The Bewildering World of Psychotherapy

Certain generalizations beneath the apparent chaos of the field of psychotherapy are noted, including the flourishing of psychotherapies in times of social change, the congruence of the values of popular psychotherapies with the values of their era, the similarity of improvement rates following all forms of psychotherapy, and the fact that all cohorts of patients improve on the average over time. These findings are consistent with the hypothesis that persons receive psychotherapy not primarily because of specific symptoms but because they are demoralized, and that the effectiveness of all forms lies in their ability to combat this state by a particular relationship, a special setting, a conceptual scheme, and a therapeutic task which, in conjunction, arouse the patient's hopes and restore his sense of mastery over himself and his environment. Implications for the psychotherapist as a social reformer and for research in psychotherapy are considered.