Misperceptions and misunderstandings of the evidence bases supporting depth-oriented psychotherapy, short-term structured therapy, and psychiatric medication have permeated the public and our own profession for decades. As a result, many people, including therapists, lack clear, updated information about which therapies are most effective. Evidence bases supporting short-term treatment -- whether manualized cognitive-behavioral treatments or medications -- are undisputedly large and do show these treatments can be efficacious. However, there are many indications that these evidence bases are crumbling, and short-term treatments have been overvalued and depth therapies undervalued. Unfortunately, the narrative from proponents of short-term treatments (academic psychology, government funding sources, pharmaceutical companies, insurance companies), with their substantial financial resources, has crowded out awareness and understanding of the strong evidence for longer-term, psychodynamic treatment.
The general public is also influenced by these narratives, in addition to having their own biases and ideas about therapy. To assess what people know about therapy and mental health, and what they really want from treatment, the Psychotherapy Action Network (PsiAN) conducted extensive original research with the general public. From this innovative and unprecedented effort to talk directly to the public, we learned about the attitudes people have towards therapy, which benefits matter most, what their misperceptions and biases are, and what they know and don’t know about mental health and therapy.
It’s critical for therapists to have the most updated and accurate information about the evidence bases for different forms of treatment. It’s also invaluable to understand how the general public views therapy and what’s really most important to them. This presentation will review the evidence bases for short-term and long-term treatments, and outline the various factors that have contributed to the misperceptions of the evidence. It will also share the findings from PsiAN’s original research with the general public. Finally, it will offer ideas about how to communicate and engage with the public in ways that are meaningful and relevant, so that the public gains greater awareness, understanding and appreciation for therapies of depth, insight, and relationship.
1) Describe the evidence base for psychoanalytic treatment
2) Describe the evidence base for short-term structured treatments
3) Assess the consequences of misinterpreting these evidence bases
4) Describe the benefits that the general public seeks from therapy and their attitudes towards issues of mental health care
Linda Michaels, PsyD, MBA is a clinical psychologist in private practice in Chicago. She is Co-Chair of the Psychotherapy Action Network (PsiAN), Associate Editor of Psychoanalytic Inquiry, a fellow of the Lauder Institute Global MBA program. She has published and presented on the value of psychotherapy, the therapeutic relationship and technology, and scientism. Linda has a former career in business, with over 15 years’ experience consulting organizations in the US and Latin America, focusing on marketing, brand and innovation strategies. In addition to her doctorate degree in clinical psychology from the Illinois School of Professional Psychology, she is a graduate of the Adult Psychoanalytic Psychotherapy program at the Chicago Psychoanalytic Institute, and has an MBA from Wharton, and a BA from Harvard.
Evidence in peer-reviewed research:
• Gnaulati, E. (2019). Overlooked ethical problems associated with the research and practice of evidence-based treatments. Journal of Humanistic Psychology, pp. 1 – 16. doi: 10.1177/0022167818800219.
• Laska, K.M., Gurman, A.S., & Wampold, B.E. (2014). Expanding the lens of evidence-based practice in psychotherapy: A common factors perspective. Psychotherapy, 51, 467-481.
• Lazar, S. (2018). The Place for psychodynamic therapy and obstacles to its provision. Psychiatric Clinics of North America, https://doi.org/10.1016/j.psc.2018.01.004
• Leichsenring, F., Abbass, A.l, Hilsenroth, M. etal. (2018). “Gold standards,” plurality and monocultures: the need for diversity in psychotherapy. Frontiers in Psychiatry, 9:159. doi: 10.3389/fpsyt.2018.00159.
• Leichsenring, F., & Steinert, C. (2017). Is cognitive behavioral therapy the gold standard for psychotherapy? The need for plurality in treatment and research. JAMA, 318, (14), 1323-1324.
• Norcross, J. & Wampold, B. (2019). Relationship and responsiveness in the psychological treatment of trauma: the tragedy of the APA clinical practice guideline. Psychotherapy, 56 (3). http:dx.doi.org/10.1037/pst0000228
• Shedler, J. (2015). Where is the evidence for “evidence-based” therapy? Journal of Psychological Therapies in Primary Care, 4, pp. 47-59.
• Steinert, C., Munder, T., Rabung, S., Hoyer, J., & Leichsenring, F. (2017). Psychodynamic therapy: As efficacious as other empirically supported treatments? A meta-analysis testing equivalence of outcomes. American Journal of Psychiatry, 174, issue 10, p. 943-953. doi: 10.1176/appi.ajp.2017.17010057
Applied for 3 CEs for psychologists, social workers, licensed mental health counselors, nursing & LMFTS.