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American Therapy: The Rise of Psychotherapy in the United States Hardcover – October 30, 2008

2.8 out of 5 stars 9 customer reviews

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Editorial Reviews

From Publishers Weekly

Since 50% of Americans will reportedly undergo some form of psychotherapy in their lifetimes, Engel, a professor of health care policy and management at Seton Hall University, presents a complete survey of the 100-year-old history of American mental health practitioners. Tracing the rise and decline of psychoanalysis in America (including the pioneering theories of homegrown talents Harry Stack Sullivan and Karen Horney), and its replacement by other, more targeted forms of therapy, this book notes that mental health treatment has become intensely consumer-oriented, tailored to finicky patients and leading to a variety of therapies such as Gestalt, rebirthing, primal scream therapy and medications like Prozac and Zoloft (though the discussion of medications fails to do justice to their complexities). Engel (The Epidemic: A Global History of AIDS) touts community mental health facilities and new progress in treatments and drugs to control addictions and mental instability. Highly informative, if a bit textbookish in tone, this is a capable introduction to the ever-changing American mental health industry and its practitioners. 8 pages of b&w photos. (Nov.)
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From Booklist

Health-care-policy professor Engel delves deeply, perhaps too deeply, into the nuts (no pun intended), bolts, and history of psychological analysis in the last 100 years. For the general public, there may not be such a thing as too much information about all the permutations of therapeutic analysis, beginning with Freud and continuing through primal screaming and Rolfing. Anyone considering such mental-health interventions may, however, find this amount of background detail daunting. Engel’s accounts of early attempts at determining just what might or might not work for any given patient, from aversion therapy to frontal lobotomy and electroshock treatments, raise real fear. Later chapters, however, are more reassuring, if only because the profession seems to have achieved a status quo in which patients are at little risk of encountering once-popular experimental therapies. On the other hand, due to changing trends insofar as managed care—which severely limits funding for what Engel calls the optimum therapy; namely, combining psychopharmaceuticals with analysis—is concerned, the picture is not so rosy. --Donna Chavez

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Product Details

  • Hardcover: 368 pages
  • Publisher: Gotham (October 30, 2008)
  • Language: English
  • ISBN-10: 1592403808
  • ISBN-13: 978-1592403806
  • Product Dimensions: 6.3 x 1.3 x 9.3 inches
  • Shipping Weight: 1.2 pounds
  • Average Customer Review: 2.8 out of 5 stars  See all reviews (9 customer reviews)
  • Amazon Best Sellers Rank: #1,720,772 in Books (See Top 100 in Books)

Customer Reviews

Top Customer Reviews

By R. Elliott Ingersoll on January 15, 2010
Format: Hardcover Verified Purchase
I rarely "bash" books when I review them but this is one time I feel obligated to. "American Therapy" is without a doubt the most poorly written and weakly researched account of... well... it is so poorly written it is hard to say exactly what it is supposed to be about. If it is supposed to be a history of therapy in America it falls woefully short. If it is supposed to give the reader a sense of the state-of-the-art of therapy it totally fails. As far as I can tell it is a propaganda piece for the pharmaceutical industry but, I am getting ahead of myself. Let me start with the author's so-called "research."

This book is riddled with more errors than the charter for the "Flat Earth Society." Engel frequently eschews peer-reviewed sources and relies heavily on popular sources like "Time" and "Newsweek" which can hardly be said to have a grasp of the history of psychotherapy let alone how therapy works. The book clearly had no "fact check" or peer-review process as the author goes on and on about the research done by behavior therapists and totally misses the fact that Carl Rogers (who Engel dismisses as "one of a number of humanistic psychologists") pioneered psychotherapy research and was the first one to record sessions, publish transcripts and analyze transcripts of entire therapy relationships from start to finish.

Engel seems unaware that Rogers is credited with "virtually founding the professional counseling movement and made professional counseling accessible to diverse helping professions" (Howard Kirschenbaum, "The Life and Work of Carl Rogers," p. 581). But to be fair, Engel doesn't even seem to know that a counseling profession exists with licenses in every state and a national organization of 47,000 members.
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Format: Hardcover Verified Purchase
I think the reviewer who said "passing knowledge" was correct, though not for himself.

Another reviewer stated the "research" was skimmed from the surface was more on target: this guy, a ph d. -- they are supposed to be trained in researching -- is wildly inaccurate: there's 10 errors in his account of AA alone. His research staff uncovered hearsay accounts and may have verified same with surface cursory readings of historical accounts. But they stopped as soon as they assumed they had. Never assume. Even the smallest amount of a little more digging would have shown the dangers of anecdote. This "work" merely spit up chewed-up myths commonly held.

Read it if only to gauge how scarily inept the ph d. racket has become.
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Format: Hardcover
This book is a once-over lightly summary of a few aspects of the development of psychotherapy in the U. S. The author is a historian, and his lack of understanding of psychology and psychotherapy is apparent. He beats up Freud again, as if that were needed, and emphasizes the kooks and quacks in the history of therapy such as L. Ron Hubbard, Werner Erhard, and Arthur Janov. A review of their nutty ideas can be entertaining to people who have never heard of them, but why focus on them? The author criticizes Carl Rogers as naive and "humanistic" but likes Albert Ellis and Aaron Beck. He calls Thomas Szasz, one of the most respected and influential psychiatrists, a "kook." The author loves AA and claims it works, and is apparently unaware that since AA is anonymous (duh) there is almost no research supporting its effectiveness. He is so gushing about AA that one wonders if he is an alcoholic who just enjoys going to his meetings. Why the author felt it was necessary to inject his personal opinions into what should have been an objective history is unclear. The book is sloppily written, with misattributions, inaccurate information, and missing references. On page 173 he refers to Hans Strupp, who was a psychoanalytic researcher, as a "humanistic therapist" and on page 234 he refers to the same man as Hans Krupp. Didn't anyone proofread the manuscript? With so many errors and outright false information, anyone who looks to this book for accurate history will be disappointed.
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Format: Hardcover
Engel begins by telling readers that one-on-one doctor-patient psychoanalysis and psychiatry make up a very small portion of American mental health care. Social workers, priests, pastoral counselors, self-help gurus, and support groups (eg. AA) must also be included. WWII greatly altered America's understanding and perception of mental illness when thousands of draftees (about 12%) were found mentally unfit, many other broke down from traumatic stress (about 1 million), and alcoholism rates rose significantly after the war (consumption increased about 30%).

Engel contends that psychoanalysis (eg. Freud and interpretation of dreams) does not work. A 1950s study by the American Psychoanalytic Association showed only one in six ultimately were cured; most other studies indicate a nearly 90% remission rate for neurotic patients over five years, with remission rates for those in analysis somewhat lower.

On the other hand, Engel believes that psychotherapy (empathetic help in managing one's life) does work - multiple studies over the past half-century have demonstrated that about two-thirds of recipients improve within 6 months. Success rates seem independent of the type of therapy used, though the qualities of the therapist (especially empathy, honesty, and the ability to connect quickly) are more important. Engel also concedes that the exact mechanism by which therapy works has not been identified.

Further clouding the issue is the fact that about one-third of all patients achieve spontaneous remission, the conclusion that most mental disorders have a chemical or physiological basis, and that psychotherapy has proven only modestly successful with alcohol or drug abuse.

Psychotherapy has lately been challenged by a series of miracle drugs. Research, however, shows that most patients improve more thoroughly when treated with a combination of medication and therapy.
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