SAVING PSYCHOTHERAPY

An impassioned critique of psychotherapy with salient suggestions for improvement.

Family therapist and associate professor Caldwell (Couples and Family Therapy/Alliant International Univ.; Preparing for the California MFT Law and Ethics Exam, 2015, etc.) minces no words in his critical assessment of his profession, claiming, “We don’t know who or what it is that therapists are fighting for.” His main point is that, despite therapy’s proven effectiveness, “fewer people are going,” and he believes it’s up to the individual psychotherapist to take specific actions to repair the field’s reputation. The book begins with an overview of psychotherapy, citing studies and statistics that show therapy yields positive results, but those seeking help often choose prescription medication instead. Included is an excellent, insightful discussion of broad issues surrounding psychotherapy, like the perceived social stigma of counseling and the negative portrayal of the profession in movies and TV. Early on, Caldwell introduces the “five tasks” therapists can employ to “save psychotherapy,” which include “embrace science” and “accept accountability,” and, in subsequent chapters, describes them clearly and in considerable detail. Caldwell tackles knotty issues head-on, including the incompetence of some therapists: “When a profession itself is relatively undefined in the mind of the professional…a natural consequence is that it can be hard for that professional to know what it means to be good at their job.” Regarding training and licensure, the author is even more blunt: “Increasing evidence suggests that many of the requirements to become a therapist don’t serve their intended purposes.” Still, the intent here isn’t to lambaste psychotherapy; Caldwell offers rational, pragmatic ideas to improve the profession. In terms of individual accountability, for example, Caldwell urges therapists to gather data on their practices and make it public as well as “Hold your peers to a higher standard.”

Tough love and astute suggestions for a profession in need of reform.