Strategic psychotherapy in psychiatric consultations.

Inpatient psychiatric consultation work often involves the need to quickly bring about behavioral changes in distressed patients who are not interested in participating in psychotherapy. The behavior of such patients often impinges upon other individuals in the general hospital milieu and can be viewed within a systems framework. The strategic psychotherapeutic approach is summarized and two cases are described that illustrate the benefits that such an approach can have in effective consultations. Reframing, pacing and leading, and confusion techniques are among the specific tactics that are discussed.