As part of each evaluation, the clinician must decide whether or not a psychiatric treatment is indicated. It is unfortunate that there is little available research to aid in this decision, and it has not received much attention in the clinical literature. In actual practice, therapists tend to recommend treatment almost automatically and without a careful consideration of its necessity or possible harmful effects. The research methodology and problems is defining those patients who are better off without psychiatric treatment is discussed. This group is categorized into negative responders and nonresponders and spontaneous improvers. A set of preliminary criteria for no treatment and clinical examples are provided.
