American Therapy

September 22, 2008
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.

September 1, 2008
Medical historian Engel (public & health-care administration, Seton Hall Univ.; "Poor People's Medicine: Medicaid and American Charity Care Since 1965"; "Doctors and Reformers: Discussion and Debate over Health Policy, 19251950") writes a blunt epitaph for psychoanalysis in a plainspoken survey of mental health care in the United States over the last century. Among the special topics are child guidance, alcohol, narcotics, and narcissism (therapy as self-indulgence). To make a living, psychiatrists, who are physicians first, have increasingly focused on medication, leaving psychotherapy to psychologists and social workers. Engel explains the need for and the methods of outcome research: it shows that brief cognitive-behavioral treatment with comfortably engaged therapists, along with medication when indicated, wins the laurels. Although Engel discusses religious attitudes to therapy, he gives short shrift to family and couples therapy and pastoral counseling. An authoritative, readable book, this is highly recommended for large general libraries and collections in health and social science.E. James Lieberman, George Washington Univ. Sch. of Medicine, Washington, DC

Copyright 2008 Library Journal, LLC Used with permission.

November 15, 2008
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. Engels 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 carewhich severely limits funding for what Engel calls the optimum therapy; namely, combining psychopharmaceuticals with analysisis concerned, the picture is not so rosy.(Reprinted with permission of Booklist, copyright 2008, American Library Association.)