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Summary: Trends in Therapy

Increasingly, therapists feel uncomfort­able identifying themselves with only one school of psychotherapy. Many feel that they should be competent in a variety of approaches, so they can tailor therapy to a client's needs.

As a result, many of today's therapists are eclectic in orientation: they draw from many therapy perspectives. Few, how­ever, are comfortable with the "eclectic" label, so this trend is obscured when surveys ask therapists about their orientation.

Pressure for competence in a variety of therapy types comes from insurance companies and health maintenance organizations (HMOs). They want to assure their payments are going toward treatments that work.

Starting in 1994, the term EBP (evidence-based practice) became common in the United States, applied to all public health related services. In psychology, there is a demand for evidence-based therapies. This requires good research with appropriate controls and attention to problems such as selective reporting of positive outcomes.

In 1969, George Miller urged psychol­ogists to "give psychology away," and shortly thereafter a vigorous self-help movement in psychology emerged. Prominent researchers wrote popular books to share psychological knowledge with the public.

Studies showed that self-help books could work, but most of the time people who start a self-help program do not complete the program. When people quit before completing a program, self-help therapies do not work as advertised.

Many classic psychotherapies were very lengthy, extending over months or years. Psychologists experimented with briefer therapies and found sometimes they were very effective. Bloom offered an "impasse service" consisting of a single two-hour session. Cummings provided instructions for having an impact and making a change in brief therapy.

Family involvement in therapy, peer counseling, and internet-based therapy are all trends in the 21st Century. Family involvement works as long as accurate information and support services are available.

Peer counseling is uniquely effective for a range of issues in which personal exper­ience adds credibility and insider know­ledge to counseling. Peer counsel­ing produces good results in programs to reduce substance abuse, lessen adoles­cent behavior disorders, cope with can­cer and HIV diagnoses, and encourage breastfeeding by new mothers.

Internet-based therapies are widely available now. Typically they are supple­mented by contact with a therapist, in person or by email. They are more successful with this type of support. Studies show that internet-based therapies can be just as effective as other therapies, especially when deadlines are enforced and therapists provide the human element with empathy and occasional prompting.


Write to Dr. Dewey at psywww@gmail.com.


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