PROBLEM
The process of psychotherapy consists of a series of verbal communications between a therapist and a patient. This involves not only the mutual comprehension and manipulation of concepts and symbols but also the ability to utilize words as a medium for expressing emotions. Significant differences have been found between middle class and lower class subjects in preferences for verbal and motoric orientations, with middle class subjects being more verbally and conceptually oriented, while lower class subjects are more motorically inclined. ( 2 )
These findings suggest that psychotherapy should be more suitable for middle rather than lower class patients. Colby(') and Redlich, Hollingshead, and B e l l i ~( ~) note that persons from the lower socioeconomic groups rarely come to psychotherapy spontaneously or voluntarily, communicate poorly with therapists, usually regard their difficulties as purely somatic in nature, and resist any interpretations relating their symptoms to emotional problems. These resistances raise the question of the importance of psychotherapy as a form of treatment from the point of view of the patient. No attempt has been made t o assess the attitudes of patients in this respect. This paper is a report of such a survey of the attitudes of a representative group of psychiatric patients at a VA neuropsychiatric hospital. The threefold purpose of this investigation was (a) to determine the degree to which a predominantly lower class group of patients preferred psychotherapy to other therapeutic activities in a mental hospital, (b) to investigate, within the limits of this sample, the relationship between preference for psychotherapy and such variables as occupation, social class, experience with psychotherapy, and degree of chronicity of illness, and (c) t o assess patient attitudes concerning the importance and helpfulness of psychotherapy as treatment. The findings of previous studies suggested that the patients sampled here would show less preference for psychotherapy than for other, more motorically oriented activities, and that they would feel that it was less significant than other activities in bringing about improvement in their conditions. 'The author gratefully acknowledges the assistance of Messrs. Zilaitie, Vardack, Page, Dr. Coburn, and Dr. Comers