Three decades ago, doing therapy was a relatively uncomplicated affair. After graduate school, you set up shop as a family therapist, a psychodynamic healer, or a cognitive-behavioral specialist. Whichever model you adopted, you were likely to see yourself as firmly in charge of the process, with your client (or “patient”) following your lead. You, after all, were the expert. Few clinicians felt the need to explain how therapy was going to proceed, or if, indeed, it would even work. It’s a different world now.

Decades ago, trainees in our field were imbued with the notion that therapy was about transformation: big, dramatic changes in the direction of self-actualization. Was this an overpromise? And now, when the average length of therapy in the United States is less than eight sessions, is it even desired by clients anymore, or necessary for successful therapy?

Today’s clients are shifting out of their customary position of mannerly deference and asserting far more specifically what they want—and don’t want—from therapy. Increasingly, therapists are moving from the role of acknowledged expert in the room to something approaching an informed colleague. For some, it’s a sea change in professional identity, but a growing body of evidence suggests it pays off.

To be a young, intellectually curious therapist in the 1960s and ’70s was to fall under the spell of the new systems practitioners, who were redefining what psychotherapy was all about. And no one embodied this new way of practicing the clinical craft with more skill, creativity, and chutzpah than Salvador Minuchin. In light of his recent passing, we pay tribute to his influence on several generations of therapists.

In Networker editor Rich Simon’s introduction to the conference, he likened it to a deeply stimulating marketplace of ideas, where clinicians get an expanded opportunity to embrace a fuller range of therapeutic identities.

A highlight of this year’s Symposium was iconic therapist Irvin Yalom receiving the Networker Lifetime Achievement Award. In this excerpt from his recent memoir Becoming Myself, Yalom describes how, at this stage of his career, patients’ preconceptions about him can shape the therapeutic encounter.

Clinicians interested in applying coaching skills in psychotherapy believe that working more from a collaborative partnership position—like a personal trainer or a mentor—can produce faster change and, for many clients, enhanced motivation.

When I first heard about the growing research on the therapeutic use of psychedelics to treat trauma, I was frankly a bit bemused. But it’s been hard to dismiss the overwhelmingly positive results of early trials. Will psychedelic-assisted therapy continue to gain traction? Will it eventually be practice-changing for everyday clinicians? We can’t know the answer at this point, but what's clear is that the clinical interest in psychedelics is much more than a haphazard, tie-dyed pursuit.

It’s been nearly 30 years since SSRIs came on the scene, but despite their ubiquity and pairing with a variety of talk- and body-centered treatments, the rates of PTSD, depression, and anxiety are soaring. Could the ineffable insights and experiences of psychedelic drugs revolutionize the practice of psychotherapy?

As a researcher and outspoken advocate for therapeutic innovation, Bessel van der Kolk has been as influential as anyone in shaping the landscape of trauma therapy today. He describes what’s distinctive about the therapeutic potential of psychedelics.