Monday, October 20, 2014

Supporting the Role of Psychotherapy in Modern Life

Psychotherapy has proven over and over to be effective. In some cases its has proven superior to other interventions, including medication. And yet, over the last 20-30 years there has also been a variety of factors which has limited access to these services.  From the time of the rise of accountable care or health maintenance organizations, many of which have limited its approval and duration, psychotherapy has been struggling to stay alive much less to thrive.

Numerous other societal influences have contributed to this problem.  These include:

  • The reduction of time in psychological services provided in medical settings, which have claimed to integrate such services but have only cursorily done so.
  • Shifting emphases away from psychotherapy in training programs.  It is now not uncommon to meet trainees with only a handful of therapy contacts under their belts. This is partly due to the sources of grant funding, an orientation toward other health care activities and settings, and the development of manualized treatment programs which place less value on the relationship dyad.
  • Burdensome issues relating to overhead costs and below market-pricing for those in private practice, a disincentive to engage in this work.
  • Clear valuing of medication delivery in the medico-pharma-insurance conglomerate, to the exclusion of other approaches.  (This may change as pharmaceutical development for mental health slows down due its reaching a ceiling in benefit to humans.)
  • A public which has been encouraged to seek quick, effortless relief from life's ordinary challenges.
  • A parallel trend in which the public has been convinced that ordinary challenges, such as bereavement, are mental illnesses requiring a biological intervention.
  • A reduction in mental health funding at the state level, which actually releases the hospitalized back into the community where they will face long waits just to talk to someone.
  • The erosion of privacy in healthcare settings.
  • The digital age, which has directed the attention of individuals to devices and away from the support of each other.
  • A lack of humanizing development in psychotherapy itself.  All recent "innovations" I can think of actually reduce human contact, as in the cases of online therapy and telemental health services.

In an era in which humans crave and need human contact and community, psychotherapy has a role which is more relevant than ever.  But on top of that, IT WORKS!  There is an ample base of evidence for this.  When you or yours need assistance with one of life's many challenges, seek out a competently trained therapist first.  Look for those trained in accredited, residential programs, who are fully licensed in their jurisdiction, and who will meet you face to face for no less than a full 50-minute session per week, just to start. Insist on a high degree of privacy such that only you and your therapist know your concerns, so that you may experience trust.  (As stated in a previous post, confidentiality is the magic behind therapy.)  When dozens have access to your record, this is lost.

Life-changing therapy relationships are possible.  Don't settle for inferior or illusory "interventions".  Seek out the best psychotherapy possible.  College counseling services are one of the last true preserves of psychotherapy; encourage your student to take advantage of this opportunity which may never be as cost-effective or convenient during their lifetimes.