|Deutsch: Phrenologie (Photo credit: Wikipedia)|
Therapies are manualized. Follow this cookbook recipe with every client you have with this diagnosis, and they'll get better. It's pigeonholing clients, and reducing professionals to technicians. Everything, even assessment, is by the numbers. The person's humanity is out the window, all their experiences and dreams and complexity reduced to three symptoms from group A, two from group B, for a duration of not less than two years, and not due to some other specified disorder or circumstance listed in Appendix C.
Worse, the therapies don't work. Or they only work in the lab. One I got all excited about last year after a workshop turned out to be this sort of dud. Thirty percent of the potential participants in the big study its proponents were trumpeting were weeded out before the study ever started. They had more than one problem, or they were on medication, or whatever variation in their circumstances that normal human beings coming into clinician's offices every day exhibit. So at best, I'm thinking as I'm reading this, the new treatment works with 70% of people with this diagnosis, right?
Not so fast, Virginia. No fewer than 50% of the folk enrolled in the study dropped out! So now, if the new treatment helped every single one of the completers (which, of course, it didn't), we're talking about a therapy that is effective for 35% of the folk for whom a clinician might consider it. Thirty-five percent.
And yet this has now become the only approved therapy for this disorder.
I kid thee not. It works for maybe 35% of the population with this disorder, but if I don't deploy it with every one of them who walks through my front door, I will not be treating my people according to the standard of care, once this gets written into the standards, which it will. Mark my words.
Ironically, chasing the money has led us to fly directly in the face of the best and latest science, offering "treatments" that are absolutely proven not to work for "disorders" that are pretty much proven by now not to exist because they are lucrative. Jumping on the weight-loss bandwagon, as psychology has over the past year or two, is perhaps the best example.
I want to go back to sitting with my clients. And no, they're not patients. They're not sick! I want to go back to being with my clients, not sitting there trying to look attentive while running algorithms in my head or jumping ahead to what I'm supposed to say next according to the treatment protocol. I want to go back to the day when the therapeutic relationship was the primary healing factor, when my own best tool was my self, not a checklist with lines and boxes and graphs to complete to tell me what's the matter with the person. I want to go back to the day when my care was caring, not steps I followed in a manual, to a time when good therapeutic technique mattered, yes, but when there was an art to it.
Is that too much to ask?