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Maximizing Effectiveness in Dynamic Psychotherapy Self-Compassion in Psychotherapy101 Healing StoriesA Clinician's Guide to Legal Issues in PsychotherapyA Map of the MindA Primer for Beginning PsychotherapyACT With LoveActive Treatment of DepressionAffect Regulation, Mentalization, and the Development of SelfAlready FreeBad TherapyBecoming an Effective PsychotherapistBefore ForgivingBeing a Brain-Wise TherapistBetrayed as BoysBeyond Evidence-Based PsychotherapyBeyond MadnessBeyond PostmodernismBinge No MoreBiofeedback for the BrainBipolar DisorderBody PsychotherapyBoundaries and Boundary Violations in PsychoanalysisBrain Change TherapyBrain Science and Psychological DisordersBrain-Based Therapy with AdultsBrain-Based Therapy with Children and AdolescentsBrief Adolescent Therapy Homework PlannerBrief Child Therapy Homework PlannerBrief Therapy Homework PlannerBuffy the Vampire Slayer and PhilosophyBuilding on BionCare of the PsycheCase Studies in DepressionCaught in the NetChild and Adolescent Treatment for Social Work PracticeChoosing an Online TherapistChronic DepressionClinical Dilemmas in PsychotherapyClinical Handbook of Psychological DisordersClinical Intuition in PsychotherapyClinical Pearls of WisdomCo-Creating ChangeCognitive Therapy for Challenging ProblemsCompassionConfessions of a Former ChildConfidential RelationshipsConfidentiality and Mental HealthConfidingContemplative Psychotherapy EssentialsControlConversations About Psychology and Sexual OrientationCoping with BPDCouch FictionCounseling in GenderlandCounseling with Choice TheoryCouple SkillsCrazy for YouCreating a Life of Meaning and CompassionCreating HysteriaCritical Issues in PsychotherapyCrucial Choices, Crucial ChangesDeafness In MindDecoding the Ethics CodeDeconstructing PsychotherapyDeep Brain StimulationDemystifying TherapyDepression 101Depression in ContextDialogues on DifferenceDissociative ChildrenDo-It-Yourself Eye Movement Techniques for Emotional HealingDoing CBTE-TherapyEarly WarningEncountering the Sacred in PsychotherapyEnergy Psychology InteractiveErrant SelvesEssays on Philosophical CounselingEssentials of Wais-III AssessmentEthically Challenged ProfessionsEthics and Values in PsychotherapyEthics in Plain EnglishEthics in Psychotherapy and CounselingExpectationExploring the Self through PhotographyExpressing EmotionFacing Human SufferingFairbairn's Object Relations Theory in the Clinical SettingFamily TherapyFavorite Counseling and Therapy Homework AssignmentsFear of IntimacyFlourishingFolie a DeuxForms of Intersubjectivity in Infant Reasearch and Adult TreatmentFoundations of Ethical Practice, Research, and Teaching in PsychologyFreud and the Question of PseudoscienceFrom Morality to Mental HealthFundamentals of Psychoanalytic TechniqueGenes on the CouchGod & TherapyHalf Empty, Half FullHandbook of Clinical Psychopharmacology for TherapistsHandbook of Counseling and Psychotherapy with Lesbian, Gay, and Bisexual ClientsHandbook of Evidence-Based Therapies for Children and AdolescentsHealing the Heart and Mind with MindfulnessHeinz KohutHelping Children Cope With Disasters and TerrorismHigh RiskHistory of PsychotherapyHow and Why Are Some Therapists Better Than Others?How Clients Make Therapy WorkHow People ChangeHow Psychotherapists DevelopHow to Fail As a TherapistHow to Go to TherapyHypnosis for Inner Conflict ResolutionHypnosis for Smoking CessationI Never Promised You a Rose GardenIf Only I Had KnownIn Others' EyesIn SessionIn Therapy We TrustIn Treatment: Season 1Incorporating Spirituality in Counseling and PsychotherapyInside the SessionInside TherapyIs Long-Term Therapy Unethical?Issues in Philosophical CounselingIt's Not as Bad as It SeemsItís Your HourLearning from Our MistakesLearning Supportive PsychotherapyLetters to a Young TherapistLife CoachingLogotherapy and Existential AnalysisLove's ExecutionerMadness and DemocracyMaking the Big LeapMan's Search for MeaningMetaphoria: Metaphor and Guided Metaphor for Psychotherapy and HealingMind GamesMindfulnessMindfulness and AcceptanceMindfulness-Based Cognitive Therapy for DepressionMindworks: An Introduction to NLPMockingbird YearsMoments of EngagementMomma and the Meaning of LifeMotivational Interviewing: Preparing People For ChangeMulticulturalism and the Therapeutic ProcessMultifamily Groups in the Treatment of Severe Psychiatric DisordersNarrative PracticeOn the CouchOne Nation Under TherapyOur Inner WorldOur Last Great IllusionOutsider ArtOutsider Art and Art TherapyOvercoming Destructive Beliefs, Feelings, and BehaviorsOverexposedPathways to SpiritualityPersonality and PsychotherapyPhilosophical CounselingPhilosophical Counselling and the UnconsciousPhilosophical Issues in Counseling and PsychotherapyPhilosophical PracticePhilosophy and PsychotherapyPhilosophy for Counselling and PsychotherapyPhilosophy PracticePhilosophy's Role in Counseling and PsychotherapyPillar of SaltPlan BPlato, Not Prozac!Polarities of ExperiencesPower GamesPractical Psychoanalysis for Therapists and PatientsPrinciples and Practice of Sex TherapyPsychologists Defying the CrowdPsychology, Psychotherapy, Psychoanalysis, and the Politics of Human RelationshipsPsychosis in the FamilyPsychotherapyPsychotherapyPsychotherapy and ConfidentialityPsychotherapy As PraxisPsychotherapy for Children and AdolescentsPsychotherapy for Personality DisordersPsychotherapy Is Worth ItPsychotherapy Isn't What You ThinkPsychotherapy with Adolescent Girls and Young WomenPsychotherapy with Children and AdolescentsPsychotherapy without the SelfPsychotherapy, American Culture, and Social PolicyRapid Cognitive TherapyRational Emotive Behavior TherapyRational Emotive Behavior TherapyRationality and the Pursuit of HappinessRebuilding Shattered LivesReclaiming Our ChildrenRecovery OptionsRelationalityRent Two Films and Let's Talk in the MorningSaving the Modern SoulScience and Pseudoscience in Clinical PsychologySecond-order Change in PsychotherapySelf-Compassion in PsychotherapySelf-Determination Theory in the ClinicSelf-Disclosure in Psychotherapy and RecoverySerious ShoppingSex, Therapy, and KidsSexual Orientation and Psychodynamic PsychotherapySigns of SafetySoul Murder RevisitedStaring at the SunStraight to JesusStrangers to OurselvesSubjective Experience and the Logic of the OtherTaking America Off DrugsTales of PsychotherapyTales of UnknowingTalk is Not EnoughTalking Cures and Placebo EffectsTelling SecretsThe Behavioral Medicine Treatment PlannerThe Body in PsychotherapyThe Brief Couples Therapy Homework Planner with DiskThe Case Formulation Approach to Cognitive-Behavior TherapyThe Challenge for Psychoanalysis and PsychotherapyThe Child and Adolescent Psychotherapy Treatment PlannerThe Clinical Child Documentation SourcebookThe Clinical Documentation SourcebookThe Complete Adult Psychotherapy Treatment PlannerThe Couch and the TreeThe Couples Psychotherapy Treatment PlannerThe Crucible of ExperienceThe Cure of SoulsThe Death of PsychotherapyThe Education of Mrs. BemisThe Ethical Treatment of DepressionThe Ethics of PsychoanalysisThe Gay and Lesbian Psychotherapy Treatment PlannerThe Gift of TherapyThe Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work The Healing JourneyThe Heart & Soul of ChangeThe Heroic ClientThe Husbands and Wives ClubThe Love CureThe Making of a TherapistThe Mindful TherapistThe Mirror Crack'dThe Mummy at the Dining Room TableThe Neuroscience of PsychotherapyThe Neuroscience of Psychotherapy: Healing the Social BrainThe New Rational TherapyThe Older Adult Psychotherapy Treatment PlannerThe Other Side of DesireThe Pastoral Counseling Treatment PlannerThe Philosopher's Autobiography The Pornographer's GriefThe Portable CoachThe Portable Ethicist for Mental Health Professionals The Present Moment in Psychotherapy and Everyday LifeThe Problem of EvilThe Problem with Cognitive Behavioural TherapyThe Psychodynamics of Gender and Gender RoleThe Psychotherapy Documentation PrimerThe Psychotherapy Documentation PrimerThe Psychotherapy of HopeThe Real World Guide to Psychotherapy PracticeThe Schopenhauer CureThe Sex Lives of TeenagersThe Talking CureThe Therapeutic "Aha!"The Therapist's Guide to PsychopharmacologyThe Therapist's Guide to Psychopharmacology, Revised EditionThe Therapist's Ultimate Solution BookThe Trauma of Everyday LifeThe Trouble with IllnessThe UnsayableThe Way of the JournalTheory and Practice of Brief TherapyTherapy with ChildrenTherapy's DelusionsTheraScribe 3.0 for WindowsTheraScribe 4.0Thinking about ThinkingThinking for CliniciansThinking for CliniciansThoughts Without a ThinkerThriveToward a Psychology of AwakeningTracking Mental Health OutcomesTrauma, Truth and ReconciliationTreating Attachment DisordersTreatment for Chronic DepressionTreatment Plans and Interventions for Depression and Anxiety DisordersUnderstanding Child MolestersUnspeakable Truths and Happy EndingsWhat the Buddha FeltWhat Works for Whom?What Works for Whom? Second EditionWhen the Body SpeaksWhispers from the EastWise TherapyWittgenstein and PsychotherapyWorking MindsWoulda, Coulda, ShouldaWriting About PatientsYoga Skills for Therapists:Yoga Therapy
Have you ever wanted to know if mental health care is a worthy endeavor for all parties involved? Besides ethical and psychological considerations, do economic analyses support the idea of devoting public funds to the treatment and perhaps prevention of mental illness? Often the debate on the potential beneficial effects of prevention and treatment of mental illness tends to focus on single individuals and revolve around the critical issue of whether interventions are evidence-based. Yet, health care policies may impact both the individuals who require services and the communities where these services are offered. Thus, how do potential benefits for single individuals translate into effects that are not only large-scale and long-term, but also both psychologically successful and economically sound? In Thrive: How better mental health care transforms lives and saves money, Richard Layard and David M. Clark analyze the economic costs and benefits of a public policy approach that equates the relevance of physical health and mental health needs. Their analyses lead to the conclusion that large-scale programs that make available effective mental illness treatments to consumers in need are economically viable, psychologically sound, and morally desirable. Most importantly, their analyses cleverly circumvent the often debated dilemma of whether health care is to be conceived as a right for all or a privilege that only a few can afford.
The authors' narrative is informative, poignant, and accessible to a broad readership. The text is divided into two conceptually complementary sections: Part 1 is devoted to a description of the problem, whereas Part 2 is dedicated to available remedies. Across the entire text, scientific evidence is elegantly and concisely reported not only to explain its meaning, but also to emphasize its practical value. The authors skillfully combine a psychological viewpoint of mental suffering and its remedies with an economic viewpoint where treatment costs and benefits are pitted against those yielded by the lack of treatment. By doing so, they do not ignore structural and societal issues (e.g., poverty, lack of adequate education, unemployment, crime, physical illness and the shortage of adequate housing) that may be responsible for triggering and sustaining diverse forms of mental illness. Indeed, the authors acknowledge the utility of preventive policies and the necessity of social changes. Yet, they also recognize that interventions need to be considered for the people who are currently suffering from mental illness. Furthermore, they argue that mental illness, which may reflect both internal and external sources, is unlikely to disappear entirely even if structural and societal influences are addressed and salubrious alternatives are provided.
A well-developed review of the existing clinical literature leads Layard and Clark to highlight the desirable characteristics of cognitive behavioral therapy and its beneficial effects on a variety of mental disorders (e.g., depression and anxiety-based illnesses). Characteristics include the systematic structure of the treatment offered, its reliance on measurement to define the patient's condition and therapeutic success, and the availability of evidence of effectiveness provided by both traditional clinical studies and cutting-edge brain research. As such, it is expressly recommended for some disorders, such as mild, moderate, and severe depression, anxiety disorders, disorders of trauma and stress (e.g., post-traumatic stress disorder) and eating disorders. Of course, the term "cognitive behavioral therapy" refers to an umbrella under which one can find different specialized interventions that address qualitatively different problems, but conform to the same overriding theoretical principles.
According to Layard and Clark, in spite of the number of individuals suffering from psychological disturbances in many countries around the world and the demonstrable effectiveness of specific psychological treatments (e.g., cognitive behavioral therapies), treatment is still unavailable to many. The authors share their experiences with "Improving Access to Psychological Therapies" (IAPT), which is a program that attempts to organize the delivery of treatment interventions by practitioners who are part of England's National Health Service. The program, which started in late 2008, makes available to localities teams of well-trained mental health practitioners whose interventions are supervised and measured. In doing so, it offers clearly defined guidelines for interventions and measurement, evidence of patients' progress and expected outcomes, and accessible information about therapists' required training and experience. Since the service is available to consumers without a general practitioner's referral and is performed close to where they reside, the program makes clinical treatments not only accountable and transparent to the public, but also available to those in need. Most importantly, its reliance on the supervised administration of required treatments allows quality control to be performed. In the book, the authors methodically examine evidence of the effectiveness of the IAPT and consider the criticism it has received since its inception. They conclude that albeit there is always room for improvement, it can be considered an effective model of mental health service delivery if its success rates are compared with those of existing service models.
In sum, the authors' engaging writing style, selection of topics and content organization make Thrive: How better mental health care transforms lives and saves money a great read. The entire book or a targeted selection of chapters can be used as reading materials for a variety of higher education courses, from public health to abnormal psychology. For both broad and specialized readerships, the book can serve as a model for program evaluation based on the consideration and assessment of an array of factors, including psychological, social, ethical and economic benefits. It can also serve as an introduction to a mental health delivery program based on scientific principles, and thus reliant on measurable outcomes. Irrespective of the specific purpose that it may fulfill for each reader, the book is a must-read if one wants to appreciate current and past debates over health care policy.
© 2015 Maura Pilotti
Maura Pilotti, Ph.D., Ashford University