a provider of services, one is told that it is necessary to select a psychotherapist from a preselected panel of candidates, a very small fraction of those who might otherwise be available. The members of this panel have usually been chosen on the basis of some minimal academic requirements and the willingness to work under adverse conditions. These adverse conditions include low pay and frequent violation of the privacy necessary for effective psychotherapy.
The trivialization of psychotherapy as a result of the conditions imposed by managed care is increasingly being matched by conditions imposed by the professional disciplines which provide formal training and credentials for most psychotherapists. Psychology is probably the discipline with the most noteworthy case of identification with the aggressor. It has actively promoted the “manualization” of psychotherapy. This term does not refer to conducting psychotherapy without the use of machinery; it refers to the notion that for any given condition, like depression, there is a single correct therapeutic approach to be taken. This approach can be described in a manual, and then any person who can read the manual and follow its instructions can perform the psychotherapy. While it may be true that anyone who can read a map and drive a car can deliver a pizza, it is certainly not that simple with psychotherapy. For psychology as a profession to pretend otherwise trivializes and demeans psychotherapy.
I was recently involved in an informal supervision session, in which a very mature and sophisticated psychotherapist presented a complicated clinical dilemma which had arisen in one of her psychotherapy groups. Several respected colleagues, all working