The New York Times – The Opinion Pages – By BRANDON A. GAUDIANO – Published: September 29, 2013 – Psychotherapy’s Image Problem
Although the appearance of Brandon Gaudino’s article is a little bit of good news for therapy, I can’t help pointing out another revealing unconscious bias in it. Note the word “even”: “It is clear that a variety of therapies have strong evidentiary support, including cognitive-behavioral, mindfulness, interpersonal, family and even brief psychodynamic therapies.” Guadiano seems to have no notion of such orientations as Relational Psychoanalysis. Nor does he acknowledge that some of the American Psychiatric Association treatment guidelines for conditions such a borderline personality disorder do not primarily push medications. He seems to have this old-fashioned and reductionistic perspective on what effective psychotherapy is.
This whole business of empirically supported treatments rests upon a model that really doesn’t fit much of psychotherapy. (And the objection of people such as Guadiano that this fact is somehow a valid criticism of psychotherapies that don’t fit the model is merely tautological thinking). For a ringing defense of the relational model and of single case research study design, I recommend Irwin Z Hoffman’s “Doublethinking Our Way to Scientific Legitimacy”.
Brand allegiance and finite areas of specialty have evolved into must-have pedigree pets. (“Today shall is see my Mindfulnees Based Stress-Reduction therapist, or my Family Systems therapist?”) Clients deserve access to specific and appropriate treatment for whatever it is that brings into session. Clients, therapists, Big Pharm, third party payers and legitimizing researchers are well-served to approach treatment and healing paradigms with this flexible perspective.
Remember when Sweden decided it’s public health system would only compensate for Cognitive and Behavioral mental health treatment? Those were some dark years in Sweden.