A consulting room with a view: Psychotherapy and the ecological context

BACKGROUND

The field of psychotherapy is witnessing a lively debate today. The literature on the efficacy of psychological interventions has grown exponentially, but the assumptions of the prevailing research paradigms have been criticised from many points of view. One of the main concerns is that of a too often simplistic conception of psychotherapy, viewed as a set of specific methods for the treatment of point-like problems or symptoms.

LITERATURE REVIEW ON MENTAL HEALTH AND THE ECOLOGICAL CONTEXT

Instead, emerging perspectives are trying to promote a more complex view on psychotherapy, as a process based on the therapeutic potential of relationships, which takes place in relevant social and cultural contexts. Even the ecological context is taken in greater consideration, as growing evidence exists about the detrimental effects of ecological threats-such as climate change and other environmental challenges-on mental health.

CONCLUSIONS

Psychotherapists and psychotherapy associations are now paying due attention to such issues, as well as to social justice and other dimensions that no longer can be thought of as mere elements of the scenario in which psychotherapy is practiced. Rather they are dimensions that exert a strong influence on psychological well-being, and thus must be properly acknowledged and assessed to connect clinical work with the communities and ecological contexts in which people live.

From Craft to Labor: How Automation is Transforming the Practice of Psychotherapy

I argue that the emergence of ICBT (Internet Cognitive Behavioral Therapy), a novel computerized psychotherapeutic intervention, heralds a shift in the status of psychotherapy from craft to labor. Psychotherapy, as is practiced commonly today, retains its status as craft; therapists in managed settings still work within what I term an opaque bubble, their work invisible and uninterrupted, even by their immediate supervisors and managers. The therapists participating in the Israeli Ministry of Health's course training the first cohort of 'online therapists' find themselves in uncharted territory: The automation of psychotherapy in the form of ICBT constitutes the profession's first major 'division of labor,' not only minimizing the role of the human therapists, but rendering their craft transparent and controllable in ways previously unimaginable. This shift is theorized as a transition from a workmanship of risk, to a workmanship of certainty, and the potential degradation of therapists' skills and status is explored.

Learning Compassion and Meditation: A Mixed-Methods Analysis of the Experience of Novice Meditators

Over the last decade, numerous interventions and techniques that aim to engender, strengthen, and expand compassion have been created, proliferating an evidence base for the benefits of compassion meditation training. However, to date, little research has been conducted to examine individual variation in the learning, beliefs, practices, and subjective experiences of compassion meditation. This mixed-method study examines changes in novice meditators' knowledge and contemplative experiences before, during, and after taking an intensive course in CBCT® (Cognitively-Based Compassion Training), a contemplative intervention that is increasingly used for both inter- and intrapersonal flourishing. The participants in this study (n = 40) were Christian healthcare chaplains completing a 1-year residency in Clinical Pastoral Education (CPE) who learned CBCT as part of their professional chaplaincy training curriculum. Prior to and upon completion of training, we surveyed participants to assess their beliefs about the malleability of compassion, types of engagement in compassion meditation, and perceptions of the impact of taking CBCT. We also conducted in-depth interviews with a subset of participants to gain a qualitative understanding of their subjective experiences of learning and practicing compassion meditation, a key component of CBCT. We found that participants reported increases in the extent to which they believed compassion to be malleable after studying CBCT. We also found high levels of variability of individual ways of practicing and considered the implications of this for the study of contemplative learning processes. This multi-methodological approach yielded novel insights into how compassion practice and compassion-related outcomes interrelate, insights that can inform the basic scientific understanding of the experience of learning and enacting compassion meditation as a means of strengthening compassion itself.