What is your view of psychotherapy?
Do you think of it in terms of positive growth? Or in terms of negatives and time wasted?
Sadly, a lot of people would react negatively if you told them that they needed counseling. One reason is that to say someone needs counseling is to say they are “sick” or “ill” in some way. The other issue is because psychotherapy (in some ways) seems to have lost a level of “legitimacy” that it strove so hard to achieve and maintain over the years.
This article will focus on potential ways psychotherapy has lost is clout in the eyes of people who may benefit from it.
I truly love what I do for a living. Providing counseling, psychoeducation, motivation for change, engaging in social justice issues, creating new ways to support humans, contributing to theoretical concepts, writing to empower certain populations, etc., makes my life-calling mean so much to me. What I do is not simply a living. It is a way of life. It is my identity. But I can’t help but recognize that the field of psychotherapy has been struggling since 2010 and possibly before that.
What has happened to psychotherapy?
The American Psychological Association shared an article detailing the perspective of the field. The article purports that there has been, according to studies on the topic, a decrease in psychotherapy. Although this article can be defined as quite dated, I can’t help but consider that perhaps things have taken a nosedive.
While I am very glad to see the field progressing and changing with the modernity of times, I can’t help but wonder if psychotherapy is losing (or has lost) its “flavor.” Do people have a negative view of psychotherapy? Do you have a negative view of psychotherapy?
To open up our exploration of this topic a bit, I have included some negative views of the field that have been shared with me during conferences and webinars where I discussed this topic. Psychotherapy may be losing its stamina because:
- Politicization of counseling: The politicization of counseling includes all of the protests, arguments, and challenges to the field’s sophistication in an attempt to ensure everyone feels equal. An example of this may include arguments over the leveling of certain deviant behaviors such as child molestation. There have been arguments in the past about the DSM including “paraphilic disorders” and “fetishism” as a problem. Believe it or not, “support groups” in favor of reducing stigma have argued that the DSM labels a natural behavior (sexual desire) a problem that needs treatment. Other groups such as social justice groups want the disorder removed from the DSM and placed under the umbrella of a crime. There are tons of other topics involving human behavior that has completely politicized the field of psychotherapy.
- Politicization of the DSM: Politicization of the DSM became a real problem during the “development” of the DSM-5. This version of the field’s so-called “bible” included politicized labels that would characterize most of humanity as clinically in need of help. It would also produce such broad categorization that no one would be able to escape the DSM’s labels and receive fair treatment. An example of this would be the “child-version” of bipolar disorder known as Disruptive Mood Dysregulation Disorder. We all know that kids have tantrums, and we all know that some kids have difficult temperaments. Some kids have had tantrums every single day of their lives but grew up to become pretty stable adults. But with the new label of DMDD, a lot of kids would be categorized as having a form of bipolar disorder. That stigmatizing label (including its historical treatment challenges), would follow them into adulthood. Even though the criteria can be useful in identifying kids who express tantrums far beyond the norm, I shake my head every time someone mentions the name.
- Increased use of teletherapy: Research suggests that psychotherapy is becoming more “modernized” through teletherapy. Using online counseling is a preference many of my clients have when they come to see me. In fact, the National Board For Certified Counselors began offering a Distance Counseling Certification for counselors who would like to become certified to offer this service. They report in their policy on distance professional services that they have always recognized the impact of computers on counseling decades ago.
- Insurance standards: Insurance companies are also updating their policies to include coverage and reimbursement of distance counseling services. This is great! But it can also create the facade that counseling is as simple as turning on your computer and talking. Counseling involves a lot of work for both the therapist and the patient (or client). It entails a lot of time, exploration, energy, dedication, seriousness, and emotional stamina to get through it. We have to be careful not to reduce the standards and the excellence of psychotherapy by unintentionally reducing it to “online counseling.” There are certainly benefits here. But I also need to point out that psychotherapy involves a lot of work that can’t be done online.
There is definitely a large number of things I could add to this list but we will stop here. I continue to love EVERYTHING about my profession. I am dedicated to its TRUE cause. But because of my dedication, I cannot overlook the challenges I see. We have come a very long way in the field of psychotherapy but there is definitely a lot more road to travel.
What has been your experience? Do you notice problems? If so, post your responses below.