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As a psychologist from the EU, currently doing postgrad research at a top (sic!) UK institution, I often find myself returning to the same question I used to wonder about as an undergraduate: Why does the American public not revolt to the fact that pharmaceutical and insurance (interchangeable terms?) companies blatantly dictate the sort of treatment which is 'evidenced' to efficiently help solve a patient's/ client's issues? And, at the end of the day, how wise is it to depend on the most complex of research (or the most complex products psychopharmacology has to offer) to come up with 'something' to address 'issues', or 'nosological entities' (use the term you like best -'themes' feels somehow more accurate to me) that are indeed quite simple, as well as integral to our human existence? It's a philosophical, anthropological, as well as political an issue at its core, and somewhat cliché; I know. But that simply doesn't make it less important. Mental health services simply cannot always count on the shortest, most economical solution to deliver treatment. It's not in the interest of the people who need the services, and I bet it's not in the insurance-payers' interest either, once it's them who will eventually have to bear the burden (and I only mean the financial one, here) these decisions bring; because, people will return for more m.h. services, either due to too-short interventions, or in the absence of a therapy that brings substantial change from within, rather than acting as a pill-popping counter... Finally, excuse the nickname. It wasn't chosen in a spirit of hubris; I've been using it for a long time and it comes from that Prodigy song ('Poison', I believe). Maybe I'll pick 'witch-doctor' next time; might be more accurate :-)