Psychotherapy Today: What s Wrong? 3 Issues 3 Solutions

Psychotherapy Today: What s Wrong? 3 Issues 3 Solutions

Psychotherapy Today: What s Wrong? Issue #1 The De-humanization of Therapy

The Medical Model Systematized Routinized Manualized

Our field struggles with the notion that treatments work like medicine. It s as if people coming to therapy have a variety of infections that different psychotherapy models will attack like antibiotics. But the truth is that there isn t any evidence that one therapeutic method achieves better results than any other. Scott Miller, Ph.D., International Center for Clinical Excellence

We can t simply follow a protocol. Research indicates that the frequency and severity of ruptures [in the therapeutic alliance] increased with rigid adherence to a treatment manual and an excessive number of transference interpretations. (John Norcross, 2010)

Solution #1: We have to be human. The deliver system is not an IV or pill It s the relationship.

Psychotherapy Today: What s Wrong? Issue #2 The Negativity Bias

The Brain s Negativity Bias AS our ancestors evolved, sticks generally had more urgency and impact than carrots. As a major feature of the brain: 1. We scan for bad news. 2. Over-focus on it, losing sight of the whole. 3. Over-react to it 4. Install it rapidly into implicit memory 5. Sensitize the brain to the negative 6. Create vicious cycles Rick Hanson, Ph.D., Pos. Neuroplasticity Training

Conditions for learning: Activation PLUS Installation Psychotherapy is notoriously poor at installing.

We can t let the negativity bias strangle our effectiveness Glass half empty Neurons that fire together wire together. If our brains are wired to scan for bad news.how does that affect what we react to in session with our clients?

Solution #2: We have to be resource rich. We need to activate, absorb, and install beneficial experiences for ourselves..

Psychotherapy Today: What s Wrong? Issue #3 Insight and Psychoeducation emphasis

The CBT Myth 2012 from Sweden s National Board of Health and Welfare, which, after placing CBT at the top of a list of recommended treatments for depression and anxiety, concluded after a two-year trial period that CBT had no noticeable advantage over alternative therapies and that increasing numbers of clients were dropping out of treatment after finding it ineffective. Psychotherapy Networker Nov/Dec 2015 Because the experiential system is largely unconscious and nonverbal, it is very difficult to change a learned pattern through conscious, verbal reasoning alone. Courtney Armstrong, LPC

Rational Brain vs. Emotional Brain Rational = 5% Emotional = 95% Illustration courtesy of NIMH

We can t suppress default mode processing and forget about creativity. More opportunities should be provided for developing minds and brains to spontaneously experience default-mode processing. Learning environments could be designed to enhance and/or maintain relevant default network activity despite existing external task demands. Frontier Human Neuroscience, August 2014

Solution #3: We have to create sensory rich experiences. The key is to create conditions that facilitate an experience that changes the implicit meaning and purpose associated with an emotional pattern.

Psychotherapy Today: What s Wrong? And, How to Make it Right. Issue De-humanization Negativity Bias Insight/Psychoeducation Solution Humanness Resource Rich Experiential

Resources Kramer s third hand art interventions, Art Therapy: Journal of the American Art Therapy Association, 27(4) pp. 160-167 AATA, Inc. 2010 Rubin, Judith. The Art of Art Therapy. Routledge, 2013 The neuroscience of creativity, Tim Newman, http://www.medicalnewstoday.com/articles/306611.php, Feb 2016. Retrieved 3/7/17. Armstrong, Courtney. The Therapeutic Aha. Norton, 2015. Farber, B. A., & Lane, J. S. (2002). Positive regard. In J. C. Norcross (Ed.), Psychotherapy relationships that work (pp. 175 193). New York: Oxford University Press. Has CBT lost its mojo?, Chris Lyford. https://www.psychotherapynetworker.org/magazine/article/962/clinicians-digest, November/December 2015. Retrieved 1/6/16.

Resources Hanson, Rick. The Professional Course in Positive Neuroplasticity Training Manual. October 2016. Swedish National Audit Office concludes: When all you have is CBT, mental health suffers, Scott Miller, November 10, 2105, http://www.scottdmiller.com/feedback-informed-treatment-fit/swedishnational-audit-office-concludes-when-all-you-have-is-cbt-mental-healthsuffers/, retrieved 12/3/15.