PDF Download Saving Talk Therapy: How Health Insurers, Big Pharma, and Slanted Science are Ruining Good Mental Health Care, by Enrico Gnaulati
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Saving Talk Therapy: How Health Insurers, Big Pharma, and Slanted Science are Ruining Good Mental Health Care, by Enrico Gnaulati
PDF Download Saving Talk Therapy: How Health Insurers, Big Pharma, and Slanted Science are Ruining Good Mental Health Care, by Enrico Gnaulati
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Review
“Saving Talk Therapy is a compelling, meticulously researched, and accessible account of how the machinations of two very powerful industries—health insurers and pharmaceutical companies—have undermined the viability of the practice of talk therapy and corrupted the research paradigms in use to evaluate the effects of all mental health treatments. Moving beyond critique, Gnaulati provides clinical vignettes from his own practice to illustrate what is beneficial about psychodynamic/humanistic psychotherapy. For the millions of mental health patients who are dissatisfied with the dehumanized treatments they have received, and for the thousands of young mental health professionals who know the work they are doing feels much less rewarding than they had thought it would be, this is the book to read.”—Ronald B. Miller, professor of psychology, St. Michael’s College, and author of Not So Abnormal Psychology: A Pragmatic View of Mental Illness“In this remarkable and highly readable book, Dr. Enrico Gnaulati, an eminent author and seasoned clinical psychologist, provides a compelling and spirited argument for the value of psychotherapy for individuals and for society. Drawing upon a wide range of research, he also does the public and mental health professions a great service by questioning the often extravagant claims made for the effectiveness and safety of psychiatric medication, and the overstated benefits of quick-fix therapies.”—Steen Halling, professor of psychology emeritus, Seattle University, and author of Intimacy, Transcendence, and Psychology: Closeness and Openness in Everyday Life“Saving Talk Therapy is an impassioned defense of the emotionally evocative form of psychotherapy that many people still seek. It is now vanishing. Dr. Gnaulati brilliantly lays out the history of the field and provides incisive analysis of the forces—political, economic, and cultural—that have endangered its future. This is a compelling and essential read for mental health professionals and consumers alike.”—Ben Gorvine, assistant chair, Department of Psychology, Northwestern University“Saving Talk Therapy is a brilliant exposé of what has happened to the field of psychotherapy and should be required reading for therapists and patients alike. Both authoritative and engaging, Dr. Gnaulati masterfully lays bare the deceits and disinformation that prevent most people from ever getting meaningful therapy and most therapists from learning how to provide it.”—Jonathan Shedler, PhD, Clinical Associate Professor of Psychiatry, University of Colorado School of Medicine and author of The Efficacy of Psychodynamic Psychotherapy
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About the Author
Dr. Enrico Gnaulati is a clinical psychologist based in Pasadena, California, and the author of the nationally acclaimed book Back to Normal: Why Ordinary Childhood Behavior Is Mistaken for ADHD, Bipolar Disorder, and Autism Spectrum Disorder. His work has been featured on Al Jazeera America, KPCC Los Angeles, and KPFA Berkeley; in Maclean’s and Prevention magazines; and online at the Atlantic and Salon.
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Product details
Hardcover: 264 pages
Publisher: Beacon Press (January 9, 2018)
Language: English
ISBN-10: 0807093408
ISBN-13: 978-0807093405
Product Dimensions:
6.2 x 1 x 9.3 inches
Shipping Weight: 1.2 pounds (View shipping rates and policies)
Average Customer Review:
4.8 out of 5 stars
20 customer reviews
Amazon Best Sellers Rank:
#323,650 in Books (See Top 100 in Books)
This is a wonderful book, written by a thoughtful and insightful psychotherapist.I am a psychologist and psychotherapist, I identify as primarily humanistic and secondarily psychodynamic, and agree with the majority of the author's thoughts and conclusions. It is really difficult to find psychotherapists who practice real talk therapy, related to a variety of factors that the author outlines.Because I agree so much with what the author has presented, I will focus on some areas I feel he neglected, or was not up to date.The author criticizes the current overfocus on CBT and short, structured treatments. Working at the VA, however, I have observed that a large minority of patients actually improve significantly with these treatments. When they do improve, they note that they have learned coping skills that help them feel in control of their symptoms, whereas before their symptoms were uncontrollable. Also, some patients want to work in a brief and problem-solving manner, they don't want, or need, extended psychotherapy, although this could be helpful in areas beyond symptom management. So, CBT is very useful for some patients.Which brings me to the central issue the author missed, in my opinion. Psychological treatment is beginning to fragment into 1) treatment of diagnosable mental disorders, which is short term and structured and paid for by insurance companies, and 2) psychotherapy for the sorts of issues described by the author, the problems of living, sometimes severe, that all of us have, to a greater or lesser extent, including crises that precipitate a desire to enter psychotherapy. The author is advocating #2, as am I. And much of #1 can be treated in the second matter, and often more profoundly and definitively. However, this longer, less structured, open ended psychotherapy is no longer being paid for by insurance companies, and unfortunately, organized psychology has colluded in it's demise with the overfocus on diagnosable mental disorders treated in short term, structured, time-limited therapy, the so called "evidence based treatments."So we are talking apples and oranges and I see no way that this is going to change. It is heartbreaking. I see it every day at the VA. Patients who need longer term care, including for ptsd, and are terminated from treatment because they have reached "maximum treatment benefit" (i.e., a certain number of sessions). Fortunately, I work in a spinal cord injury center and these same constraints are not placed on my work, but I am very aware of what is going around me and how a large number of veterans (and in the non-VA world, regular citizens) have no access to the help that they really need - unless they have significant financial resources.In my mind, then, talk therapy is dying, and there is no stopping it, just as psychodynamic therapy has been replaced by cognitive-behavioral therapy. Perhaps there will be a small number of psychotherapists from various disciplines who will be able to make a go of being talk therapists, but this will not be the norm. It is incredibly sad to me, knowing how transformative 'real" psychotherapy can be.
Having been in practice over 40 years, I was very pleased to read Enrico's reminder of the importance of the humanistic and depth approaches to the practice of psychotherapy. In the future, (which is rapidly approaching) an informed culture will demand that this type of therapy be the "standard" for truly helping our patients and the society as a whole. This is, and should be, a must-read for mental health professionals and patients alike. One cannot overstate the usefulness of active engagement, authenticity and the judicious use of humor in helping people.
Gnaulati has written a valuable account of how talk therapy has been methodically misrepresented as not supported by research and set aside for short-term, manualized therapies that don't actually live up to their "evidence-based" claims. He explains clearly the research conundrum, the forces that prefer to push talk therapy to the periphery, and describes the evidence for these therapies of depth and relationship. An important book that's a wakeup call about a mental health system crisis that is growing in the U.S.
As a practicing psychiatrist, I trained in providing various forms of supportive and insight-oriented therapy. Each of my training sessions with patients was an hour long and I quickly learned what this author also learned through his experience - simply providing medication doesn't work well, and patients often seek more feedback than simple reflection of their own statements. Therapy is very much a two way street. The author describes what has happened, and what has gone wrong, with a system driven by research - research which can't do a very good job over a years-long therapeutic alliance to determine the benefits of such an alliance. Unfortunately, we're now stuck in that system and the only way out for those of us in the field is to have our own private practice and to charge fees directly of the patient, bypassing insurance in the process entirely. That works, but it also means that a good proportion of the public can't afford the care that would actually result in lowering of their overall demand on the healthcare system. If only the legislators would read this text, perhaps we'd all have a chance.
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