Response to Hansen: Economic Pressures, Not Science, Undermine Humanistic Counseling.

The author contends that it was economic interests, not reductionist scientific methods, that displaced the humanities as the basis for counseling profession. Attacking scientific methods may inadvertently marginalize humanistic counselors. Instead, science in counseling should be viewed more broadly and thereby support the humanities as a basis for counseling. ********** I was energized by Hansen's incisive critique of the current professional counseling landscape (Hansen, 2012). I agree with many points he made, including his statement that there has been an increasing emphasis on diagnosis, treatment planning guides, and evidence-based practices (EBP) in the counseling profession. However, I disagree with his "diagnosis" of the trend. He suggests these trends have been caused by grounding the conceptualization of counseling in science. I argue that these trends are not the result of science but, instead, are the result of economic and policy interests. If Hansen's vision for the profession is to succeed, he must take into account the influence and concerns of reimbursement. Central to Hansen's (2012) thesis is that the increasing reliance of scientific methods is having a variety of negative effects on counseling generally and humanistic counseling specifically. However, the viability of his argument depends on a view of science that is strictly positivistic, the implications of which allow for science in counseling to be easily dismissed as unimportant to the profession. In contrast, I contend that most scientific research conducted about counseling is postpositivist or postmodern, approaches outside Hansen's current criticisms of the science used in counseling. In this article, I describe postpositivist science and provide an example of that approach to illustrate its importance to counseling. I also present a view in which science and humanistic approaches can be harmonious, using EBP, and redirect Hansen's diagnosis from science to economic interests so that prohumanistic scholars and researchers can better cope with the concerns that Hansen eloquently describes. Throughout, I present historical background to make my points. In his article, Hansen (2012) lays out growing restrictions and rules that are "stifling" (p. 140) to counselors: Reductive diagnostics, symptom-focused treatment planning, defining counselor education goals in terms of lists of competencies, techniques training, and manualized counseling models are just a few of the many signs that an emphasis on subjective meaning systems is gradually being lost in the profession. The creeping spread of scientific ideology, and concomitant loss of a humanities perspective, is arguably responsible for this shift. (p. 138) Although I agree with Hansen's portrayal of the field, I believe that the science has been a pawn of economic and political interests. In general, sociologists have documented how political and economic forces can have the strong and sometimes surprising influences on scientific endeavors (Goldfried & Wolfe, 1996). Given that health care costs in the United States rose 4,000% from 1960 to 1990 (Patterson, McIntosh-Koontz, Baron, & Bischoff, 1997), it is understandable that policy makers and payers of mental health services intervened, seeking remedies for soaring costs. RISE OF THE MENTAL HEALTH INDUSTRY With mental health costs escalating, research about and researchers of mental health services were increasingly consulted. Unfortunately, when psychotherapy research encountered reimbursement policy making, it was as if "Bambi [had met] Godzilla" (Parloff, 1982, p. 718). From 1955 to 1980 the utilization of mental health services in the United States increased from about 1% to 10% (Klerman, 1983). Costs had soared. The specter of tax hikes and escalating health insurance premiums provoked consumer concerns. Policy makers began seeking answers to fundamental questions regarding psychotherapy: Was it a health intervention and, if so, should it be covered by health insurance? …