The New York Times recently published two opinion pieces on psychotherapy. The first, written by Dr. Brandon Gaudiano of Brown University Medical School, laments the lack of attention that psychotherapy receives by researchers, clinicians, media, and the general public as compared to that of pharmacotherapy. This is a shame, Dr. Gaudiano notes, because most of the existing research has documented effects equivalent to (or in some cases better than) medication. An added benefit is that there are generally no side effects associated with psychotherapy. And so, Dr. Gaudiano concludes that the reason that the mountain of evidence documenting the effectiveness of psychotherapy for mental illness has not more well known is that (a) the pharmacological industry has lobbied hard in support of phamacotherapy, and (b) the American Psychological Association has not.

In many ways, this conceptualization of the problem is well considered. But it does miss a few important self-inflicted wounds created by the psychotherapy field. In particular, the vast array of psychological approaches (some of which have dubious evidence bases) makes psychotherapy a much more convoluted field for patients to navigate. This has been changing in the past 15 years, with the publication of lists of “empirically supported treatments,” but this movement has experienced considerable backlash and resistance from proponents of treatments not on this list. No matter how this debate unfolds, the public still has little guidance regarding how to identify a therapist whose theoretical orientation would work well for that problem. The continued move to online information may help in this regard, but to date, this is not an easy process.

Then, there are other ways that the psychotherapy field continues to create problems for itself. Read this article about the shrinking psychotherapy hour…