Medical psychotherapy

Medical psychotherapists are trained psychiatrists (doctors who treat mental health problems) who have specialised in psychotherapy (psychological or talking treatments). This can include different therapies such as cognitive behaviour therapy, psychodynamic psychotherapy, and systemic (group or family) therapy.

This page provides useful information on the nature of the work, the common procedures/interventions, sub-specialties and other roles that may interest you.

Nature of the work

Psychotherapy allows patients to come to a better understanding of their difficulties, worries, abilities and motivations. This specialty makes use of techniques that help patients explore difficult and often painful emotions and experiences, or reflect on patterns of behaviour and habits that may not serve them well. What patients might experience within the therapeutic experience can also be healing. Psychotherapy can take place individually or in groups, and there are many different forms that can be tailored to meet individual needs.

Within the NHS, medical psychotherapists contribute a psychological and relationship-oriented understanding to other aspects of psychiatric practice, such as the impact of mental illness on patients’ lives and the role of carers and relatives in promoting health and compliance with medication.

Medical psychotherapists offer advice to the community mental health team (CMHT) on the treatment of complex patients. They also deliver training to different members of the CMHT to help them deal more effectively with more complex presentations such as borderline personality disorder.

There are many forms of psychotherapy, and a range of models for psychotherapeutic treatment.  Medical psychotherapists are likely to specialise in one form of psychotherapy, although they are trained to have a working knowledge of all the main evidence-based branches of psychotherapy.

Assessing complex psychiatric cases and deciding on treatment modality, or advising on management, is a core aspect of the medical psychotherapist’s work.

A wide range of patients are referred to psychotherapy services, especially those with more serious mental illnesses, psychological difficulties, personality disorders and co-morbid conditions.  Therapists may see patients individually or in groups, and may work alone or in a team.

Medical psychotherapists spend much of their time teaching and supervising, as well as advocating and managing psychotherapy services.  Often a medical psychotherapist will be the psychotherapy tutor who co-ordinates training locally.  This makes the work varied and often highly self-directed and autonomous.

Patients with a variety of mental health problems may be referred for psychotherapy, including those with:

Patients may have more than one diagnosis, and may have a range of psychological or other difficulties including low self-esteem, anger or recurrent self-harm. Some medical psychotherapists will work exclusively with children and their families.

Specialist psychotherapy is an important part of all psychiatric services, but there is increasing interest in applying psychotherapeutic principles in other settings, such as:

Medical psychotherapists have extremely varied working lives. In clinical practice, some chiefly assess patients in an outpatient setting, both treating patients themselves and also supervising the treatment of others. Other medical psychotherapists run units dealing with eating disorders, trauma, personality disorder, or deliberate self-harm.

There are also exciting developments in the use of new technologies to deliver psychotherapy, including computerised therapy, mobile phone apps and web-based approaches.

Common procedures/interventions

Medical psychotherapists make detailed assessments of patients to determine their suitability for psychotherapy. Therapists then decide, together with the patient, which therapy best suits their needs.  In other situations, the medical psychotherapist may consult health professionals or teams to help them manage complex situations.

The main types of therapy used are:


Forensic psychotherapy is becoming a recognised sub specialty within medical psychotherapy. Applying psychotherapy to specialist areas of psychiatry is also a developing area.

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