Psychotherapy

Source: Wikipedia, the free encyclopedia.
(Redirected from
Psychological therapy
)

Psychotherapy
MeSHD011613

Psychotherapy (also psychological therapy, talk therapy, or talking therapy) is the use of

evidence-based for treating some diagnosed mental disorders; other types have been criticized as pseudoscience.[2]

There are hundreds of psychotherapy techniques, some being minor variations; others are based on very different conceptions of psychology.[3] Most involve one-to-one sessions, between the client and therapist, but some are conducted with groups,[4] including families.

Psychotherapists may be

mental health professionals such as psychiatrists, psychologists, mental health nurses, clinical social workers, marriage and family therapists, or professional counselors. Psychotherapists may also come from a variety of other backgrounds, and depending on the jurisdiction
may be legally regulated, voluntarily regulated or unregulated (and the term itself may be protected or not).

Definitions

The term

Children or adults who do not engage in verbal communication (or not in the usual way) are not excluded from psychotherapy; indeed some types are designed for such cases.

The

Freudian) methods, namely psychoanalysis, in contrast with other methods to treat psychiatric disorders such as behavior modification.[11]

Some definitions of

Somatotherapy refers to the use of physical changes as injuries and illnesses, and sociotherapy to the use of a person's social environment to effect therapeutic change.[13] Psychotherapy may address spirituality as a significant part of someone's mental / psychological life, and some forms are derived from spiritual philosophies, but practices based on treating the spiritual as a separate dimension are not necessarily considered as traditional or 'legitimate' forms of psychotherapy.[14]

Delivery

Psychotherapy may be delivered in person (one on one, or with couples, or in groups) or via telephone counseling or online counseling (see also § Telepsychotherapy).[15] There have also been developments in computer-assisted therapy, such as virtual reality therapy for behavioral exposure, multimedia programs to teach cognitive techniques, and handheld devices for improved monitoring or putting ideas into practice (see also § Computer-supported).[15][16]

Most forms of psychotherapy use spoken conversation. Some also use various other forms of communication such as the written word, artwork, drama, narrative story or music. Psychotherapy with children and their parents often involves play, dramatization (i.e. role-play), and drawing, with a co-constructed narrative from these non-verbal and displaced modes of interacting.[17]

Regulation

Psychotherapists traditionally may be

mental health professionals
like psychologists and psychiatrists; professionals from other backgrounds (family therapists, social workers, nurses, etc.) who have trained in a specific psychotherapy; or (in some cases) academic or scientifically trained professionals.
social workers, mental health counselors, pastoral counselors, and nurses with a specialization in mental health, also often conduct psychotherapy. Many of the wide variety of psychotherapy training programs and institutional settings are multi-professional. In most countries, psychotherapy training is completed at a postgraduate level, often at a master's degree (or doctoral) level, over four years, with significant supervised practice and clinical placements. Mental health professionals that choose to specialize in psychotherapeutic work also require a program of continuing professional education after basic professional training.[19]

A listing of the extensive professional competencies of a European psychotherapist was developed by the European Association of Psychotherapy (EAP) in 2013.[20]

As sensitive and deeply personal topics are often discussed during psychotherapy, therapists are expected, and usually legally bound, to respect client or patient confidentiality. The critical importance of client confidentiality—and the limited circumstances in which it may need to be broken for the protection of clients or others—is enshrined in the regulatory psychotherapeutic organizations' codes of ethical practice.[21] Examples of when it is typically accepted to break confidentiality include when the therapist has knowledge that a child or elder is being physically abused; when there is a direct, clear and imminent threat of serious physical harm to self or to a specific individual.

Europe

As of 2015, there are still a lot of variations between different European countries about the regulation and delivery of psychotherapy. Several countries have no regulation of the practice or no protection of the title. Some have a system of voluntary registration, with independent professional organizations, while other countries attempt to restrict the practice of psychotherapy to 'mental health professionals' (psychologists and psychiatrists) with state-certified training. The titles that are protected also vary.[22] The European Association for Psychotherapy (EAP) established the 1990 Strasbourg Declaration on Psychotherapy, which is dedicated to establishing an independent profession of psychotherapy in Europe, with pan-European standards.[23] The EAP has already made significant contacts with the European Union & European Commission towards this end.

Given that the European Union has a primary policy about the free movement of labor within Europe, European legislation can overrule national regulations that are, in essence, forms of restrictive practices.

In Germany, the practice of psychotherapy for adults is restricted to qualified psychologists and physicians (including psychiatrists) who have completed several years of specialist practical training and certification in psychotherapy.

Social workers may complete the specialist training for child and teenage clients.[26] Similarly in Italy, the practice of psychotherapy is restricted to graduates in psychology or medicine who have completed four years of recognised specialist training.[27][28] Sweden has a similar restriction on the title "psychotherapist", which may only be used by professionals who have gone through a post-graduate training in psychotherapy and then applied for a licence, issued by the National Board of Health and Welfare.[29]

Legislation in France restricts the use of the title "psychotherapist" to professionals on the National Register of Psychotherapists,[30] which requires a training in clinical psychopathology and a period of internship which is only open to physicians or titulars of a master's degree in psychology or psychoanalysis.[31]

Austria and Switzerland (2011) have laws that recognize multi-disciplinary functional approaches.[citation needed]

In the United Kingdom, the government and Health and Care Professions Council considered mandatory legal registration but decided that it was best left to professional bodies to regulate themselves, so the Professional Standards Authority for Health and Social Care (PSA) launched an Accredited Voluntary Registers scheme.[32][33][34][35][36] Counseling and psychotherapy are not protected titles in the United Kingdom. Counsellors and psychotherapists who have trained and qualify to a certain standard (usually a level 4 Diploma) can apply to be members of the professional bodies who are listed on the PSA Accredited Registers.

United States

In some states, counselors or therapists must be licensed to use certain words and titles on self-identification or advertising. In some other states, the restrictions on practice are more closely associated with the charging of fees. Licensing and regulation are performed by various states. Presentation of practice as licensed, but without such a license, is generally illegal.[37] Without a license, for example, a practitioner cannot bill insurance companies.[38] Information about state licensure of psychologists is provided by the American Psychological Association.[39]

In addition to state laws, the American Psychological Association requires its members to adhere to its published Ethical Principles of Psychologists and Code of Conduct.[40] The American Board of Professional Psychology examines and certifies "psychologists who demonstrate competence in approved specialty areas in professional psychology".[41]

Canada

Regulation of psychotherapy is in the jurisdiction of, and varies among, the provinces and territories.

In

guidance counsellors, criminologists, sexologists, psychoeducators, and registered nurses may obtain a psychotherapy permit by completing certain educational and practice requirements; their professional oversight is provided by their own professional orders. Some other professionals who were practising psychotherapy before the current system came into force continue to hold psychotherapy permits alone.[42]

On 1 July 2019, Ontario's Missing Persons Act came into effect, with the purpose of giving police more power to investigate missing persons. It allows police to require (as opposed to permit) health professionals, including psychotherapists, to share otherwise confidential documents about their client, if there is reason to believe their client is missing.[43][44] Some have expressed concern that this legislation undermines psychotherapy confidentiality and could be abused maliciously by police,[45] while others have praised the act for how it respects privacy and includes checks and balances.[46]

History

Psychotherapy can be said to have been practiced through the ages, as medics, philosophers, spiritual practitioners and people in general used psychological methods to heal others.[47][48]

In the

hypnotism, yet further.[54] Charles Lloyd Tuckey's 1889 work, Psycho-therapeutics, or Treatment by Hypnotism and Suggestion popularized the work of the Nancy School in English.[54][56] Also in 1889 a clinic used the word in its title for the first time, when Frederik van Eeden and Albert Willem van Renterghem in Amsterdam renamed theirs "Clinique de Psycho-thérapeutique Suggestive" after visiting Nancy.[54] During this time, travelling stage hypnosis became popular, and such activities added to the scientific controversies around the use of hypnosis in medicine.[54] Also in 1892, at the second congress of experimental psychology, van Eeden attempted to take the credit for the term psychotherapy and to distance the term from hypnosis.[54] In 1896, the German journal Zeitschrift für Hypnotismus, Suggestionstherapie, Suggestionslehre und verwandte psychologische Forschungen changed its name to Zeitschrift für Hypnotismus, Psychotherapie sowie andere psychophysiologische und psychopathologische Forschungen, which is probably the first journal to use the term.[54] Thus psychotherapy initially meant "the treatment of disease by psychic or hypnotic influence, or by suggestion".[5]

Freud, seated left of picture with Jung seated at the right of the picture. 1909

conscious/unconscious
influence on external relationships and the self. Sessions tended to number into the hundreds over several years.

phobias, as well as other disorders.[58]

Some therapeutic approaches developed out of the European school of

person-centered psychotherapy into mainstream focus. The primary requirement was that the client receive three core "conditions" from his counselor or therapist: unconditional positive regard, sometimes described as "prizing" the client's humanity; congruence [authenticity/genuineness/transparency]; and empathic understanding. This type of interaction was thought to enable clients to fully experience and express themselves, and thus develop according to their innate potential.[59] Others developed the approach, like Fritz and Laura Perls in the creation of Gestalt therapy, as well as Marshall Rosenberg, founder of Nonviolent Communication, and Eric Berne, founder of transactional analysis. Later these fields of psychotherapy would become what is known as humanistic psychotherapy
today. Self-help groups and books became widespread.

During the 1950s,

Aaron T. Beck developed a form of psychotherapy known as cognitive therapy. Both of these included relatively short, structured and present-focused techniques aimed at identifying and changing a person's beliefs, appraisals and reaction-patterns, by contrast with the more long-lasting insight-based approach of psychodynamic or humanistic therapies. Beck's approach used primarily the socratic method, and links have been drawn between ancient stoic philosophy and these cognitive therapies.[60]

Cognitive and behavioral therapy approaches were increasingly combined and grouped under the umbrella term

systemic coaching
.

expressive therapy, applied positive psychology and the human givens approach. A survey of over 2,500 US therapists in 2006 revealed the most utilized models of therapy and the ten most influential therapists of the previous quarter-century.[62]

Types

There are hundreds of psychotherapy approaches or schools of thought. By 1980 there were more than 250;[63] by 1996 more than 450;[64] and at the start of the 21st century there were over a thousand different named psychotherapies—some being minor variations while others are based on very different conceptions of psychology, ethics (how to live) or technique.[65][66] In practice therapy is often not of one pure type but draws from a number of perspectives and schools—known as an integrative or eclectic approach.[67][68] The importance of the therapeutic relationship, also known as therapeutic alliance, between client and therapist is often regarded as crucial to psychotherapy. Common factors theory addresses this and other core aspects thought to be responsible for effective psychotherapy. Sigmund Freud (1856–1939), a Viennese neurologist who studied with Jean-Martin Charcot in 1885, is often considered the father of modern psychotherapy. His methods included analyzing his patient's dreams in search of important hidden insights into their unconscious minds. Other major elements of his methods, which changed throughout the years, included identification of childhood sexuality, the role of anxiety as a manifestation of inner conflict, the differentiation of parts of the psyche (id, ego, superego), transference and countertransference (the patient's projections onto the therapist, and the therapist's emotional responses to that). Some of his concepts were too broad to be amenable to empirical testing and invalidation, and he was critiqued for this by Jaspers. Numerous major figures elaborated and refined Freud's therapeutic techniques including Melanie Klein, Donald Winnicott, and others. Since the 1960s, however, the use of Freudian-based analysis for the treatment of mental disorders has declined substantially. Different types of psychotherapy have been created along with the advent of clinical trials to test them scientifically. These incorporate subjective treatments (after Beck), behavioral treatments (after Skinner and Wolpe) and additional time-constrained and centered structures, for example, interpersonal psychotherapy. In youth issue and in schizophrenia, the systems of family treatment hold esteem. A portion of the thoughts emerging from therapy are presently pervasive and some are a piece of the tool set of ordinary clinical practice. They are not just medications, they additionally help to understand complex conduct.

Therapy may address specific forms of diagnosable

interpersonal relationships or meeting personal goals. A course of therapy may happen before, during or after pharmacotherapy (e.g. taking psychiatric medication
).

Psychotherapies are categorized in several different ways. A distinction can be made between those based on a

DSM-IV
, the diagnostic and statistical manual of mental disorders in the United States is an example of a medically exclusive model. The humanistic or non-medical model in contrast strives to depathologise the human condition. The therapist attempts to create a relational environment conducive to experiential learning and help build the client's confidence in their own natural process resulting in a deeper understanding of themselves. The therapist may see themselves as a facilitator/helper.

Another distinction is between individual one-to-one therapy sessions, and group psychotherapy, including couples therapy and family therapy.[69]

Therapies are sometimes classified according to their duration; a small number of sessions over a few weeks or months may be classified as

brief therapy
(or short-term therapy), others, where regular sessions take place for years, may be classified as long-term.

Some practitioners distinguish between more "uncovering" (or "depth") approaches and more "supportive" psychotherapy. Uncovering psychotherapy emphasizes facilitating the client's insight into the roots of their difficulties. The best-known example is classical psychoanalysis. Supportive psychotherapy by contrast stresses strengthening the client's coping mechanisms and often providing encouragement and advice, as well as reality-testing and limit-setting where necessary. Depending on the client's issues and situation, a more supportive or more uncovering approach may be optimal.[70]

Humanistic

These psychotherapies, also known as "

subjective meaning, a rejection of determinism, and a concern for positive growth rather than pathology.[71] Some posit an inherent human capacity to maximize potential, "the self-actualizing tendency"; the task of therapy is to create a relational environment where this tendency might flourish.[72] Humanistic psychology can, in turn, be rooted in existentialism—the belief that human beings can only find meaning by creating it. This is the goal of existential therapy. Existential therapy is in turn philosophically associated with phenomenology.[73][74]

Person-centered therapy, also known as client-centered, focuses on the therapist showing openness, empathy and "unconditional positive regard", to help clients express and develop their own self.[75]

Humanistic Psychodrama (HPD) is based on the human image of humanistic psychology.[76] So all rules and methods follow the axioms of humanistic psychology. The HPD sees itself as development-oriented psychotherapy and has completely moved away from the psychoanalytic catharsis theory.[77] Self-awareness and self-realization are essential aspects in the therapeutic process. Subjective experiences, feelings and thoughts and one's own experiences are the starting point for a change or reorientation in experience and behavior in the direction of more self-acceptance and satisfaction. Dealing with the biography of the individual is closely related to the sociometry of the group.[78]

Gestalt therapy, originally called "concentration therapy", is an existential/experiential form that facilitates awareness in the various contexts of life, by moving from talking about relatively remote situations to action and direct current experience. Derived from various influences, including an overhaul of psychoanalysis, it stands on top of essentially four load-bearing theoretical walls: phenomenological method, dialogical relationship, field-theoretical strategies, and experimental freedom.[79]

A briefer form of humanistic therapy is the human givens approach, introduced in 1998–99.[80] It is a solution-focused intervention based on identifying emotional needs—such as for security, autonomy and social connection—and using various educational and psychological methods to help people meet those needs more fully or appropriately.[81][82][83][84]

Insight-oriented

psychodynamic therapy, of which psychoanalysis is the oldest and most intensive form, these applications of depth psychology encourage the verbalization of all the patient's thoughts, including free associations
, fantasies, and dreams, from which the analyst formulates the nature of the past and present unconscious conflicts which are causing the patient's symptoms and character problems.

There are six main schools of psychoanalysis, which all influenced psychodynamic theory:

group therapy
have also developed.

Cognitive-behavioral

monistic (rejecting mind-body dualism and treating the person as a unit), and relational (analyzing bidirectional interactions).[89]

Cognitive therapy focuses directly on changing the thoughts, in order to improve the emotions and behaviors.

emotions and behaviors
. Generally in CBT, the therapist, through a wide array of modalities, helps clients assess, recognize and deal with problematic and dysfunctional ways of thinking, emoting and behaving.

The concept of "third wave" psychotherapies reflects an influence of Eastern philosophy in clinical psychology, incorporating principles such as meditation into interventions such as mindfulness-based cognitive therapy, acceptance and commitment therapy, and dialectical behavior therapy for borderline personality disorder.[65]

Interpersonal psychotherapy (IPT) is a relatively brief form of psychotherapy (deriving from both CBT and psychodynamic approaches) that has been increasingly studied and endorsed by guidelines for some conditions. It focuses on the links between mood and social circumstances, helping to build social skills and social support.[90] It aims to foster adaptation to current interpersonal roles and situations.

Exposure and response prevention (ERP) is primarily deployed by therapists in the treatment of OCD.[91] The American Psychiatric Association (APA) state that CBT drawing primarily on behavioral techniques (such as ERP) has the "strongest evidence base" among psychosocial interventions.[92] By confronting feared scenarios (i.e., exposure) and refraining from performing rituals (i.e., responsive prevention), patients may gradually feel less distress in confronting feared stimuli, while also feeling less inclination to use rituals to relieve that distress. Typically, ERP is delivered in "hierarchical fashion", meaning patients confront increasingly anxiety-provoking stimuli as they progress through a course of treatment.[93][94]

Other types include

co-occurring disorders therapies such as Seeking Safety.[95]

Systemic

Group therapy, Ukraine

marriage counseling). Community psychology
is a type of systemic psychology.

The term

Northfield Hospital in Birmingham gave its name to what came to be called the two "Northfield Experiments", which provided the impetus for the development since the war of both social therapy, that is, the therapeutic community movement, and the use of small groups for the treatment of neurotic and personality disorders. Today group therapy is used in clinical settings and in private practice settings.[96]

Expressive

Expressive psychotherapy is a form of therapy that utilizes artistic expression (via improvisational, compositional, re-creative, and receptive experiences) as its core means of treating clients. Expressive psychotherapists use the different disciplines of the creative arts as therapeutic interventions. This includes the modalities dance therapy, drama therapy, art therapy, music therapy, writing therapy, among others.[97] This may include techniques such as affect labeling. Expressive psychotherapists believe that often the most effective way of treating a client is through the expression of imagination in creative work and integrating and processing what issues are raised in the act.

Postmodernist

Also known as

post-structuralist or constructivist. Narrative therapy gives attention to each person's "dominant story" through therapeutic conversations, which also may involve exploring unhelpful ideas and how they came to prominence. Possible social and cultural influences may be explored if the client deems it helpful. Coherence therapy posits multiple levels of mental constructs that create symptoms as a way to strive for self-protection or self-realization. Feminist therapy does not accept that there is one single or correct way of looking at reality and therefore is considered a postmodernist approach.[98]

Other

Transpersonal psychology addresses the client in the context of a spiritual understanding of consciousness.[99] Positive psychotherapy (PPT) (since 1968) is a method in the field of humanistic and psychodynamic psychotherapy and is based on a positive image of humans, with a health-promoting, resource-oriented and conflict-centered approach.

Hypnotherapy is undertaken while a subject is in a state of hypnosis. Hypnotherapy is often applied in order to modify a subject's behavior, emotional content, and attitudes, as well as a wide range of conditions including: dysfunctional habits,[100][101][102][103][104] anxiety,[105] stress-related illness,[106][107][108] pain management,[109][unreliable source?][110] and personal development.[111][unreliable source?][112]

shamanic healing rituals of indigenous people. Researchers identified two main differences: the first is the shamanic belief that multiple realities exist and can be explored through altered states of consciousness, and second the belief that spirits encountered in dreams and visions are real.[116][115] The charitable initiative Founders Pledge has written a research report on cost-effective giving opportunities for funding psychedelic-assisted mental health treatments.[117][118]

integrative body psychotherapy; Ron Kurtz's Hakomi psychotherapy; sensorimotor psychotherapy; Biosynthesis psychotherapy; and Biodynamic psychotherapy. These approaches are not to be confused with body work
or body-therapies that seek to improve primarily physical health through direct work (touch and manipulation) on the body, rather than through directly psychological methods.

Some non-Western

Integrative psychotherapy is an attempt to combine ideas and strategies from more than one theoretical approach.[122] These approaches include mixing core beliefs and combining proven techniques. Forms of integrative psychotherapy include multimodal therapy, the transtheoretical model, cyclical psychodynamics, systematic treatment selection, cognitive analytic therapy, internal family systems model, multitheoretical psychotherapy and conceptual interaction. In practice, most experienced psychotherapists develop their own integrative approach over time.

Child

Psychotherapy needs to be adapted to meet the developmental needs of children. Depending on age, it is generally held to be one part of an effective strategy to help the needs of a child within the family setting.[123] Child psychotherapy training programs necessarily include courses in human development. Since children often do not have the ability to articulate thoughts and feelings, psychotherapists will use a variety of media such as musical instruments, sand and toys, crayons, paint, clay, puppets, bibliocounseling (books), or board games. The use of play therapy is often rooted in psychodynamic theory, but other approaches also exist.

In addition to therapy for the child, sometimes instead of it, children may benefit if their parents work with a therapist, take parenting classes, attend grief counseling, or take other action to resolve stressful situations that affect the child. Parent management training is a highly effective form of psychotherapy that teaches parenting skills to reduce their child's behavior problems.

In many cases a different psychotherapist will work with the care taker of the child, while a colleague works with the child.[124] Therefore, contemporary thinking on working with the younger age group has leaned towards working with parent and child simultaneously, as well as individually as needed.[125][126]

Computer-supported

Research on computer-supported and computer-based interventions has increased significantly over the course of the last two decades.[127][128] The following applications frequently have been investigated:

  • Virtual reality: VR is a computer-generated scenario that simulates experience. The immersive environment, used for simulated exposure, can be similar to the real world or it can be fantastical, creating a new experience.[129][130]
  • Computer-based interventions (or online interventions or internet interventions): These interventions can be described as interactive self-help. They usually entail a combination of text, audio or video elements.[131][132]
  • Computer-supported therapy (or blended therapy): Classical psychotherapy is supported by means of online or
    software application elements. The feasibility of such interventions has been investigated for individual[133] and group therapy.[134][135]

Telepsychotherapy

Telemental health session

Telepsychiatry or telemental health refers to the use of telecommunications technology (mostly videoconferencing and phone calls) to deliver psychiatric care remotely for people with mental health conditions. It is a branch of telemedicine.[136][137]

Telepsychiatry can be effective in treating people with mental health conditions. In the short-term it can be as acceptable and effective as face-to-face care.[138]

It can improve access to mental health services for some but might also represent a barrier for those lacking access to a suitable device, the internet or the necessary digital skills. Factors such as poverty that are associated with lack of internet access are also associated with greater risk of mental health problems, making digital exclusion an important problem of telemental health services.[138]

During the COVID-19 pandemic mental health services were adapted to telemental health in high-income countries. It proved effective and acceptable for use in an emergency situation but there were concerns regarding its long-term implementation.[139]

Effects

Evaluation

There is considerable controversy about whether, or when, psychotherapy efficacy is best evaluated by

idiographic methods.[140]

One issue with trials is what to use as a

control group. Often, this group includes patients on a waiting list, or those receiving some kind of regular non-specific contact or support. Researchers must consider how best to match the use of inert tablets or sham treatments in placebo-controlled studies in pharmaceutical trials. Several interpretations and differing assumptions and language remain.[141] Another issue is the attempt to standardize and manualize therapies and link them to specific symptoms of diagnostic categories, making them more amenable to research. Some report that this may reduce efficacy or gloss over individual needs. Fonagy and Roth's opinion is that the benefits of the evidence-based approach outweighs the difficulties.[142]

There are several formal frameworks for evaluating whether a psychotherapist is a good fit for a patient. One example is the Scarsdale Psychotherapy Self-Evaluation (SPSE).[143] However, some scales, such as the SPS, elicit information specific to certain schools of psychotherapy alone (e.g. the superego).

Many psychotherapists believe that the nuances of psychotherapy cannot be captured by questionnaire-style observation, and prefer to rely on their own clinical experiences and conceptual arguments to support the type of treatment they practice. Psychodynamic therapists increasingly believe that evidence-based approaches are appropriate to their methods and assumptions, and have increasingly accepted the challenge to implement evidence-based approaches in their methods.[144]

A pioneer in investigating the results of different psychological therapies was psychologist

behavior therapy is the only effective one. However, it was revealed that Eysenck (who died in 1997) falsified data in his studies about this subject, fabricating data that would indicate that behavioral therapy enables achievements that are impossible to believe. Fourteen of his papers were retracted by journals in 2020, and journals issued 64 statements of concern about publications by him. Rod Buchanan, a biographer of Eysenck, has argued that 87 publications by Eysenck should be retracted.[145][146][147][148][149][150][151]

Outcomes in relation with selected kinds of treatment

Large-scale international reviews of scientific studies have concluded that psychotherapy is effective for numerous conditions.[8][22]

One line of research consistently finds that supposedly different forms of psychotherapy show similar effectiveness. According to The Handbook of Counseling Psychology: "Meta-analyses of psychotherapy studies have consistently demonstrated that there are no substantial differences in outcomes among treatments". The handbook states that there is "little evidence to suggest that any one psychological therapy consistently outperforms any other for any specific psychological disorders. This is sometimes called the Dodo bird verdict after a scene/section in Alice in Wonderland where every competitor in a race was called a winner and is given prizes".[152]

Further analyses seek to identify the factors that the psychotherapies have in common that seem to account for this, known as common factors theory; for example the quality of the therapeutic relationship, interpretation of problem, and the confrontation of painful emotions.[153][154][page needed][155][156]

Outcome studies have been critiqued for being too removed from real-world practice in that they use carefully selected therapists who have been extensively trained and monitored, and patients who may be non-representative of typical patients by virtue of strict inclusionary/exclusionary criteria. Such concerns impact the replication of research results and the ability to generalize from them to practicing therapists.[154][157]

However, specific therapies have been tested for use with specific disorders,[158] and regulatory organizations in both the UK and US make recommendations for different conditions.[159][160][161]

The Helsinki Psychotherapy Study was one of several large long-term clinical trials of psychotherapies that have taken place. Anxious and depressed patients in two short-term therapies (solution-focused and brief psychodynamic) improved faster, but five years long-term psychotherapy and psychoanalysis gave greater benefits. Several patient and therapist factors appear to predict suitability for different psychotherapies.[162]

Meta-analyses have established that

cognitive behavioural therapy (CBT) and psychodynamic psychotherapy are equally effective in treating depression.[163]

A 2014 meta analysis over 11,000 patients reveals that Interpersonal Psychotherapy (IPT) is of comparable effectiveness to CBT for depression but is inferior to the latter for eating disorders.[164] For children and adolescents, interpersonal psychotherapy and CBT are the best methods according to a 2014 meta analysis of almost 4000 patients.[165]

Mechanisms of change

It is not yet understood how psychotherapies can succeed in treating mental illnesses.[166] Different therapeutic approaches may be associated with particular theories about what needs to change in a person for a successful therapeutic outcome.

In general, processes of emotional arousal and memory have long been held to play an important role. One theory combining these aspects proposes that permanent change occurs to the extent that the neuropsychological mechanism of memory reconsolidation is triggered and is able to incorporate new emotional experiences.[167][168][169][170]

Adherence

Patient

adherence
to a course of psychotherapy—continuing to attend sessions or complete tasks—is a major issue.

The dropout level—early termination—ranges from around 30% to 60%, depending partly on how it is defined. The range is lower for research settings for various reasons, such as the selection of clients and how they are inducted. Early termination is associated on average with various demographic and clinical characteristics of clients, therapists and treatment interactions.[171][172] The high level of dropout has raised some criticism about the relevance and efficacy of psychotherapy.[173]

Most psychologists use between-session tasks in their general therapy work, and cognitive behavioral therapies in particular use and see them as an "active ingredient". It is not clear how often clients do not complete them, but it is thought to be a pervasive phenomenon.[171]

From the other side, the adherence of therapists to therapy protocols and techniques—known as "treatment integrity" or "fidelity"—has also been studied, with complex mixed results.[174] In general, however, it is a hallmark of evidence-based psychotherapy to use fidelity monitoring as part of therapy outcome trials and ongoing quality assurance in clinical implementation.

Adverse effects

Research on adverse effects of psychotherapy has been limited, yet worsening of symptoms may be expected to occur in 3% to 15% of patients, with variability across patient and therapist characteristics.[175][176][177] Potential problems include deterioration of symptoms or developing new symptoms, strains in other relationships, social stigma, and therapy dependence.[178] Some techniques or therapists may carry more risks than others, and some client characteristics may make them more vulnerable.[176] Side-effects from properly conducted therapy should be distinguished from harms caused by malpractice.[178]

General critiques

Some critics are skeptical of the healing power of psychotherapeutic relationships.[179][180][181] Some dismiss psychotherapy altogether in the sense of a scientific discipline requiring professional practitioners,[182] instead favoring either nonprofessional help[182] or biomedical treatments.[183] Others have pointed out ways in which the values and techniques of therapists can be harmful as well as helpful to clients (or indirectly to other people in a client's life).[184][185][186]

Many resources available to a person experiencing emotional distress—the friendly support of friends, peers, family members, clergy contacts, personal reading, healthy exercise, research, and independent coping—all present considerable value. Critics note that humans have been dealing with crises, navigating severe social problems and finding solutions to life problems long before the advent of psychotherapy.[187]

On the other hand, some argue psychotherapy is under-utilized and under-researched by contemporary psychiatry despite offering more promise than stagnant medication development. In 2015, the US

pharmaceutical companies), despite plentiful evidence they can work and that patients are more likely to prefer them.[188]

Further critiques have emerged from

feminist, constructionist and discourse-analytical sources.[189][190][191] Key to these is the issue of power.[190][192] In this regard there is a concern that clients are persuaded—both inside and outside the consulting room—to understand themselves and their difficulties in ways that are consistent with therapeutic ideas.[180][190] This means that alternative ideas (e.g., feminist,[193] economic,[194] spiritual[195]) are sometimes implicitly undermined.[196] Critics suggest that we idealize the situation when we think of therapy only as a helping relationship—arguing instead that it is fundamentally a political practice, in that some cultural ideas and practices are supported while others are undermined or disqualified, and that while it is seldom intended, the therapist–client relationship always participates in society's power relations and political dynamics.[180][197][198] A noted academic who espoused this criticism was Michel Foucault.[199][200][201]

See also

References

  1. ^ "What is Psychotherapy?". www.psychiatry.org. Retrieved 12 March 2022.
  2. PMID 26720821
    . TFT, a treatment applied to mood, anxiety, and trauma-related disorders, is a prime example of practice founded on pseudoscience.
  3. . Though there are hundreds if not thousands of different kinds of psychotherapy, in many ways some are quite similar—they share some common factors.
  4. ^ Jeremy Schwartz (14 July 2017). "5 Reasons to Consider Group Therapy". US News. Archived from the original on 22 July 2017.
  5. ^ a b "psychotherapy, n.". OED Online. March 2015. Oxford University Press. (accessed 23 May 2015)
  6. ^ "Psychotherapy". nami.org. National Alliance on Mental Illness. Archived from the original on 29 March 2015. Retrieved 29 March 2015.
  7. ^ 'Talk Therapy' Archived 16 July 2015 at the Wayback Machine The American Heritage® Dictionary of the English Language, 5th edition
  8. ^ from the original on 1 January 2016.
  9. ^ APA Recognition of Psychotherapy Effectiveness Archived 29 July 2015 at the Wayback Machine Approved August 2012
  10. ^ Frank, J. D., & Frank, J. B. (1991, 3rd ed. First published 1961). Persuasion and healing: A comparative study of psychotherapy Archived 23 July 2015 at the Wayback Machine. Baltimore: Johns Hopkins University Press. Page 2.
  11. .
  12. ^ History of Counselling & Psychotherapy Greg Mulhauser, CounsellingResource Library, 2014
  13. ^ Theory and Practice of Nursing: An Integrated Approach to Caring Practice Archived 23 July 2015 at the Wayback Machine Lynn Basford, Oliver Slevin, Nelson Thornes, 2003. Page 533
  14. ^ Psychotherapy in a Traditional Society: Context, Concept and Practice Archived 16 July 2015 at the Wayback Machine Vijoy K Varma, Nitin Gupta. Jaypee Brothers Publishers. 2008. Page 230
  15. ^ a b Wright, Jesse H. (1 December 2008). "Computer-Assisted Psychotherapy | Psychiatric Times". Psychiatric Times. Psychiatric Times Vol 25 No 14. 25 (14). Archived from the original on 24 September 2015.
  16. PMID 20683681
    .
  17. .
  18. ^ "How to Become a Psychiatrist – Career Path, Salary and Job Description | UniversityHQ". universityhq.org. Retrieved 13 March 2022.
  19. ^ "Psychoanalytic Psychotherapy Training | APsaA". apsa.org. Retrieved 26 March 2022.
  20. ^ Professional Competencies of a European Psychotherapist "The Professional Competencies of a European Psychotherapist: Home Page". Archived from the original on 8 July 2017. Retrieved 25 January 2018.
  21. ^ Ethical Principles (2010) of the American Psychological Association, Standard 4: Privacy and Confidentiality online at "Ethical Principles of Psychologists and Code of Conduct". Archived from the original on 1 April 2015. Retrieved 1 April 2015..
  22. ^ a b Psychotherapy for mental illness in Europe: An exploration on the evidence base and the status quo Archived 22 July 2015 at the Wayback Machine Eva Woelbert, 2015, Joint Research Centre, Publications Office of the European Union
  23. ^ "Appendix 1a". Archived from the original on 27 January 2011.
  24. ^ "A guide to psychotherapy in Germany: Where can I find help?", InformedHealth.org [Internet], Institute for Quality and Efficiency in Health Care (IQWiG), 23 December 2016, retrieved 2 October 2023
  25. ^ "PsychTh-APrV – Ausbildungs- und Prüfungsverordnung für Psychologische Psychotherapeuten". www.gesetze-im-internet.de. Archived from the original on 28 September 2017.
  26. ^ A guide to psychotherapy in Germany: Where can I find help? Archived 1 January 2016 at the Wayback Machine January 2013; Next update: 2016. IQWiG (Institute for Quality and Efficiency in Health Care)
  27. ^ "Regulation of the profession of the psychologist". Archived from the original on 2 April 2015. Retrieved 19 March 2015.
  28. ^ Moreno, Manghi (December 2004). "Cosa regolamenta effettivamente la legge Ossicini?" (PDF) (in Italian). Archived from the original (PDF) on 2 April 2015. Retrieved 19 March 2015.
  29. ^ "Application for licence to practise as a psychotherapist". National Board of Health and Welfare (Sweden). Archived from the original on 9 January 2014. Retrieved 31 March 2013.
  30. ^ "Arrêté du 9 juin 2010 relatif aux demandes d'inscription au registre national des psychothérapeutes" (in French). Archived from the original on 7 July 2010. Retrieved 21 July 2010.
  31. ^ "Psychotherapy in France". European Association for Psychotherapy. Retrieved 28 January 2024.
  32. UK Department of Health (21 February 2007). "Trust, assurance and safety: The regulation of health professionals" (PDF) (White Paper). London: The Stationery Office. Archived from the original
    (PDF) on 7 January 2013. Retrieved 22 February 2013.
  33. .
  34. ^ McGivern, Gerry; Fischer, Michael; Ferlie, Ewan; Exworthy, Mark (October 2009). Statutory regulation and the future of professional practice in psychotherapy and counselling: Evidence from the field (PDF). Economic and Social Research Council, King's College London. Archived (PDF) from the original on 9 January 2014. Retrieved 22 February 2013.[page needed]
  35. ^ "Health and Social Care Act 2012", legislation.gov.uk, The National Archives, 2012 c. 7
  36. ^ "Voluntary Registers: About Accreditation". Professional Standards Authority for Health and Social Care. Archived from the original on 9 January 2014. Retrieved 9 January 2014.
  37. ^ Counselling Resource, "Professional Licensing in Mental Health". Accessed 11 March 2015.
  38. ^ Wolf, Abraham; Keitner, Gabor; Jennings, Barbara. "The Psychotherapeutic Professions in the United States of America" (PDF). Archived from the original (PDF) on 2 April 2015. Retrieved 1 April 2015..
  39. ^ "State Licensure". apapracticecentral.org. Archived from the original on 2 April 2015. Retrieved 1 April 2015.
  40. ^ Ethical Principles (2010) of the American Psychological Association, online at "Ethical Principles of Psychologists and Code of Conduct". Archived from the original on 1 April 2015. Retrieved 1 April 2015..
  41. ^ "PUBLIC – American Board of Professional Psychology". www.abpp.org. Archived from the original on 13 June 2011. Retrieved 1 April 2015.
  42. ^ "Qui pratique la psychothérapie ?". Ordre des psychologues du Québec. Retrieved 2 November 2020.
  43. ^ "New Legislation: Missing Persons Act, 2018" (PDF). The E-Bulletin. 10 (4): 6. October 2019.
  44. ^ "New Missing Persons act gives Ontario police more power to investigate". 6 June 2019.
  45. ^ Mares, Beth (23 December 2019). "New police powers trump privacy in Ontario".
  46. ^ Gillis, Wendy (18 July 2019). "New Ontario law expands police powers in missing persons cases". Toronto Star.
  47. ^ Ancient Classical Roots of Psychology Archived 23 July 2015 at the Wayback Machine Laura Rehwalt in History of Science, Electrum Magazine, 2 March 2013
  48. .
  49. ^ Ellenberger, H. F. (1970). The discovery of the unconscious: The history and evolution of dynamic psychiatry. New York: Basic Books.
  50. ^ Gielen, U. P., & Raymond, J. (2015). The curious birth of psychological healing in the Western World (1775–1825): From Gaßner to Mesmer to Puységur. In G. Rich & U. P. Gielen (Eds.), Pathfinders in international psychology (pp. 25–51). Charlotte, NC: Information Age Publishing.
  51. – via Internet Archive.
  52. ^ The Oxford Handbook of the History of Medicine Archived 7 July 2015 at the Wayback Machine Mark Jackson, OUP Oxford, 25 August 2011. Pg527
  53. ^ a b c d e f g h Shamdasani S. (2005) 'Psychotherapy': the invention of a word History of the Human Sciences 18(1):1–22
  54. ^ Tuke, Daniel Hack Illustrations of the influence of the mind upon the body in health and disease: designed to elucidate the action of the imagination Henry C. Lea. Philadelphia: 1873
  55. ^ Tuckey, C. Lloyd Psycho-therapeutics, or, Treatment by sleep and suggestion Balliere, Tindall, and Cox. London: 1889
  56. PMID 13000035
    .
  57. ^ "Behaviorism | Internet Encyclopedia of Philosophy". Retrieved 15 March 2022.
  58. ^ "Person Centred Therapy – Core Conditions | Simply Psychology". www.simplypsychology.org. Retrieved 26 March 2022.
  59. .
  60. .
  61. ^ "The top 10: The most influential therapists of the past quarter-century". Psychotherapy Networker. March–April 2007. Archived from the original on 5 February 2011. Retrieved 7 October 2010.
  62. ]
  63. ]
  64. ^ a b Twenty-First Century Psychotherapies: Contemporary Approaches to Theory and Practice Archived 11 July 2015 at the Wayback Machine Jay L. Lebow, John Wiley & Sons, 2012. Introduction. Citing Garfield 2006
  65. .
  66. ]
  67. ]
  68. ^ Crago, H. (2006). Couple, Family and Group Work: First Steps in Interpersonal Intervention. Maidenhead, Berkshire; New York: Open University Press.
  69. PMID 11069130
    .
  70. ^ Maslow, A.H. (2011) "Toward A Psychology of Being" – Reprint of 1962 Edition, Martino Fine Books.
  71. .
  72. ^ Deurzen, E., Kenward, R. (2005) "Dictionary of Existential Psychotherapy and Counseling", SAGE Publications.
  73. ^ Gessmann, H.W. (1996) "Humanistische Psychologie und Humanistisches Psychodrama. In: Humanistisches Psychodrama Band 4, (Hrsg.), Verlag des PIB, Duisburg
  74. ^ Rogers, C. R. (1951) "Client-Centered Therapy: Its Current Practice, Implications, and Theory", Boston: Houghton Mifflin.
  75. ^ H.-W. Gessmann: Humanistische Psychologie und Humanistisches Psychodrama. In: Humanistisches Psychodrama. Band IV, Verlag des Psychotherapeutischen Instituts Bergerhausen, Duisburg 1996, S. 27–76.
  76. ^ H.-W. Gessmann: Erste Überlegungen zur Überwindung des Katharsisbegriffs im Humanistischen Psychodrama. In: Internationale Zeitschrift für Humanistisches Psychodrama. 5. Jahrgang, Heft 2, Dez 1999, Verlag des Psychotherapeutischen Instituts Bergerhausen, Duisburg, S. 5–26, ISSN 0949-3018
  77. .
  78. ^ Wheeler, G. (1991) "Gestalt reconsidered", New York: Gardner Press.
  79. .
  80. from the original on 14 September 2017.
  81. .
  82. from the original on 8 October 2014.
  83. .
  84. ^ Psychodynamic Therapy Archived 22 July 2015 at the Wayback Machine J. Haggerty, PsychCentral, 2013
  85. ^ Sullivan, H. S. (1953) The Interpersonal Theory of Psychiatry. New York: Norton
  86. ^ Blechner, M. J.(2018) The Mindbrain and Dreams. New York: Routledge
  87. ^ Mitchell, S. (1988) Relational Concepts in Psychoanalysis. Cambridge, MA: Harvard University Press.
  88. ]
  89. .
  90. ^ "International OCD Foundation | Exposure and Response Prevention (ERP)". International OCD Foundation. Retrieved 2 October 2023.
  91. ^ Simpson, H. Blair; Koran, Lorrin M. (March 2013). "Guideline Watch: Practice guideline for the treatment of patients with obsessive-compulsive disorder" (PDF). Psychiatry Online. American Psychiatric Association.
  92. ^ "How I Treat OCD – By Bradley C. Riemann, Ph.D." Beyond OCD. Retrieved 27 August 2020.
  93. ^ "Treating Obsessive-Compulsive Disorder" (PDF). Psychiatry Online. American Psychiatric Association (APA). August 2020.
  94. OCLC 303076493
    .
  95. .
  96. .
  97. ^ Introduction to Feminist Therapy: Strategies for Social and Individual Change Archived 23 July 2015 at the Wayback Machine 2010. Introduction pg180
  98. ^ "Transpersonal Psychology: Principles and Applications". Psych Central. 3 November 2011. Retrieved 2 October 2023.
  99. S2CID 39850409
    .
  100. (PDF) from the original on 6 July 2012.
  101. .
  102. .
  103. .
  104. .
  105. (PDF) from the original on 2 May 2013.
  106. ^ Ellner, Michael; Aurbach, Robert (2009). "Hypnosis in disability settings" (PDF). IAIABC Journal. 46 (2): 57–75. Archived from the original (PDF) on 13 July 2012. Retrieved 29 April 2013.
  107. (PDF) from the original on 2 April 2015.
  108. ^ Ngai, Hoi N. (2000). "Hypnosis in Pain Management" (PDF). Archived (PDF) from the original on 20 October 2013. Retrieved 29 April 2013.
  109. (PDF) from the original on 2 May 2013.
  110. ^ Cannon, Georgina (2008). "How to learn better study habits through hypnosis". Hypnotherapy Articles: Promoting Knowledge. Archived from the original on 26 January 2013. Retrieved 29 April 2013.
  111. PMID 6678109
    .
  112. . Retrieved 11 September 2020.
  113. .
  114. ^ . Retrieved 11 September 2020.
  115. .
  116. ^ Samuel, Sigal (9 October 2020). "The case for funding psychedelics to treat mental health". Vox. Retrieved 2 April 2021.
  117. ^ Hoeijmakers, Sjir; Goth, Aidan (25 September 2020). "Psychedelic-Assisted Mental Health Treatments Executive Summary". Founders Pledge. Retrieved 2 April 2021.
  118. ^ Non Western Therapies: a review of Meseron Therapy, what is the way forward? Archived 10 September 2015 at the Wayback Machine Carol Ofovwe, 7th World Congress on Psychotherapy, 25–29 August 2014
  119. ^ Reframing and Redefining Family Therapy: Ubuntu Perspective Archived 22 July 2015 at the Wayback Machine Mediterranean Journal of Social Sciences, Vol 5, No 23 (2014) S.H. Somni, N.S. Sandlana
  120. ^ Development of The Harmony Restoration Measurement Scale (Cosmogram) Part 1 Archived 21 July 2015 at the Wayback Machine Vol 21, No 3 (2013) EP Onyekwere, EC Lekwas, EJ Eze, NF Chukwunenyem, IC Uchenna
  121. ]
  122. PMID 1661526. Archived from the original
    on 4 March 2016. Retrieved 18 January 2015.
  123. .
  124. PMID 16292115. Archived from the original
    (PDF) on 9 January 2014.
  125. (PDF) on 9 January 2014. Retrieved 9 January 2014.
  126. .
  127. .
  128. PMID 26833396. {{cite journal}}: |last4= has generic name (help
    )
  129. .
  130. .
  131. – via Taylor & Francis Online.
  132. .
  133. from the original on 25 April 2018.
  134. .
  135. ^ "What is Telepsychiatry?". American Psychiatric Association. Retrieved 20 February 2023.
  136. ^ "What is Telemental Health?". National Institute of Mental Health (NIMH). Retrieved 20 February 2023.
  137. ^
    PMID 35767691
    .
  138. .
  139. ^ Carey, Benedict (10 August 2004). "For psychotherapy's claims, skeptics demand proof". The New York Times. Archived from the original on 19 April 2016. Retrieved 25 December 2016.
  140. ^ Talking Cures and Placebo Effects Archived 23 July 2015 at the Wayback Machine David A. Jopling OUP Oxford, 29 May 2008
  141. ^ Roth A., and Fonagy P. (2005) What Works for Whom: A critical review of psychotherapy research. Second Edition. The Guildford Press
  142. ^ "The Scarsdale Psychotherapy Self-Evaluation (SPSE)". Archived from the original on 14 April 2018.
  143. .
  144. ^ Eysenck, H. J. & Grossarth-Maticek, R. (1991). Creative novation behaviour therapy as a prophylactic treatment for cancer and coronary heart disease: II. Effects of treatment. Behaviour Research and Therapy, 29, 1, 17–31. https://doi.org/10.1016/S0005-7967(09)80003-X
  145. ^ King's College London (May 2019). King's College London enquiry into publications authored by Professor Hans Eysenck with Professor Ronald Grossarth-Maticek. https://retractionwatch.com/wp-content/uploads/2019/10/HE-Enquiry.pdf
  146. ^ Marks, D. F. (2019). The Hans Eysenck affair: Time to correct the scientific record. Journal of Health Psychology, 1–12.
  147. ^ Marks, D. F. & Buchanan, R. D. (2020). King's College London's enquiry into Hans J. Eysenck's 'unsafe' publications must be properly completed. Journal of Health Psychology, 25, 1, 3–6.
  148. ^ O'Grady, C. (15 July 2020). Misconduct allegations push psychology hero off his pedestal. Science Mag. https://www.science.org/content/article/misconduct-allegations-push-psychology-hero-his-pedestal
  149. ^ Pelosi, A. J. (2019). Personality and fatal diseases: Revisiting a scientific scandal. Journal of Health Psychology, 24, 4, 421–439.
  150. ^ Rolls, G. (2015). Classic case studies in psychology. Routledge Taylor & Francis.
  151. from the original on 14 April 2018 – via Google Books.
  152. .
  153. ^ .
  154. .
  155. (PDF) from the original on 9 January 2014.
  156. .
  157. ^ Norcross, J.C. (Ed.). (2002). Psychotherapy relationships that work. OUP.
  158. ^ "Mental health and behavioural conditions – Guidance and guideline topic – NICE". www.nice.org.uk. Archived from the original on 30 July 2015.
  159. ^ "APA Clinical Practice Guideline Development". apa.org. Archived from the original on 3 October 2015.
  160. ^ "American Psychiatric Association Practice Guidelines". psychiatryonline.org.
  161. S2CID 30877764
    .
  162. ^ "Psychodynamic Therapy Is Equivalent to CBT, Meta-Analysis Finds". alert.psychnews.org. Archived from the original on 13 April 2018.
  163. PMID 27032627
    .
  164. .
  165. .
  166. .
  167. .
  168. (PDF) from the original on 24 September 2015.
  169. (PDF) from the original on 17 November 2015.
  170. ^ a b Jennifer L. Strauss, Vito S. Guerra, Christine E. Marx, A. Meade Eggleston Ph.D, Patrick S. Calhoun Ph.D Chapter 9: Improving Patient Treatment Adherence: A Clinician's Guide Archived 16 April 2016 at the Wayback Machine In: Improving Patient Treatment Adherence: A Clinician's Guide. Edited by Hayden Bosworth. Springer Science & Business Media, 3 July 2010
  171. .
  172. ^ Egan, Jonathan (2005). "Dropout and related factors in therapy" (PDF). The Irish Psychologist. 32 (2): 27–30. Archived (PDF) from the original on 21 July 2011.
  173. ISBN 9781118625392. {{cite book}}: |journal= ignored (help
    )
  174. . Estimates of 'unwanted effects,' including long-lasting effects, of psychotherapy have ranged from 3% to 15%. Few empirical studies have been conducted in this area.
  175. ^ . 5–10% of all clients experience adverse effects of therapy (Crawford et al., 2016; Lambert, 2013; Hatfield et al, 2010; Hannan et al., 2005). However, there can be considerable variability across therapists (Saxon et al., 2017; Mohr, 1995) and according to client characteristics (Saxon et al., 2017; Crawford et al., 2016; Mohr, 1995).
  176. ^ Jarrett, Christian (10 March 2016). "How often does psychotherapy make people feel worse?". Research Digest. British Psychological Society. Retrieved 30 October 2021. Data is thin on the ground, but best estimates suggest that between 5 to 10 per cent of therapy clients experience a worsening of their symptoms.
  177. ^
    PMID 25273304
    .
  178. .
  179. ^ .
  180. .
  181. ^ .
  182. .
  183. .
  184. .
  185. . Basseches coined the term "theoretical abuse" as a parallel to "sexual abuse" in psychotherapy.
  186. .
  187. ^ Friedman, Richard A. (19 July 2015). "Psychiatry's identity crisis". The New York Times. p. SR5. Archived from the original on 31 December 2016.
  188. OCLC 30976460
    .
  189. ^ .
  190. .
  191. .
  192. .
  193. .
  194. .
  195. .
  196. .
  197. .
  198. . Michel Foucault, in what has perhaps become the most well-known critique of psychiatric and therapeutic interventions, identified a shift in the way western society conceptualized madness with the establishment of 'moral treatment' at the end of the 18th century...
  199. . Foucault's views have been used to highlight problems of power in a variety of 'mental health' fields: in nursing (e.g. Clinton & Hazelton, 2002), social work (e.g. Foote & Frank, 1999), psychiatry (e.g. Ali, 2002), and in the cross-disciplinary practices of psychotherapy (most notably in narrative therapy—e.g. Flaskas & Humphreys, 1993; Swann, 1999; White & Epston, 1990). However, there is no single 'Foucauldian' approach to power, or indeed to therapy, and his ideas are used, as he intended, more in the manner of a 'tool kit' of ideas than as a coherent theoretical account.
  200. ^ Isack, Sharonne; Hook, Derek (20 October 1995). "The psychological imperialism of psychotherapy". 1st Annual South African Qualitative Methods Conference: "A spanner in the works of the factory of truth". Johannesburg, South Africa: Critical Methods Society. Archived from the original on 19 April 2014.

Further reading