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Legitimizing an Emergent Mental Health “Monoculture”?

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Abstract

This chapter traces a critical, theoretical, and historical view of contemporary mental health “culture” as it is articulated and practiced in terms of diagnosable mental disorders and evidence-based practices (EBPs). Psychiatry’s pursuit of scientific legitimacy is examined through development of DSM-III–DSM-5 and corresponding evidence-based treatments (cf. Cochrane Collaboration for Evidence-Based Medicine). Clinical psychology is examined for championing this legitimizing direction for psychology (counselling psychology included), with attention given to neuroscience as a new form of evidence. Counselling’s discourses and approaches are reviewed as conversational practices focused on meaning and behavior change, and, drawing on “common factors” of change, Chapter 4 aims to make evident the grounds for a mental health “monoculture .”

A profession is always vulnerable to changes in the objective character of its central tasks.

(Abbott 1988: 39)

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References

  • Abbott, A. (1988). The system of professions: An essay on the division of expert labor. Chicago: University of Chicago Press.

    Google Scholar 

  • Abramovitz, M., & Zelnick, J. (2015). Privatization in the human services: Implications for direct practice. Clinical Social Work Journal, 43(3), 283–293.

    Article  Google Scholar 

  • Alberti, R., & Emmons, M. (1970). Your perfect right: A guide to assertive living. Atascadero, CA: Impact.

    Google Scholar 

  • Aubrey, R. F. (1977). Historical development of guidance and counseling and implications for the future. Personnel and Guidance Journal, 55(6), 288–295.

    Article  Google Scholar 

  • Aubrey, R. F. (1983). The odyssey of counseling and images of the future. Personnel and Guidance Journal, 62(2), 78–82.

    Article  Google Scholar 

  • Bandura, A. (1969). Principles of behavior modification. New York: Holt, Rinehart & Winston.

    Google Scholar 

  • Berman, J. S., & Norton, N. C. (1985). Does professional training make a therapist more effective? Psychological Bulletin, 98(2), 401–407.

    Article  PubMed  Google Scholar 

  • Boltanski, L., & Thévenot, L. (2006). On justification: Economies of worth. Princeton: Princeton University Press.

    Google Scholar 

  • Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research & Practice, 16(3), 252–260.

    Article  Google Scholar 

  • Borrelli, B., Sepinwall, D., Ernst, D., et al. (2005). A new tool to assess treatment fidelity and evaluation of treatment fidelity across 10 years of health behavior research. Journal of Consulting and Clinical Psychology, 73(5), 852–860.

    Article  PubMed  Google Scholar 

  • Boston Women’s Health Collective. (1971). Our bodies, ourselves. Boston: New England Free Press.

    Google Scholar 

  • Busch, L. (2011). Standards: Recipes for reality. Cambridge, MA: MIT Press.

    Google Scholar 

  • Busch, R. (2012). Problematizing social context in evidence-based therapy evaluation practice/governance. In A. Lock & T. Strong (Eds.), Discursive perspectives in therapeutic practices (pp. 245–268). Oxford: Oxford University Press.

    Chapter  Google Scholar 

  • Carkhuff, R. R. (1969). Helping and human relations: A primer for professional leaders, Vol. 1: Selection and Training. New York: Holt, Rinehart & Winston.

    Google Scholar 

  • Carkhuff, R. R. (1972). The art of helping. Amherst, MA: Human Resource Development Press.

    Google Scholar 

  • Cartwright, N., & Hardie, J. (2012). Evidence-based policy: A practical guide to doing it better. Oxford: Oxford University Press.

    Book  Google Scholar 

  • Chambless, D. L., & Hollon, S. D. (1998). Defining empirically supported therapies. Journal of Consulting and Clinical Psychology, 66(1), 7–18.

    Article  PubMed  Google Scholar 

  • Chwalisz, K. (2003). Evidence-based practice: A framework for twenty-first century scientist-practitioner training. The Counseling Psychologist, 31(5), 497–528.

    Article  Google Scholar 

  • Cooper, M., & McLeod, J. (2011). Pluralistic counselling and psychotherapy. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Cooper, M., & Reeves, A. (2012). The role of randomised controlled trials in developing an evidence base for counselling and psychotherapy. Counselling and Psychotherapy Research, 12(4), 303–307.

    Article  Google Scholar 

  • Corey, G. (2016). Theory and practice of counseling and psychotherapy (10th ed.). Boston: Cengage Learning.

    Google Scholar 

  • Coulter, J. (1979). The brain as agent. Human Studies, 2(1), 335–348.

    Article  Google Scholar 

  • Cumming, E. (1962). A review article: The reports of the joint commission on mental illness and health. Social Problems, 9(4), 391–400.

    Article  Google Scholar 

  • Cushman, P. (1995). Constructing the self, constructing America: A cultural history of psychotherapy. Boston: Da Capo Press.

    Google Scholar 

  • Davis, J. (1914). Vocational and moral guidance. Boston: Ginn.

    Google Scholar 

  • De Cicco, M. (n.d.). Communication strategy plan with regard to the CCA name change. Accessed from http://www.ccpa-accp.ca/_documents/CommunicationStrategy.pdf.

  • Downing, R. (2011). Biohealth: Beyond medicalization: Imposing health. Eugene, OR: Pickwick.

    Google Scholar 

  • Dozois, D. J. A., Mikail, S. F., Alden, et al. (2014). The CPA presidential task force on evidence-based practice of psychological treatments. Canadian Psychology, 55(3), 153.

    Google Scholar 

  • Dumit, J. (2004). Picturing personhood: Brain scans and biomedical identity. Princeton: Princeton University Press.

    Google Scholar 

  • Duncan, B. L., Miller, S. D., & Sparks, J. A. (2004). The heroic client: A revolutionary way to improve effectiveness through client-directed, outcome-informed therapy. San Francisco: Jossey-Bass.

    Google Scholar 

  • Ehrenwald, J. (Ed.). (1991). The history of psychotherapy. Northvale, NJ: Jason Aronson.

    Google Scholar 

  • Eriksen, K., & Kress, V. E. (2006). The DSM and the professional counseling identity: Bridging the gap. Journal of Mental Health Counseling, 28(3), 202–217.

    Article  Google Scholar 

  • Esposito, L., & Perez, F. M. (2014). Neoliberalism and the commodification of mental health. Humanity & Society, 38(4), 414–442.

    Article  Google Scholar 

  • Fairclough, N. (1992). Discourse and social change. Cambridge: Polity Press.

    Google Scholar 

  • Fancher, R. T. (1995). Cultures of healing: Correcting the image of American mental health. New York: W.H. Freeman.

    Google Scholar 

  • Feltham, C. (2005). Evidence-based psychotherapy and counselling in the UK: Critique and alternatives. Journal of Contemporary Psychotherapy, 35(1), 131–143.

    Article  Google Scholar 

  • Ferguson, M. (1980). The aquarian conspiracy: Personal and social transformation in our time. Los Angeles: J.P. Tarcher.

    Google Scholar 

  • Foucault, M. (1978). Discipline and punish: The birth of the prison. New York: Pantheon Books.

    Google Scholar 

  • Foucault, M. (2003). Psychiatric power: Lectures at the Collège de France, 1973–1974. New York: Picador.

    Google Scholar 

  • Frances, A. (2013). Saving normal: An insider’s revolt against out-of-control psychiatric diagnosis, DSM-5, big pharma, and the medicalization of ordinary life. New York: William Morrow.

    Google Scholar 

  • Frank, G. (1984). The Boulder Model: History, rationale, and critique. Professional Psychology: Research and Practice, 15(3), 417–435.

    Article  Google Scholar 

  • Furedi, F. (2004). Therapy culture: Cultivating vulnerability in an uncertain age. New York: Routledge.

    Google Scholar 

  • Gale, A. U., & Austin, B. D. (2003). Professionalism’s challenges to professional counselors’ collective identity. Journal of Counseling & Development, 81(1), 3–10.

    Article  Google Scholar 

  • Gazzola, N., & Smith, D. J. (2007). Who do we think we are? A survey of counsellors in Canada. International Journal for the Advancement of Counselling, 29(2), 97–110.

    Article  Google Scholar 

  • Gladding, S. T. (2013). Counseling: A comprehensive profession (7th ed.). Upper Saddle River, NJ: Pearson.

    Google Scholar 

  • Goffman, I. (1961). Asylums: Essays on the social situation of mental patients and other inmates. New York: Doubleday Anchor.

    Google Scholar 

  • Goldacre, B. (2010). Bad science: Quacks, hacks, and big pharma flacks. New York: Farrar, Straus & Giroux.

    Google Scholar 

  • Goldacre, B. (2013). Bad pharma: How drug companies mislead doctors and harm patients. New York: Farrar, Straus & Giroux.

    Google Scholar 

  • Green, D., & Latchford, G. (2012). Maximising the benefits of psychotherapy: A practice-based evidence approach. West Sussex: Wiley-Blackwell.

    Book  Google Scholar 

  • Hacking, I. (1995). The looping effects of human kinds. In D. Sperber & A. J. Premack (Eds.), Causal cognition (pp. 351–383). Oxford: Oxford University Press.

    Google Scholar 

  • Hage, S. M. (2003). Reaffirming the unique identity of counseling psychology: Opting for the ‘Road less traveled by’. The Counseling Psychologist, 31(5), 555–563.

    Article  Google Scholar 

  • Hagemoser, S. D. (2009). Braking the bandwagon: Scrutinizing the science and politics of empirically supported therapies. Journal of Psychology, 143(6), 601–614.

    Article  PubMed  Google Scholar 

  • Hartung, P. J., & Blustein, D. L. (2002). Reason, intuition, and social justice: Elaborating on Parsons’s career decision-making model. Journal of Counseling & Development, 80(1), 41–47.

    Article  Google Scholar 

  • Havighurst, R. J. (1952). Developmental tasks and education. New York: Longmans, Green.

    Google Scholar 

  • Hershenberg, R., & Goldfried, M. R. (2015). Implications of RDoC for the research and practice of psychotherapy. Behavior Therapy, 46(2), 156–165.

    Article  PubMed  Google Scholar 

  • Hoffnung, R. J. (1969). Conditioning and transfer of affective self-references in a role-played counseling interview. Journal of Consulting and Clinical Psychology, 33(5), 527–531.

    Article  PubMed  Google Scholar 

  • Holland, J. L., Magoon, T. M., & Magoon, A. R. (1981). Counseling psychology: Career interventions, research, and theory. Annual Review of Psychology, 32(1), 279–305.

    Article  PubMed  Google Scholar 

  • House, R. (2004). Therapy beyond modernity: Deconstructing and transcending profession-centred therapy. London: Karnac.

    Google Scholar 

  • Illouz, E. (2008). Saving the modern soul: Therapy, emotions, and the culture of self-help. Berkeley: University of California Press.

    Google Scholar 

  • Insel, T. (2013). Post by former NIMH director Thomas Insel: Transforming diagnosis. Accessed November 18, 2016, from https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml.

  • Ivey, A. E., D’Andrea, M. J., & Ivey, M. B. (2011). Theories of counseling and psychotherapy: A multicultural perspective (7th ed.). London: Sage.

    Google Scholar 

  • Jensen, P., Roper, M., Fisher, P., et al. (1995). Test-retest reliability of the Diagnostic Interview Schedule for Children (DISC 2.1): Parent, child, and combined algorithms. Archives of General Psychiatry, 52(1), 61–71.

    Article  PubMed  Google Scholar 

  • Jevne, R. (1981). Counsellor competencies and selected issues in Canadian counsellor education. Canadian Counsellor, 15(2), 57–63.

    Google Scholar 

  • Kaplan, D. M., Tarvydas, V. M., & Gladding, S. T. (2014). A vision for the future of counseling: The 20/20 principles for unifying and strengthening the profession. Journal of Counseling and Development, 92(3), 367–372.

    Article  Google Scholar 

  • Kesey, K. (1962). One flew over the cuckoo’s nest. New York: Viking Press.

    Google Scholar 

  • Kramer, U., & Stiles, W. B. (2015). The responsiveness problem in psychotherapy: A review of proposed solutions. Clinical Psychology: Science and Practice, 22(3), 277–295.

    Google Scholar 

  • Kutchins, H., & Kirk, S. A. (2003). Making us crazy: DSM: The psychiatric bible and the creation of mental disorders. New York: Free Press.

    Google Scholar 

  • Lafrance, M. N., & McKenzie-Mohr, S. (2013). The DSM and its lure of legitimacy. Feminism & Psychology, 23(1), 119–140.

    Article  Google Scholar 

  • Lakoff, A. (2005). Pharmaceutical reason: Knowledge and value in global psychiatry. Cambridge: Cambridge University Press.

    Book  Google Scholar 

  • Lawson, G. (2016). On being a profession: A historical perspective on counselor licensure and accreditation. Journal of Counselor Leadership and Advocacy, 3(2), 71–84.

    Article  Google Scholar 

  • Leahy, M. J., Rak, E., & Zanskas, S. A. (2015). A brief history of counseling and specialty areas of practice. In M. Stebnicki & I. Marini (Eds.), Professional counselor’s desk reference (pp. 3–8). New York: Springer.

    Google Scholar 

  • Levant, R. F. (2005). Report of the 2005 presidential task force on evidence-based practice. American Psychological Association. Accessed from https://www.apa.org/practice/resources/evidence/evidence-based-report.pdf.

  • Maslow, A. H. (1971). The farther reaches of human nature. New York: Viking Press.

    Google Scholar 

  • Mathewson, R. H. (1949). Guidance policy and practice. New York: Harper.

    Google Scholar 

  • Murray, H. A. (1938). Explorations in personality. New York: Oxford University Press.

    Google Scholar 

  • Myers, D. (2007). Implication of the scientist-practitioner model in counseling psychology training and practice. American Behavioral Scientist, 50(6), 789–796.

    Article  Google Scholar 

  • Neimeyer, R. A., & Raskin, J. D. (Eds.). (2000). Constructions of disorder: Meaning-making frameworks for psychotherapy. Washington: American Psychological Association.

    Google Scholar 

  • Nelson, T. D., Steele, R. G., & Mize, J. A. (2006). Practitioner attitudes toward evidence-based practice: Themes and challenges. Administration and Policy in Mental Health and Mental Health Services Research, 33(3), 398–409.

    Article  PubMed  Google Scholar 

  • Nichols, M. P., & Schwartz, R. C. (2008). Family therapy: Concepts and methods (8th ed.). Boston: Pearson Allyn & Bacon.

    Google Scholar 

  • Ogunfowora, B., & Drapeau, M. (2008). Comparing counselling and clinical psychology professionals: Similarities and differences on theoretical orientations revisited. International Journal for the Advancement of Counselling, 30(2), 93–103.

    Article  Google Scholar 

  • Online Etymology Dictionary. (n.d.). Therapy. Accessed November 21, 2016.http://www.etymonline.com/index.php?term=therapy.

  • Ortega, F., & Vidal, F. (Eds.). (2011). Neurocultures: Glimpses into an expanding universe. Frankfurt am Main: Peter Lang.

    Google Scholar 

  • Paré, D. (2013). The practice of collaborative counseling and psychotherapy: Developing skills in culturally mindful helping. Los Angeles: Sage.

    Google Scholar 

  • Paris, J., & Kirmayer, L. J. (2016). The National Institute of Mental Health research domain criteria: A bridge too far. Journal of Nervous and Mental Disease, 204(1), 26–32.

    Article  PubMed  Google Scholar 

  • Pearce, P. (2014). Forty years on from Rogers’ APA address ‘Some new challenges for the helping professions. Self & Society, 41(2), 38.

    Google Scholar 

  • Peavy, V., Robertson, S., & Westwood, M. (1982). Guidelines for counselor education in Canada. Canadian Counselor, 16(3), 135–143.

    Google Scholar 

  • Perls, F. S. (1969). Gestalt therapy verbatim. Gouldsboro: The Gestalt Journal Press.

    Google Scholar 

  • Pitts-Taylor, V. (2016). The brain’s body: Neuroscience and corporeal politics. Durham, NC: Duke University Press.

    Book  Google Scholar 

  • Postle, D. (2007). Regulating the psychological therapies: From taxonomy to taxidermy (2nd ed.). Ross-on-Wye: PCCS Books.

    Google Scholar 

  • Proctor, G. (2002). The dynamics of power in counselling and psychotherapy: Ethics, politics and practice. Ross-on-Wye: PCCS Books.

    Google Scholar 

  • Proctor, W. M., Benefield, W., & Wrenn, C. G. (1931). Workbook in vocations. Boston: Houghton Mifflin.

    Google Scholar 

  • Reed, G. M., & Eisman, E. J. (2006). Uses and misuses of evidence: Managed care, treatment guidelines, and outcome measurement in professional practice. In C. D. Goodheart, A. E. Kazdin, & R. J. Sternberg (Eds.), Evidence-based psychotherapy: Where practice and research meet (pp. 13–35). Washington: American Psychological Association.

    Chapter  Google Scholar 

  • Ringer, R. J. (1977). Looking out for #1. New York: Funk & Wagnalls.

    Google Scholar 

  • Robertson, S. E., & Borgen, W. A. (2016). CCPA accreditation of counsellor education programs in Canada: An historical perspective/L’accréditation par l’ACCP des programmes de formation des conseillers au Canada: Une perspective historique. Canadian Journal of Counselling and Psychotherapy (Online), 50(3), 259.

    Google Scholar 

  • Rogers, C. (1941). Counseling and psychotherapy: Newer concepts in practice. New York: Houghton Mifflin.

    Google Scholar 

  • Rose, N. (1979). The psychological complex: Mental measurement and social administration. Ideology and Consciousness, 5, 5–68.

    Google Scholar 

  • Rose, N., & Abi-Rached, J. M. (2013). Neuro: The new brain sciences and the management of the mind. Princeton: Princeton University Press.

    Book  Google Scholar 

  • Rosen, R. D. (1978). Psychobabble: Fast talk and quick cure in the era of feeling. New York: Atheneum.

    Google Scholar 

  • Sampson, E. E. (1977). Psychology and the American ideal. Journal of Personality and Social Psychology, 35(11), 767–782.

    Article  Google Scholar 

  • Schutz, W. C. (1967). Joy: Expanding human awareness. New York: Grove Press.

    Google Scholar 

  • Sennett, R. (1981). Authority. New York: Vintage.

    Google Scholar 

  • Shapin, S. (2008). The scientific life: A moral history of a late modern vacation. Chicago: University of Chicago Press.

    Book  Google Scholar 

  • Shlien, J. M., & Zimring, F. M. (1966). Research directives and methods in client-centered therapy. In L. A. Gottshalk & A. H. Auerback (Eds.), Methods of research in psychotherapy (pp. 424–447). New York: Appleton Century Crofts.

    Chapter  Google Scholar 

  • Shore, C. (2008). Audit culture and illiberal governance: Universities and the politics of accountability. Anthropological Theory, 8(3), 278–298.

    Article  Google Scholar 

  • Siegel, D. J. (2012). Pocket guide to interpersonal neurobiology: An integrative handbook of the mind. New York: W.W. Norton.

    Google Scholar 

  • Skinner, B. F. (1972). Beyond freedom and dignity. Harmondsworth: Penguin Books.

    Google Scholar 

  • Spiegel, A. (2005, January 3). The dictionary of disorder. The New Yorker. Accessed November 17, 2016 http://www.newyorker.com/magazine/2005/01/03/the-dictionary-of-disorder.

  • Stam, H. J. (2015). The neurosciences and the search for a unified psychology: The science and esthetics of a single framework. Frontiers in Psychology, 6, 1467.

    Article  PubMed  PubMed Central  Google Scholar 

  • Steiner, C. (2012). Automate this: How algorithms came to rule our world. New York: Penguin.

    Google Scholar 

  • Stiles, W. B., & Shapiro, D. A. (1989). Abuse of the drug metaphor in psychotherapy process-outcome research. Clinical Psychology Review, 9(4), 521–543.

    Article  Google Scholar 

  • Tanenbaum, S. (2003). Evidence-based practice in mental health: Practical weaknesses meet political strengths: Evidence-based practice in mental health. Journal of Evaluation in Clinical Practice, 9(2), 287–301.

    Article  PubMed  Google Scholar 

  • Tanenbaum, S. J. (2013). Reducing variation in health care: The rhetorical politics of a policy idea. Journal of Health Politics, Policy and Law, 38(1), 5–26.

    Article  PubMed  Google Scholar 

  • Timmermans, S., & Berg, M. (2003). The gold standard: The challenge of evidence-based medicine and standardization in health care. Philadelphia: Temple University Press.

    Google Scholar 

  • Truax, C. B., & Carkhuff, R. (1967). Toward effective counseling and psychotherapy: Training and practice. Chicago: Aldine.

    Google Scholar 

  • Tucker, A. R., & Blythe, B. (2008). Attention to treatment fidelity in social work outcomes: A review of the literature from the 1990s. Social Work Research, 32(3), 185–190.

    Article  Google Scholar 

  • VandenBos, G. R., Cummings, N. A., & DeLeon, P. H. (1992). A century of psychotherapy: Economic and environmental influences. In D. K. Freedheim (Ed.), History of psychotherapy: A century of change (pp. 65–102). Washington: American Psychological Association.

    Chapter  Google Scholar 

  • Whitaker, R. (2010). Anatomy of an epidemic: Magic bullets, psychiatric drugs and the astonishing rise of mental illness. New York: Broadway Paperbacks.

    Google Scholar 

  • Wilson, M. (1993). DSM-III and the transformation of American psychiatry: A history. American Journal of Psychiatry, 150(3), 399–410.

    Article  PubMed  Google Scholar 

  • Wolpe, J. (1958). Psychotherapy by reciprocal inhibition. Stanford: Stanford University Press.

    Google Scholar 

  • Wrenn, G. (1962). The counselor in a changing world. Washington: American Personnel and Guidance Association.

    Book  Google Scholar 

  • Yates, C. (2013). Evidence-based practice: The components, history, and process. Counseling Outcome Research and Evaluation, 4(1), 41–54.

    Article  Google Scholar 

  • Young, R. A., & Lalande, V. (2011). Canadian counselling psychology: From defining moments to ways forward. Canadian Psychology, 52, 248–255.

    Article  Google Scholar 

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Strong, T. (2017). Legitimizing an Emergent Mental Health “Monoculture”?. In: Medicalizing Counselling. Palgrave Studies in the Theory and History of Psychology. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-56699-3_4

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