Psychotherapy contra the market: worries of a professional in the age of do-it-yourself therapy

Jurriaan Bendien J.Bendien at
Sat Dec 14 16:42:38 MST 2002

Recently I was reading - out of curiosity - Irvin Yalom's book The Gift of
Therapy (Harper Collins), which is a series of tips for psychotherapists
from a respected professional, located somewhere in Palo Alto, California.
An interesting passage caught my eye:

"I worry where the next generation of effective psychotherapists will be
trained. Not in psychiatry residency training programs. Psychiatry is on the
verge of abandoning the field of psychotherapy, because third-party payers
now reimburse for psychotherapy only if it is delivered by low-fee (in other
words, minimally trained) practitioners. It seems certain that the present
generation of psychiatric clinicians, skilled in both dynamic psychotherapy
and in pharmacological treatment, is an endangered species. What about
clinical psychology training programs - the obvious choice to fill the gap ?
Unfortunately, clinical psychologists face the same market pressures, and
most doctorate-granting schools of psychology are responding by teaching a
therapy that is symptom-oriented, brief, and, hence, reimbursable. So I
worry about psychotherapy - about how it may be deformed by economic
pressures and impoverished by radically abbreviated training programs." (p.

In future, if the market drives you crazy, there might be no
psychotherapeutic help (if you can afford it) other than by quacks and
amateurs. For the rest it is swallow your pill, or make a revolution.

- Mom, what's a revolution ?
- Oh, I don't know, I think it's a popsong by U2


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