By pets, assistance animals, or working animals: animal-assisted therapy.
      • By horses: equine therapy, hippotherapy.
      • By dogs: pet therapy with therapy dogs, including grief therapy dogs.
      • By cats: pet therapy with therapy cats.
    • By fish: ichthyotherapy (wading with fish), aquarium therapy (watching fish).
    • By maggots: maggot therapy.
    • By worms:
      • By internal worms: helminthic therapy.
      • By leeches: leech therapy.
    • By immersion: animal bath.
  • By Meditation:
    • By mindfulness: mindfulness-based cognitive therapy.
  • By Reading:
    • By bibliotherapy.
  • By Creativity:
    • By expression: expressive therapy.
      • By writing: writing therapy.
        • Journal therapy.
    • By play: play therapy.
    • By art: art therapy.
      • Sensory art therapy.
      • Comic book therapy.
    • By gardening: horticultural therapy.
    • By dance: dance therapy.
    • By drama: drama therapy.
    • By recreation: recreational therapy.
    • By music: music therapy.
  • By Sleeping and Waking:
    • By deep sleep: deep sleep therapy.
    • By waking: wake therapy.