"Therapists tend to think they should provide most people with about a year of treatment, when in fact many people can be helped in a matter of weeks or months. Similarly, patients don't know how to evaluate the care they receive in relation to their needs, and consequently tend to leave treatment prematurely or stay in too long," said Beutler, a professor of education and psychology at UCSB and co-author of the new book "Am I Crazy, Or Is It My Shrink? How to Get the Help You Need" (Oxford University Press, 1998).
Written to help prospective patients make an informed choice from among the hundreds of types of psychotherapy now available, "Am I Crazy, Or Is It My Shrink?" also is aimed at professionals in the field, according to Beutler.
With both therapists and patients increasingly relying on questionable newspaper and television reports for information about mental health care, some 80 percent of therapists end up using unproven, or worse, counterproductive treatment methods, he said. Scientists help create the problem by failing to communicate their latest research findings to practitioners.
"We did a couple of surveys, one national and one local, and found both these things were very significant problems. We're trying to take the lead as scientists/practitioners, people who are committed to the principles of science and research and who practice the trade, to provide direct communication to both practitioners and the public," said Beutler.
Because clinicians typically want to give patients more treatment than they needand patients often want lessa kind of antagonism frequently results. Fifty percent of the people who seek counseling stop going after just one session.
According to Beutler, some of these people ultimately go to another therapist, but most give up on the process altogether. He said "Am I Crazy, Or Is It My Shrink?" is intended to help this segment of the population determine what they can realistically expect from counseling and identify their options in the event they don't like a given therapist.
"This book has two messages. Therapists need to adjust the level of care to the severity of the problem. On average that will be more in the neighborhood of 25 sessions or six months for most people and a year or more for some people, but they need to make that distinction based upon each individual's problems and the nature of the person. The amount of treatment a person receives should not be determined on the basis of some arbitrary rule that says everybody who has depression gets six sessions," Beutler said.
"The message to the patient is, you can help identify which type of depression anxiety distress you have and what type of treatment you should receive. This will enable you to determine whether your therapist or clinician is providing you with the right care, and just as importantly, how long treatment should take and what can be expected from it. Then the issue is learning to live within that constraint and giving your therapy the necessary time to be effective; your chances of being successful become so much better."
At just 214 pages, "Am I Crazy, Or Is It My Shrink?" is as concise as it is free of clinical jargon. Beutler credits Pulitzer Prize-winning journalist Joel N. Shurkin for the book's readability. Bruce Bongar, the book's other co-author, is a professor at the Pacific Graduate School of Psychology and a consulting professor of psychiatry and the behavioral sciences at Stanford University School of Medicine.