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The Psychotherapy of The Future: Available Now

Mark Dombeck, Ph.D.

Those of you who have been involved with the process of psychotherapy for many years already know that the past decade has stressed, stretched and altered the way that psychotherapy is practiced. Caught between the "rock" of managed care's preoccupation with cost containment and the "hard place" of the tremendous advancements in psychopharmacology that have brought us Prozac and Viagra, traditional psychotherapy has been forced to adapt itself so as to meet the challenges of the new health care landscape. Specifically, the challenge to psychotherapy and psychotherapists has been to show the world that therapy can be re-invented so that it costs less, works better, and is less vague and time consuming to implement.

You can view one thread of the slow progress towards developing faster, cheaper and "better" forms of psychotherapy by clicking over to the home page of the American Psychological Association's Division 12 (Society of Clinical Psychology). There you will find technical reports detailing the progress of the "Task Force on Dissemination of Psychological Procedures", a group of psychological scientists who have set out to develop a systematic list of psychotherapies that have been studied extensively and are known to work well for particular problems.

The therapies placed on this list have characteristics in common that make them different than the process oriented sort of psychotherapy you may have known in the past. Where traditional therapy tended to be open-ended in duration and general purpose in its application, the therapies appearing on the Task Force List are short-term in duration and problem-focused in their application. This means that a therapy for Depression drawn from the List would be designed to run for a set period of time (usually no more than several months). It also means that the therapy's usefulness is optimized for treating Depressive symptoms only - the therapy would not be useful for treating a different disorder (such as Panic). Where traditional therapies often encouraged patients to set the agenda for therapeutic discussion, the therapies on this list generally require the majority of the session be devoted towards working through therapeutic procedures.

A final feature of the therapies on this List is that they are all manualized. A manualized therapy is one that has been systematized and written down into book form. Each therapy is thus standardized in its procedures and sequences and has a consistent look and feel no matter who implements it.

The standardization of method and technique present in the therapies on the Task Force List is also their hallmark, and what differentiates them most from traditional process forms of therapy. The tight specification of therapeutic procedure and lessened dependence on therapist's "on the fly" judgement characteristic of these therapies make it easier for researchers to study the direct contribution of technique to the efficacy of the therapies. While not perfect creations, the therapies on this list have each been extensively studied and represent the state of the art in terms of psychotherapeutic programs that are known to work. And it is ultimately how well a therapy works - the therapy's efficacy that counts.

Reference:
Dombeck, M.J. (1999). The Psychotherapy of the Future: Available Now. [Online]. Mental Help Net.