Archives for October, 2012
The anticipation of what may be the most severe weather event in the northeastern United States since 1903 looms heavy over the region in anxious wait. In fact, hours from now, the eye of Hurricane Sandy will be hovering over my New Jersey town after “she” slams into our nearby coast, approximately 50 miles due West. So, how could I not write about the tension in the air? Excessive and irrational fears about the natural environment are common. Fears of thunder and lightening (astraphobia), rain (ombrophobia), and, yes, hurricanes or tornadoes (lilapsophobia), can cause significant distress. Unlike many of its situationally-based “cousins,” nature-based fears are essentially unavoidable, unpredictable (to a large extent), and imminent perceived threats to which the sufferer responds with physiological, cognitive, and emotional arousal. This internal activation is like an alarm being sounded (the fight-or-flight response) to alert the individual to perceived danger and prepare them, in body and mind, to effectively manage the problem. Whew! I’m exhausted just thinking about this process.
Finding a therapist can be a daunting task. Our communities are full of these trained listeners. But what makes an effective therapist? Of course, the ability of a therapist to develop a strong, therapeutic alliance and the ability to genuinely convey empathy and understanding are important factors in a therapist’s “good fit” for any given individual and their needs. This premise, frequently referred to as “common factors”, is most certainly critical for change to take place. But, beyond these relationship factors, there is strong evidence concluding that effective psychotherapy also involves an active, collaborative, skill-building, process that provides clients with the opportunity to create change through new learning experiences, involving changes in thinking, emotional processing, and behavior choices. Yet, there are varied avenues to these therapy goals. With these varied paths to change, how are consumers to choose a clinician that is likely to provide effective treatment?
A young, sullen woman in her mid-thirties lays on a couch, speaking of her dissatisfaction with life, while her bearded, middle –aged, male therapist looks through his spectacles and provides bits of insight into her mother’s contribution to her beliefs that she is inadequate and unworthy of love and happiness. We’ve all seen this mockery of psychotherapy. And, many of us know that this illustration paints an inaccurate and devaluing picture of therapy. Nevertheless, it has created an enduring hesitancy and reluctance to seek psychotherapy when in distress. Somehow, this portrayal persists in our culture’s presumptive vision of the therapy office. That being said, this is far from modern Evidence-Based Practice (EBP). Like our medical counterparts, psychology has moved further and further along the path of establishing standards of care for psychological treatments based on rigorous, scientific study. In fact, to date, over 140 treatment protocols have been identified as empirically-supported (EST), evidence-based treatments (EBT). The trouble is: how do consumers learn what “best practices” and “first line treatments” are prescribed for the difficulties they are experiencing? How does one find Therapy That Works?
Despite the progress we've made over the past two decades to help people better understand psychotherapy -- what it is, how it works, and why it's effective for some but not for others -- there are still a lot of misconceptions about therapy. Pharmaceutical...