What kinds of mental illnesses or psychological problems require psychotherapy, and when is the most appropriate time for psychotherapy? Does it need to be combined with medication? This is not only a matter of great concern to patients, but also to doctors, who need to “treat the symptoms” or “treat both the root cause and the symptoms” accordingly. In practice, however, it is not easy to make accurate judgments. Although psychotherapists and psychiatrists have basically agreed that for general psychological problems, no medication is needed, but only counseling or psychotherapy, while for severe psychiatric symptoms, medication is needed, or both. However, there are still major differences in the understanding of the two types of therapists in this regard, such as whether to medicate neurotic patients receiving psychotherapy or whether psychiatric patients with positive symptoms under control should undergo psychotherapy? Traditional psychotherapists believe that only psychotherapy is needed for neurotic patients, while traditional psychiatrists believe that both neurotic and psychotic patients need to be treated with medication. In fact, medication is often effective for most psychiatric symptoms, but it is often ineffective for symptoms caused by psychosocial factors or loss of social function, or even if the medication is effective, the patient has to suffer from long-term medication due to relapse after stopping the medication, and still does not know how to face psychosocial problems after stopping the medication. As the saying goes, “heart disease needs heart medicine”. If the patient’s condition is quite serious, such as extreme anxiety, depression, repeated suicide, severe insomnia, severe impulsive behavior, acute stress reaction, transient psychotic state that endangers life or seriously hampers social function, medication should be the main treatment, but for most other mental conditions related to psychosocial problems, as long as the patient is willing to cooperate with psychotherapy, the first choice should be Psychotherapy. The process of psychotherapy is a process of helping the patient to recognize, discover and utilize his or her own resources, to learn to endure irreversible suffering and to increase his or her stamina for growth, and to mobilize his or her sense of self-help so that he or she can learn to help himself or herself in a constructive way to enter a virtuous cycle. If we rely mainly on medication during this period, it will shake their belief in their own destiny, affect their determination and motivation to help themselves, and in serious cases, make them give up their responsibility for their own recovery and growth, and encourage their dependence on external forces, just like children who are spoiled by their parents, who do not want to work hard, avoid things and do not seek improvement. Since human understanding of psychological phenomena or mental illness is still quite limited, the judgment of the etiology of psychiatric symptoms basically relies on phenomenological understanding, and without reliable instruments or laboratory tests or imaging examinations, an accurate diagnosis of the etiology cannot be made, and many cases may be related to biological, psychological and social factors, and it is difficult to determine exactly the proportion of biological defects or psychological etiology based on the assessment of psychological phenomena alone. The proportion of biological deficits or psychopathogenic causes is difficult to determine with certainty by assessing psychological phenomena alone. Therefore, the diagnostic classification of psychiatric or psychological disorders is still at the stage of phenomenological classification, and the difficulty of diagnosis and management is greatly increased by problems that are difficult to categorize and by the presence of a mixture of problems or co-morbidities. However, in any case, we should try to diagnose or categorize the disorders relatively clearly and prioritize the problems in order to provide the necessary psychotherapy or combined medication. In case of suspected and risky psychiatric symptoms, if the diagnosis cannot be confirmed, medication alone can be considered for a period of time, and if it is ineffective or not effective, psychotherapy can be provided when psychological problems are further detected. In patients with atypical manifestations of obsessive-compulsive disorder or phobia, medication and psychotherapy may be administered simultaneously in order to exclude the possibility of the presence of symptoms of occult depression or schizophrenia. Diagnostic treatment is often necessary, and necessary corrections to diagnosis and treatment are made in a timely manner according to the specific problems that exist during the course of treatment. For example, in typical obsessive-compulsive disorders and phobias, where drugs have been proven to be ineffective, it is best to stop abusing them. If depressed and anxious patients are found to play an important role in the treatment process of psychological problems or family psychological problems, the focus is shifted to psychotherapy.