Major trends in psychotherapy: Implication for priorities for Psychotherapy.

Abstract

The field of psychotherapy has been evolving rapidly in the past decade. As the halflife of our knowledge decreases exponentially from year to year, it is increasingly important that the information we receive is the most current available. Despite the inevitability of a publication lag, we will attempt to publish those articles that will keep you informed and up-to-date. This can be accomplished not only by an effective and efficient operation of the journal office, but also by identifying those trends and themes in mental health service delivery that will have a major impact upon the current and future practices of psychotherapy.We have targeted seven major trends of interest to our readership. Though by no means exhaustive, this list is comprehensive. It includespsychoeconomics, the new client, gender and psychotherapy, psychotherapy and the elderly, drug therapy and psychotherapy, professional training at the doctoral level and beyond, and pragmatism. We encourage authors to send us articles in these areas. PsychoeconomicsMental health is now big business. There are countless articles concerning the impact of mental health care financing on service delivery in general and the practice of psychotherapy in particular. The federal government, insurance carriers, and self-insured corporations have a stake in how mental health services are delivered. Cost-effectiveness, accountability, and pre-authorization are terms that already impact most therapists' livelihood.One of the consequences of the new psychoeconomics is the move toward brief psychotherapy. Whether or not necessity is the mother of invention, there are a variety of interesting and innovative efforts in this area, including Lazarus (1989a,b), Strupp & Binder (1984), Budman et al. (1988), Hoyt (1985, Donovan (1987), andSifneos (1985).Another trend in psychoeconomics is the increasing number of mental health dollars spent on inpatient settings. As Cummings (1987) pointed out, mental health costs are growing at a rate of 30-40% per annum, with the majority of that money going to inpatient care. In 1985, psychiatric hospitals increased their capacity by nearly forty percent. This trend is buttressed by the enactment of state laws to mandate mental health coverage.Many psychologists view prescription privileges as a threat to the integrity of our profession. However, use and misuse of hospitalization is a far more potentially corruptive force to our profession than prescription privileges. Hospitalization legitimizes a host of invasive and expensive diagnostic procedures and treatment interventions not necessarily in the best interests of the client. CAT scans, dexamethesone suppression tests, 3-Methoxy-4-Hydroxyphenylglycol (MHPG) tests, and daily individual psychotherapy are just a few of the expensive procedures or treatments readily available and frequently employed with inpatients.Indeed, the very use of inpatient settings as appropriate settings for a variety of disorders needs to be examined. We would be particularly interested in articles related to...

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