The presentation will be divided into two sections. In the first part the author will present theoretical and practical implications of working in a biomedical model. The author will analyze the evolution of the biomedical model and consider:

1. a. The reasons why some psychotherapies fit the concept of evidence based medicine more easily than others.

2. b. How societal and clients' expectations help drive the biomedical approach.

3. c. What are the gains and losses of economically driven health system from psychotherapy point view.

In the second part of the presentation an attempt will be made to describe a mental health system aimed at blending a modern psychiatric service with one based on traditional knowledge and holistic values in a multicultural environment. The author will endeavour to address the following questions:

1. a. Does multicultural approach translate to openness and readiness to use different psychotherapeutic options?

2. b. How can a systemic approach be used to develop culturally sensitive assessments?

3. c. What are the theoretical difficulties and pitfalls faced by a mental health service based on holistic values and traditional knowledge?

Finally with the use of a case presentation consideration will be given to the idea of using a systemic intervention within a cognitive behavioural paradigm of a Child and Adolescent Mental Health Service. Some advantages and disadvantages of using such interventions will be discussed with special reference to the principle of optimal difference (Cecchin).