Therapy (often abbreviated tx, Tx, or Tx) is the attempted remediation of a health problem, usually following a diagnosis. In the medical field, it is usually synonymous with treatment (also abbreviated tx or Tx). Among psychologists and other mental health professionals, including psychiatrists, psychiatric nurse practitioners, and clinical social workers, the term may refer specifically to psychotherapy (sometimes dubbed 'talking therapy'). The English word therapy comes via Latin therapīa from Greek: θεραπεία and literally means "curing" or "healing".
As a rule, each therapy has indications and contraindications.
The words care, therapy, treatment, and intervention overlap in a semantic field, and thus they can be synonymous depending on context. Moving rightward through that order, the connotative level of holism decreases and the level of specificity (to concrete instances) increases. Thus, in health care contexts (where its senses are always noncount), the word care tends to imply a broad idea of everything done to protect or improve someone's health (for example, as in the terms preventive care and primary care, which connote ongoing action), although it sometimes implies a narrower idea (for example, in the simplest cases of wound care or postanesthesia care, a few particular steps are sufficient, and the patient's interaction with that provider is soon finished). In contrast, the word intervention tends to be specific and concrete, and thus the word is often countable; for example, one instance of cardiac catheterization is one intervention performed, and coronary care (noncount) can require a series of interventions (count). At the extreme, the piling on of such countable interventions amounts to interventionism, a flawed model of care lacking holistic circumspection—merely treating discrete problems (in billable increments) rather than maintaining health. Therapy and treatment, in the middle of the semantic field, can connote either the holism of care or the discreteness of intervention, with context conveying the intent in each use. Accordingly, they can be used in both noncount and count senses (for example, therapy for chronic kidney disease can involve several dialysis treatments per week).
The words aceology and iamatology are obscure and obsolete synonyms referring to the study of therapies.
Levels of care classify health care into categories of chronology, priority, or intensity, as follows:
Emergency care handles medical emergencies and is a first point of contact or intake for less serious problems, which can be referred to other levels of care as appropriate.Intensive care, also called critical care, is care for extremely ill or injured patients. It thus requires high resource intensity, knowledge, and skill, as well as quick decision making.Ambulatory care is care provided on an outpatient basis. Typically patients can walk into and out of the clinic under their own power (hence "ambulatory"), usually on the same day.Home care is care at home, including care from providers (such as physicians, nurses, and home health aides) making house calls, care from caregivers such as family members, and patient self-care.Primary care is meant to be the main kind of care in general, and ideally a medical home that unifies care across referred providers.Secondary care is care provided by medical specialists and other health professionals who generally do not have first contact with patients, for example, cardiologists, urologists and dermatologists. A patient reaches secondary care as a next step from primary care, typically by provider referral although sometimes by patient self-initiative.Tertiary care is specialized consultative care, usually for inpatients and on referral from a primary or secondary health professional, in a facility that has personnel and facilities for advanced medical investigation and treatment, such as a tertiary referral hospital.Follow-up care is additional care during or after convalescence. Aftercare is generally synonymous with follow-up care.End-of-life care is care near the end of one's life. It often includes the following:Palliative care is supportive care, most especially (but not necessarily) near the end of life.Hospice care is palliative care very near the end of life when cure is very unlikely. Its main goal is comfort, both physical and mental.Treatment decisions often follow formal or informal algorithmic guidelines. Treatment options can often be ranked or prioritized into lines of therapy: first-line therapy, second-line therapy, third-line therapy, and so on. First-line therapy (sometimes called induction therapy, primary therapy, or front-line therapy) is the first therapy that will be tried. Its priority over other options is usually either: (1) formally recommended on the basis of clinical trial evidence for its best-available combination of efficacy, safety, and tolerability or (2) chosen based on the clinical experience of the physician. If a first-line therapy either fails to resolve the issue or produces intolerable side effects, additional (second-line) therapies may be substituted or added to the treatment regimen, followed by third-line therapies, and so on.
An example of a context in which the formalization of treatment algorithms and the ranking of lines of therapy is very extensive is chemotherapy regimens. Because of the great difficulty in successfully treating some forms of cancer, one line after another may be tried. In oncology the count of therapy lines may reach 10 or even 20.
Often multiple therapies may be tried simultaneously (combination therapy or polytherapy). Thus combination chemotherapy is also called polychemotherapy, whereas chemotherapy with one agent at a time is called single-agent therapy or monotherapy.
Adjuvant therapy is therapy given in addition to the primary, main, or initial treatment, but simultaneously (as opposed to second-line therapy). Neoadjuvant therapy is therapy that is begun before the main therapy. Thus one can consider surgical excision of a tumor as the first-line therapy for a certain type and stage of cancer even though radiotherapy is used before it; the radiotherapy is neoadjuvant (chronologically first but not primary in the sense of the main event). Premedication is conceptually not far from this, but the words are not interchangeable; cytotoxic drugs to put a tumor "on the ropes" before surgery delivers the "knockout punch" are called neoadjuvant chemotherapy, not premedication, whereas things like anesthetics or prophylactic antibiotics before dental surgery are called premedication.
Step therapy or stepladder therapy is a specific type of prioritization by lines of therapy. It is controversial in American health care because unlike conventional decision-making about what constitutes first-line, second-line, and third-line therapy, which in the U.S. reflects safety and efficacy first and cost only according to the patient's wishes, step therapy attempts to mix cost containment by someone other than the patient (third-party payers) into the algorithm. Therapy freedom and the negotiation between individual and group rights are involved.
Treatments can be classified according to the method of treatment:
by drugs: pharmacotherapy, chemotherapy (also, medical therapy often means specifically pharmacotherapy)by medical devices: implantationcardiac resynchronization therapyby specific molecules: molecular therapy (although most drugs are specific molecules, molecular medicine refers in particular to medicine relying on molecular biology)by specific biomolecular targets: targeted therapymolecular chaperone therapyby chelation: chelation therapyby specific chemical elements:by metals:by heavy metals:by gold: chrysotherapy (aurotherapy)by platinum-containing drugs: platin therapyby biometalsby lithium: lithium therapyby potassium: potassium supplementationby magnesium: magnesium supplementationby chromium: chromium supplementation; phonemic neurological hypochromium therapyby copper: copper supplementationby nonmetals:by diatomic oxygen: oxygen therapy, hyperbaric oxygen therapy (hyperbaric medicine)transdermal continuous oxygen therapyby triatomic oxygen (ozone): ozone therapyby fluoride: fluoride therapyby other gases: medical gas therapyby water:hydrotherapyaquatic therapyrehydration therapyoral rehydration therapywater cure (therapy)by biological materials (biogenic substances, biomolecules, biotic materials, natural products), including their synthetic equivalents: biotherapyby whole organismsby viruses: virotherapyby bacteriophages: phage therapyby animal interaction: see animal interaction sectionby constituents or products of organismsby plant parts or extracts (but many drugs are derived from plants, even when the term phytotherapy is not used)scientific type: phytotherapytraditional (prescientific) type: herbalismby animal parts: quackery involving shark fins, tiger parts, and so on, often driving threat or endangerment of speciesby genes: gene therapygene therapy for epilepsygene therapy for osteoarthritisgene therapy for color blindnessgene therapy of the human retinagene therapy in Parkinson's diseaseby epigenetics: epigenetic therapyby proteins: protein therapy (but many drugs are proteins despite not being called protein therapy)by enzymes: enzyme replacement therapyby hormones: hormone therapyhormonal therapy (oncology)hormone replacement therapyestrogen replacement therapyandrogen replacement therapyhormone replacement therapy (menopause)hormone replacement therapy (transgender)hormone replacement therapy (male-to-female)hormone replacement therapy (female-to-male)antihormone therapyandrogen deprivation therapyby whole cells: cell therapy (cytotherapy)by stem cells: stem cell therapyby immune cells: see immune system products belowby immune system products: immunotherapy, host modulatory therapyby immune cells:T-cell vaccinationcell transfer therapyautologous immune enhancement therapyTK cell therapyby humoral immune factors: antibody therapyby whole serum: serotherapy, including antiserum therapyby immunoglobulins: immunoglobulin therapyby monoclonal antibodies: monoclonal antibody therapyby urine: urine therapy (some scientific forms; many prescientific or pseudoscientific forms)by food and dietary choices:medical nutrition therapygrape therapy (quackery)by salts (but many drugs are the salts of organic acids, even when drug therapy is not called by names reflecting that)by salts in the airby natural dry salt air: "taking the cure" in desert locales (especially common in prescientific medicine; for example, one 19th-century way to treat tuberculosis)by artificial dry salt air:low-humidity forms of speleotherapynegative air ionization therapyby moist salt air:by natural moist salt air: seaside cure (especially common in prescientific medicine)by artificial moist salt air: water vapor forms of speleotherapyby salts in the waterby mineral water: spa cure ("taking the waters") (especially common in prescientific medicine)by seawater: seaside cure (especially common in prescientific medicine)by aroma: aromatherapyby other materials with mechanism of action unknownby occlusion with duct tape: duct tape occlusion therapyby electric energy as electric current: electrotherapy, electroconvulsive therapyby magnetic energy:magnet therapypulsed electromagnetic field therapymagnetic resonance therapyby electromagnetic radiation (EMR):by light: light therapy (phototherapy)ultraviolet light therapyPUVA therapyphotodynamic therapyphotothermal therapycytoluminescent therapyblood irradiation therapyby darkness: dark therapyby lasers: laser therapylow level laser therapyby gamma rays: radiosurgeryGamma Knife radiosurgerystereotactic radiation therapycobalt therapyby radiation generally: radiation therapy (radiotherapy)intraoperative radiation therapyby EMR particles:particle therapyproton therapyelectron therapyintraoperative electron radiation therapyAuger therapyneutron therapyfast neutron therapyneutron capture therapy of cancerby radioisotopes emitting EMR:by nuclear medicineby brachytherapyquackery type: electromagnetic therapy (alternative medicine)by mechanical: manual therapy as massotherapy and therapy by exercise as in physiotherapy and exercise therapyinversion therapyby sound:by ultrasound:ultrasonic lithotripsyextracorporeal shock wave lithotripsyextracorporeal shockwave therapysonodynamic therapy (largely pseudoscientific)by music: music therapyneurologic music therapyby temperatureby heat: heat therapy (thermotherapy)by moderately elevated ambient temperatures: hyperthermia therapyby dry warm surroundings: Waon therapyby dry or humid warm surroundings: sauna, including infrared sauna, for sweat therapyby cold:by extreme cold to specific tissue volumes: cryotherapyby ice and compression: cold compression therapyby ambient cold: hypothermia therapy for neonatal encephalopathyby hot and cold alternation: contrast bath therapyby counseling, such as psychotherapy (see also: list of psychotherapies)systemic therapyby group psychotherapyby cognitive behavioral therapyby cognitive therapyby cognitive rehabilitation therapyby behaviour therapyby dialectical behavior therapyby cognitive emotional behavioral therapyby family therapyby educationby psychoeducationby information therapyby physical therapy/occupational therapy, massage therapy, chiropractic or acupunctureby lifestyle modifications, such as avoiding unhealthy food or maintaining a predictable sleep scheduleby coachingby pets, assistance animals, or working animals: animal-assisted therapyby horses: equine therapy, hippotherapyby dogs: pet therapy with therapy dogs, including grief therapy dogsby cats: pet therapy with therapy catsby fish: ichthyotherapy (wading with fish), aquarium therapy (watching fish)by maggots: maggot therapyby worms:by internal worms: helminthic therapyby leechs: leech therapyby mindfulness: mindfulness-based cognitive therapyby bibliotherapyby expression: expressive therapyby writing: writing therapyjournal therapyby play: play therapyby art: art therapysensory art therapycomic book therapyby gardening: horticultural therapyby dance: dance therapyby drama: drama therapyby recreation: recreational therapyby music: music therapyBy sleeping and waking
by deep sleep: deep sleep therapyby waking: wake therapy