A century of psychotherapy: Economic and environmental influences.

Abstract

Today, in 1992, when most psychotherapists are asked to identify the "creator" of modem psychotherapy, they think of Sigmund Freud. The setting of his work was private practice in Vienna, Austria. In the United States, the first psychology clinic was established at the University of Pennsylvania by Lightner Witmer in 1896 (Cattell, 1954). The employment setting was an academic one. Witmer's first case involved a child with an apparent academic problem (Brotemarkle, 1947), although one would infer from the initial report that the child may actually have been retarded.Over the course of the past 100 years, there have 'been many contributors to the development, evolution, and today's practice of psychotherapy, and they have been employed within a host of settings: private practice, universities, public psychiatric hospitals, child and family guidance centers, private psychotherapeutic centers, independent offices, schools, prisons, and the military. The sites themselves have influence over practice because the settings have provided differing patient populations.

Dodo birds, doctors and the evidence of evidence

“…1 For an excellent account of the political and economic background to the reception of psychoanalysis and other health initiatives, see Vanderbos et al (1992). 2 cf.…”

Legislative warriors: American psychiatrists, psychologists, and competing claims over psychotherapy in the 1950s

“…Rogers had moved on from his prewar work with children to build a personal following at Ohio State and then Chicago in the 1940s and 1950s. As a reaction to more directive forms of therapy, he tended to emphasize conscious self-reflection rather than psychopathology (APA, 1950;VandenBos, Cummings, & DeLeon, 1992). His easy-to-follow approach gained an extensive foothold in university counseling centers because it was seen as amenable to the relatively mild problems of student life.…”

“…over particular issues. The debate came to include case handling responsibility and parity in health insurance plans, hitherto rarely covering outpatient psychotherapy (Mowrer, 1963;VandenBos, Cummings, & DeLeon, 1992). Stimulated by the rise in power of the other paramedical sciences and the attractions of a more collaborative approach, the AMA adopted more moderate interprofessional policies in 1960 and psychiatrists followed suit.…”

“…In fact, a shortage of psychiatrists in some areas meant that psychologists headed many. In the late 1960s, psychologists also began to convince private health insurers to cover psychotherapeutic services, with provisions for equal reimbursement of both lay and medical practitioners(VandenBos, Cummings, & DeLeon, 1992).RENOUNCING ANALYSIS AND SHIFTING PRIORITIESClinical psychologists progressively broke down the medical monopoly over psychoanalysis in the 1960s and 1970s -although this became something of a moot point. The psychoanalytic institutes experienced dwindling student enrolments in the late 1960s and…”

A Brief Historical Overview of Madness in Social Psychiatry

“…F. Basaglia (1963) (From the Manifesto of the French Surrealist painters to the Asylum Directors, 1923) By examining its historical development from the vantage point of a twenty-fi rstcentury observer, it is impressive to see how the fi eld of mental health has developed via institutions, new psychiatric care structures, professionals and users of services. For example, in 1890, only a very small number of professionals could call themselves psychotherapists in the USA (VandenBos et al 1992 ). Today, even applying stricter criteria and in the same country, a minimum of 100,000 professionals are now considered to be highly specialised psychotherapists, and using wider criteria, more than 250,000 psychotherapists and mental health counsellors meet the needs of the US population.…”