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date: 09 March 2021

Abstract and Keywords

Despite a robust and growing evidence base to support the effectiveness of psychotherapy in treating mental illness and promoting mental health, funding and access is often limited. Psychotherapy’s claim on a share of individual and social resources must compete, on the one hand, with other mental health services devoted to treating mental illness, and on the other hand, with a variety of social services that promote mental health and human flourishing. This chapter focuses on different theories of justice to consider (a) whether a case might be made for the unique value of psychotherapy amongst other competing services, and (b) if not, what criteria might be relevant in assessing its relative cost and value. The chapter begins by reviewing some relevant concepts of justice and how they might be applicable to allocation of psychotherapy resources, specifically, Rawlsian, capabilities, utilitarian, and communitarian theories. It then discusses how these concepts of justice can be used to navigate research about psychotherapy outcomes as well as its cost-effectiveness. Decisions about which outcomes to consider are not value-neutral and can be guided by relevant theories of justice. The chapter concludes with a brief discussion of lower-income countries.

Keywords: justice, psychotherapy, cost-effectiveness, rationing, evidence-based treatment

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