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The Top 10 - Page 2


The majority of survey participants graduated between 1990 and 2006, though a significant number received their most advanced degrees between 1970 and 1989. A surprisingly large percentage—41.4 percent—are relative novices, having practiced for from 0 to 10 years (suggesting, given their mean age, that, for many, therapy is a second career, or else that the kids have at last moved out). A little more than 30 percent have practiced between 11 and 20 years, 21.2 percent between 31 and 40 years, and the rest (8.3 percent) are real old-timers, having been therapists for between 40 and 54 years.

How do our clinicians identify themselves? What kind of therapy do they actually practice? As with the therapists who influenced them, respondents could mention a range of different orientations that comprised their approach. Perhaps the most important finding is how eclectic most therapists are. Of 2,281 completed and valid surveys (not all of the 2,598 responses contained enough information to determine clinical approach), only about 95 respondents (4.2 percent) were purists of one sort or another, meaning that they described themselves as using one model virtually exclusively. The rest—95.8 percent—admitted to combining a variety of approaches.

Even though Rogers was named the most influential therapist, the most popular therapeutic approach—what most people in our survey really do at least part of the time in their practice—is cognitive-behavioral therapy (CBT). Of the 2,281 fully completed responses, CBT is used (mostly in combination with other methods) by 68.7 percent, or 1,566 people. Only 31 percent of the respondents own up to using a "Rogerian/client-centered/humanistic" approach at all, even in part, and only one lonely soul admitted to being exclusively Rogerian. Oddly enough, just about the same percentage as those who use Rogerian methods don't use CBT at all. Are these CBT refuseniks and the Rogerian holdouts the same people? How do they get paid?

The second most used model, after CBT, is marital and family systems (1,135 respondents and 49.8 percent), but half say they don't use MFT at all, and only .4 percent (about 9 people) identify themselves exclusively as MFT therapists. And yet, three of the most influential therapists named this time are Salvador Minuchin, Virginia Satir, and Murray Bowen—so why aren't there more MFT practitioners? Looking back, in 1982, when the family therapy movement could still claim some revolutionary fervor, the only actual family therapist listed in the top 10 most influential psychotherapists was Jay Haley (who was number 8). And only 2.6 percent of the respondents to that survey (11 individuals—admittedly from a small pool) said family therapy was their orientation. It seems likely then that while the family therapy revolution is now over—at least in all its doctrinal purity—the revolutionaries actually won, in that systems thinking has been incorporated by a broad swath of therapists all across the clinical spectrum.

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