The attempt to define psychotherapeutic skills appropriate for psychiatrists has aroused an interest in supportive psychotherapy, a previously undervalued and underdeveloped member of the psychotherapeutic family. This has been coupled with an increasing recognition of the importance of support within formal psychotherapies, especially when working with highly disturbed patients.

A review of supportive psychotherapy (ST) was performed, based on a Medline literature search.

It is argued that, from the perspective of attachment theory, support is an integral part of all psychotherapies. ST is also a specific mode of treatment suitable for some patients suffering from psychotic illnesses and borderline personality disorder. ST is an eclectic treatment drawing on many theoretical approaches. A common theme based on a narrative co-constructionist perspective, the search for positive meaning, is identified.

Supportive psychotherapy is an essential component of good psychiatric practice. Further research is needed to define its benefits and limitations.

We assess the evidence that psychiatric patients are at increased risk of infection with HIV and discuss some of the clinical implications.

Surveys of HIV seroprevalence and risk behaviours among psychiatric patients were obtained from a manual and computer search (Medline and AIDSline).

Most studies report an increased prevalence of HIV infection among psychiatric patients compared to the general population. Risk behaviours, and obstacles to risk reduction, are identified.

There is a strong case for investigating the seroprevalence of HIV in psychiatric settings in the UK. Issues relating to HIV and AIDS are likely to assume increasing importance in general psychiatric practice.