Alan Kazdin - Rebooting Psychotherapy

This press release from Association for Psychological Science is basically a summary of the new article from Alan Kazdin on Rebooting Psychotherapy Research and Practice to Reduce the Burden of Mental Illness (the article is actually open access, so it's free for download).

My fear is that this represents yet another call for more evidence based therapy, which generally means therapies that can be manualized and systematized, and not the more intuitive approaches - the world does not need more versions of CBT and all its kin.

On the other hand, he seems to be calling for a more integrative approach, as well as a more innovative model of delivering mental health services - that sounds like a good thing.

Here's the abstract:

Rebooting Psychotherapy Research and Practice to Reduce the Burden of Mental Illness
Alan E. Kazdin and Stacey L. Blase
Department of Psychology, Yale University, New Haven, CT


Citation:
Kazdin, AE & Blase, SL. (2011, ). Rebooting Psychotherapy Research and Practice to Reduce the Burden of Mental Illness. Perspectives on Psychological Science, 6:21. DOI: 10.1177/1745691610393527


Abstract
Psychological interventions to treat mental health issues have developed remarkably in the past few decades. Yet this progress often neglects a central goal—namely, to reduce the burden of mental illness and related conditions. The need for psychological services is enormous, and only a small proportion of individuals in need actually receive treatment. Individual psychotherapy, the dominant model of treatment delivery, is not likely to be able to meet this need. Despite advances, mental health professionals are not likely to reduce the prevalence, incidence, and burden of mental illness without a major shift in intervention research and clinical practice. A portfolio of models of delivery will be needed. We illustrate various models of delivery to convey opportunities provided by technology, special settings and nontraditional service providers, self-help interventions, and the media. Decreasing the burden of mental illness also will depend on integrating prevention and treatment, developing assessment and a national database for monitoring mental illness and its  burdens, considering contextual issues that influence delivery of treatment, and addressing potential tensions within the mental health professions. Finally, opportunities for multidisciplinary collaborations are discussed as key considerations for reducing the burden of mental illness.

And here is the press release from APS, which includes a 30-minute video of Kazdin:

PRESS RELEASE

September 13, 2011 
For Immediate Release

Contact: Lucy Hyde
Association for Psychological Science
202.293.9300
lhyde@psychologicalscience.org

Rebooting Psychotherapy

Psychotherapy has come a long way since the days of Freudian psychoanalysis – today, rigorous scientific studies are providing evidence for the kinds of psychotherapies that effectively treat various psychiatric disorders. But Alan Kazdin, the John M. Musser Professor of Psychology at Yale University, believes that we must acknowledge a basic truth – all of our progress and development in evidence-based psychotherapy has failed to solve the rather serious problem of mental illness in the United States. In an article published in the January 2011 issue of Perspectives on Psychological Science, Kazdin and his co-author, Stacey Blase, also at Yale University, urge psychological scientists to rethink the current mental health system in order to make adequate treatment available and accessible to all who need it.

Now, in the latest issue of Perspectives on Psychological Science, several eminent scientists have come forth in response to Kazdin and Blase’s article, highlighting important points that will need to be addressed before the mental health care system can be overhauled, including:

• Understanding what works and for whom: Psychological scientists Varda Shoham, of the University of Arizona-Tucson and Thomas R. Insel, Director of the National Institute of Mental Health, contend that knowing which treatments work won’t matter unless we know how to target the interventions to the people who will benefit most. “In the absence of such knowledge,” they argue, “we risk treatment decisions guided by accessibility to resources rather than patient needs – the very problem Kazdin and Blase aim to solve.”

• Integrating several levels of care: Marc S. Atkins and Stacy L. Frazier at the University of Illinois at Chicago argue that “only a comprehensive and integrated public health model can adequately address the pervasive societal problems that underlie our country’s mental health needs.” Adopting such a public health approach will require that we pay attention to all levels of mental health care, distributing resources equally from the prevention to intervention stage of the treatment process.

• Identifying optimal methods of delivery: According to Brian Yates of American University, we have to find more effective ways to deliver treatment – “methods that use less therapist time, less client time, minimize client transportation costs as well as brick-and-mortar space, and use less of other increasingly scarce and costly resources.”

While the notion of rethinking the current approach to mental health care seems like an incredibly daunting endeavor, there is some hope. As the authors of one commentary point out, the United States Department of Veterans Affairs has already developed and implemented new and innovative programs to address the mental health of its veterans.

Together, these commentaries offer frank insights into the challenges we face in trying to address the mental health burden in the United States.

Alan Kazdin discusses this pressing issue at the 2010 APS Annual Convention:

###

For more information about this study, please contact: Alan Kazdin at alan.kazdin@yale.edu.

Perspectives on Psychological Science is ranked among the top 10 general psychology journals for impact by the Institute for Scientific Information. It publishes an eclectic mix of thought-provoking articles on the latest important advances in psychology. For a copy of the article "Rebooting Psychotherapy Research and Practice to Reduce the Burden of Mental Illness" and access to other Perspectives on Psychological Science research findings, please contact Lucy Hyde at 202-293-9300 or lhyde@psychologicalscience.org.