A commenter recently posted--
On a macro level, isn't it interesting how the pendulum swings. We have gone from insight to a medical model and now are seeing the flaws in the medical model and looking again to the soul for healing.
I wish I were more optimistic, but I must say I believe that there is a very long uphill battle between where we are now and where many of us might wish to be. It takes a very knowledgeable patient to know that there is more than one kind of therapy out there. Indeed, many do not have a clue about differences among the various disciplines to which therapists belong, much less any theoretical differences. And why should they? We have made little or no effort to provide maps of the therapy terrain. So for most people, if they are willing to consider therapy at all, the choice is about who is close and takes their insurance. The bulk of what we talk about here then is very much inside baseball stuff.
Even in the medical community, there is very little knowledge or understanding about different psychotherapeutic approaches. Unless a physician has him or herself experienced therapy, most of what they know is what they were taught. And the curriculum has been CBT and meds all the way for some years now.
I have said before and repeat now that I do not believe that there is much future for psychodynamically oriented psychotherapy under the medical model. That model moves more and more toward a brain disease theory of emotional problems and scorns the value of depth. I think we need to think of ourselves more in the realm of alternative health or even personal education. Which mean forgoing third party payments. In all likelihood in your town there are alternative health practitioners of all kinds who cannot accept insurance as payment. To say nothing of cosmetic surgery which is not covered. Yet people find the money to pay for them because they believe their lives will be better. We need to do the same thing. And learn to talk about why we believe that the depth therapies are worthwhile.
My son recently started an MSW program, planning to become a therapist. In Maine, community mental health centers are not now hiring therapists, having gone to a medication + case management model. Those centers were where social workers and mental health counselors used to do internships and field placements. But if those students want to be therapists, it may well be that college and university counseling centers are the only places still offering what they need. Where will would-be therapists find training outside the classroom? And will any of those places lean toward anything other than CBT?
Like a said, we are a long way away from nirvana.