Psychotherapy Is Not Dead

Last weekend What Brand Is Your Therapist was published by the New York Times Lori Gottlieb, the author, interviewed me and a couple of other psychologists for the piece.

In her article Ms. Gottlieb writes about her journey as a new therapist setting up a practice in the congested California market.  As she struggles to find clients, she looks to other, more established clinicians for advice.  Some say find a specialty area, others tell her to focus on consultation and/or coaching work rather than traditional psychotherapy, still others (me) tell her to increase her social media presence.

With this advice in mind, Ms. Gottlieb wonders if Americans have moved past the need for psychotherapy, citing statistics indicating that fewer people have sought talk therapy in recent years.  She also wonders if our super-fast, I-want-results-now culture makes the slower paced psychotherapy process outdated.

After stewing about it for a few days, I have gathered my thoughts, and offer this response proving that psychotherapy is not dead, in fact, it is alive and well.  With this caveat: it is essential that we change (at least a little bit) with the times.  Here goes:

Having been married to an architect for nearly 15 years, I have come to know a bit about that profession.  While it may not seem that a psychologist and an architect would have much in common professionally, I have come to realize that we do – and more than it would seem.  In addition to the arduously long training process involved in both fields, many of the current dynamics and changing business models are similar.  Take a look:

Fads Come and Go.  Colonial, craftsman, beaux arts, mid-centurn modern – these are just a few of the hundreds of styles of architecture around us.  While I might like classical design, others might prefer more contemporary; the one thing we can be sure of is that styles, tastes, and fads will change.  This is a good thing in architecture – it makes our communities more interesting.  What is critical, however, is that the structure underneath is sound.  Any architect would agree that a comprehensive understanding of history, as well as a mastery of structural and construction principles is necessary before good design can emerge.

The same is true for us in the field of psychology.  There is nothing wrong with new ideas, and unique and innovative treatments – so long as there is first a fluency in psychological science.  New treatment strategies, rooted in sound science and disciplined training, can (and should!) be constantly flowing into our daily practice.  Would we accept stagnant, non-innovative care from any other field?

Gray and Green – The New Black?  Some architects have continued to design and draw only by hand, have resisted integrating technology into their firms, and have refrained from embracing environmentally sustainable design and materials clamored for by clients.  Guess what has happened to those architects in this tough economy and competitive world? They are no longer practicing – or at least not at the level to which they would like.  Successful firms have had to innovative, be responsive to the marketplace, and have had to find a way to stay productive and flexible in a time when their clients demand more, have shorter time frames, and more restricted budgets.

Psychologists are no different.  To stay relevant and helpful (that is our mission after all) we must also innovate and find new ways to give people what they want (psychological help) and need (psychological health).  A colleague of mine, June Ching, PhD, recently wrote: “I see a…theme with the ‘old ways’ juxtaposed to the newly emerged technological advances. If the mission is still the same, perhaps joining forces with the ‘grey’ and ‘green’ is a viable option.”

Merging The Old School (“gray”) with the New School (“green”) is the only way to continue to provide the type of help and care we all desire.

Everyone Deserves Mental Health.  Most of us can’t afford to live in a house designed by an architect.  Instead, most of us live in houses that were mass-produced by a CAD-wielding draftsman employed by a large construction company.  Yea, it’s kind of a bummer from a design perspective, but guess what?  The roof still keeps out the rain and the walls still keep us warm at night.  And the price is right.

Again, the similarities with psychotherapy are striking.  Therapy is kind of a weird thing.  Sitting in a room with a stranger spilling your guts week after week, while learning little to nothing about said stranger.  Bizarre.  Not to say we strangers don’t have a lot to offer – we do! But psychotherapy isn’t for everyone.  It’s a significant commitment in terms of time and money, and frankly not everyone is helped by talking about their problems.  Some folks prefer the self-help methods of reading books or watching Oprah to aid their mental health.  Others might find comfort at church or in a peer support group.  Still others may prefer to use pharmacological treatment.  Guess what?  That’s OK!

Psychotherapy has never been a treatment utilized by the masses, and my guess is that it never will be.  The great thing is that it gives us lots of opportunities to reach out to folks who will never sit on our couches.  Podcasts, books, blogs, talks, articles in the New York Times – these are all means by which we can get the word out about the importance of psychology and good mental health.  Realizing that the 50 minute psychotherapy hour isn’t our only means of providing solid, responsible, and useful mental health care should make us feel excited and energized to meet folks in need – wherever and whoever they are.   Because in the end, everyone deserves mental health, not just those who meet us on our own, narrow terms.

It is my opinion that psychotherapy is enjoying a particularly robust period in its history.  The stigma against treatment is down, the access to care is up (thanks to changes in the insurance industry, as well as technology) and psychology, mental health, and emotional wellness are a part of the language of everyday life.  Psychotherapy is far from dead – it is very much alive and growing.  It is up to us to determine how and when to best maximize this growth, for our clients and ourselves.

New York Times: What Brand Is Your Therapist?

This article came out in yesterday’s New York Times.  In it the author, Lori Gottlieb writes about some changes and innovations in the field of psychotherapy.  I was lucky enough to be interviewed for the article and have a quote in the middle of the article.  Check it out here.  I am still working on writing up my thoughts about the ideas presented in the article.  Hint: I’m not sure I agree with Ms. Gottlieb’s conclusions.  Stay tuned!

New York Times: 11/25/2012