Shrink to fit: psychotherapy in the 1990s
Scott W. Kadera/ UAF Center for Health and Counseling
What exactly is psychotherapy? In many people’s minds, the word conjures up images of a patient supinely resting on a divan, eyes closed, arms folded across the torso. Close behind a stern doctor sits attentively, legs crossed, scribbling on a notepad the verbalizations of the patient who has been instructed to utter uncensored whatever happens to come to mind. In this way, the doctor is able to unlock the secrets hidden in the unconscious depths of the patient’s psyche. Once these have been brought out in to the open and explained to the patient, the troubling and incapacitating symptoms which occasioned the need for therapy mysteriously disappear. The patient has been cured. Such was the hope of the “talking therapy” introduced in the late 19th century by Sigmund Freud whose theory and method is now known by the name of psychoanalysis.
Most therapists today do not adhere to specific schools of psychology but pick and choose in an eclectic manner whatever may be most effective in understanding and helping their clients. In fact, there are currently over 100 distinguishable types of psychological treatment, most of which have not been tested.
Does psychotherapy work? Most psychotherapists no longer think in terms of finding a total “Cure” for their clients. Rather, an attempt is made to help clients make significant improvements in the particular problems that brought them to therapy. Psychotherapy can offer clients alternative ways of valuing and thinking about themselves and their problems, making decisions, and resolving conflicts, and negotiating the demands of family, work, school, and romantic situations.
In a recent Consumer Reports (November, 1995) study, clients reported substantial benefits from psychotherapy provided by a variety of different mental health professionals. Clients staying on therapy longer (up to 2 years) reported the greatest amount of improvement. Although the average client received 5 to 6 sessions of therapy, several studies have indicated that only 50% of clients seeking treatment for major depression significantly improved after 16 sessions (or about 4 months). Regardless of the type of problem for which they seek therapy, most clients (about 75%) obtain significant benefits within a year or less of therapy. Of course, some clients do not profit at all and a small percentage (5%) actually become worse.
Despite the increasing role and positive reputation that psychotherapy is gaining in our society, some still loathe the thought of seeing a “shrink” or other mental health professional. Going to see a counselor is erroneously viewed as the ultimate sign of weakness, of not being able to “handle my own problems.” And yet, everyone has problems for which they turn to help from friends, relatives, or romantic partners. A mental health professional can offer specific skills, support, and a fresh perspective that others may not be able or willing to provide. When seeing professional help, don’t be afraid to ask your counselor questions. Find out if your counselor thinks he or she can be of help or whether it would be better to refer you to another counselor. Let the counselor know what he or she is doing that is helpful. Take an active part in your own treatment by giving the counselor appropriate feedback that will improve the psychotherapy experience for you. Counselors are not omnipotent either. Despite their best intentions, some counselors will not be as effective with certain clients as they would like to be. So, if all else fails, don’t be afraid to try out another counselor.
The Mind Body Connection is a weekly column written by the UAF Center for Health and Counseling staff to provide current information about health and mental health issues and answers to specific questions presented by students, faculty, and staff.