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Cognitive Behavioral Therapy, Revisited

CBT Isn't as Manualized as You Think, Says Judith Beck

Mary Sykes Wylie

By Mary Sykes Wylie - Today, cognitive behavioral therapy is among the most widely practiced and promulgated approach in the world. But for all its mantle of scientific rigor and official approval, many therapists find CBT's "lab therapy" hard to love, if not downright dislikable. In the following interview, renowned CBT clinician Judith Beck explains how the method works, and why it's gotten a bum rap.

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Searching for a Language for Depression

The Vocabulary of Diagnosis Isn't Telling Our Stories

Joshua Wolf Shenk

By Joshua Wolf Shenk - Each year, seventeen million Americans and one hundred million people worldwide experience clinical depression. What does this mean, exactly? Too many of us take comfort in language that raises the fewest questions, provokes the least fear of the unknown. When we funnel a sea of human experience into the linguistic equivalent of a laboratory beaker, we choke the long streams of breath needed to tell of a life in whole.

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The Cult of DSM

Ending Our Allegiance to the Great Gazoo

Gary Greenberg

By Gary Greenberg - Written just after the release of DSM-5, this masterfully sardonic look at the diagnostic charade many practitioners play argued that it was finally time to take the dissatisfaction with DSM seriously and find an alternative to an increasingly empty ritual.

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The Biomedical Model is Failing Us

Andrew Weil on Why We Need Integrative Mental Health

Andrew Weil

By Andrew Weil - Depression and anxiety should be as fully conquered as smallpox and polio. But more of us than ever aren't experiencing optimum emotional well-being. Why is the vast enterprise of professional mental health unable to help us feel better? I want you to consider the possibility that the basic assumptions of mainstream psychiatric medicine are obsolete and no longer serve us well. Those assumptions constitute the biomedical model of mental health and dominate the whole field.

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Therapy Confronts the DSM-5

Therapists React to the Latest Diagnostic and Statistical Manual

Martha Teater

Since few people argue that mental health professionals can treat people or do research without some sort of diagnostic system, we’ll have to make friends with latest version of the Diagnostic and Statistical Manual. But how are ordinary clinicians across the country adapting to its specifics? As someone who’s given dozens of workshops on DSM-5 and trained thousands of therapists in its use, I’ve had a front-row seat on how psychotherapists have reacted to the changes it means for their practice.

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How to Prepare for Insurance Company Treatment Reviews

Tips for Proving Your Therapy is Medically Necessary

Barbara Griswold

While treatment review has always been a part of insurance reimbursement, therapists in the last few years have reported an increase in such phone calls from insurance companies. But what’s the health plan looking for when reviewing for medical necessity? What does the language of medical necessity sound like, and how can you learn to speak it fluently? Here are a few tips.

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Does Prescription Medication Eliminate the Need for Therapy?

Michael Yapko on the Enduring Role of Talk Therapy

Michael Yapko

Americans have a history of valuing quick-fix solutions to difficult problems. But the simplistic psychopharmacological approach to depressive disorders underestimates the remarkable human capacity for self-transformation. We have the ability to use imagination and intelligence to change our life circumstances, our attitudes and emotions, even, to some extent, our personalities. It is the privilege of our profession to be able to help troubled people along this path, and though medications may make this journey less arduous, in the long run, therapists are indispensable for getting their clients to this destination.

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Stronger Medicine

Anti-Depressants Haven't Made Therapy Obsolete

Michael Yapko

Americans have a history of valuing quick-fix solutions to difficult problems. But the simplistic psychopharmacological approach to depressive disorders underestimates the remarkable human capacity for self-transformation. We have the ability to use imagination and intelligence to change our life circumstances, our attitudes and emotions, even, to some extent, our personalities. It is the privilege of our profession to be able to help troubled people along this path, and though medications may make this journey less arduous, in the long run, therapists are indispensable for getting their clients to this destination.

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War-Borne PTSD Enters the DSM

How Veterans Forced Mental Health to Confront the New Trauma

Mary Sykes Wylie

Before the 1970s, almost no mental health authorities imagined, much less expected and prepared for, traumatic reactions to war to emerge years after the conflict ended. But after they returned stateside, almost 50 percent of Vietnam veterans began breaking down, months or even years later. By the late 1970s, it had become obvious to many therapists that the old diagnostic system had fatal flaws. DSM-II seemed to have been written for a world in which serious trauma virtually never occurred. While the veterans were struggling for recognition on one front, another campaign was being waged---which included some of the same people---on another, to get traumatic stress back into the DSM.

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Psychotherapy Beyond the Books and Manuals

Why Psychotherapy Needs the Art of Conversation

Jay Efran and Mitchell Green

The growing emphasis on treatment manuals and empirically validated methods is a step in the wrong direction. Yes, the public needs to be protected from quacks, and managed care organizations certainly want some assurance that their money is being spent wisely. In the final analysis, however, the effectiveness of a client-therapist pairing is a function of their collaborative dialogue---a process that resists standardization. Therapy requires a certain creative ambiguity that can't be reduced to stock exercises or "bottled" like an antidepressant.

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