By now, research has demonstrated that people by and large feel helped by psychotherapy. And even more than that, it’s a real bargain: the amount of change you get for the cost of the services is out of proportion to most other kinds of professional services, be it lawyers or physicians or a masseuse. So there’s a lot right with psychotherapy that we should embrace, even trumpet.

But how can we improve what we do and the results we achieve? We first need to face up to our continuing identity confusion as a profession. Who exactly are we in the world, and what is it that we do? The fact is, as a field, we seem to shift our focus every few years and emphasize different ideas and theoretical perspectives. In the ’60s, we were all about behavior and strategy. Through the ’70s and ’80s, we zeroed in on cognitions and thoughts. Then in the ’90s, of course, we began the so-called decade of the brain. Now everywhere you look, we’re talking about bringing more mindfulness into therapy. But we lack a consistent identity or message to the public about what we can offer people.

We might actually learn a thing or two about public relations from Big Pharma. Much of its success reflects the fact that it didn’t just sell drugs: it sold an idea. Starting with the marketing of Prozac in the ’80s, it promoted the idea that depression was a biochemical illness. Forget that there was never any evidence for this notion. Consumers, and dare I say a fair number of therapists, bought…