Boston University Mental health counseling and behavioral medicine

PhilosophyPodcasts.Org

Thoughts on a degree-granting "program" at BU, called "Mental health counseling and behavioral medicine." I took some classes there but eventually quit because it was so ridiculous. What is "mental health counseling"? U.S. states wanted to regulate who could become a psychotherapist, and, given the incredible demand, a variety of academic departments wanted to be able to offer degrees that would pass legislative muster.

Medicine was first, but also nursing. Then schools of social work: the MSW degree suffices. Then psychology departments created something called a PsyD, different from a PhD. There is also pastoral counseling I believe. Finally, there was this little field called "counseling" which was essentially career counseling, then school counseling. Historically, it is part of the broad attempt by the middle class and managerial class to maintain order, and maintain their privileged status. Counseling attempted to get people into jobs. Then to keep students non-delinquent.

Well, career counseling departments wanted also to take advantage of the huge demand for psychotherapy. So they got legislative permission to create this new "mental health counseling" program. Soon, of course, mental health counseling dominated and over-ran career counseling. Career counseling now consists of one course in the BU program, and it is a course that is demeaned: take it in the summer, take it over some weekends. The BU MHCBM program apologizes for having to offer it.

What is "behavioral medicine"? Somehow "behavior medicine" became part of the title of BU's program, but it represents only one course in the curriculum too. A hypothesis is that it was thought that "behavioral medicine" would make the program seem more appropriately housed on the medical school campus. Behavioral medicine teaches how counselors can assist physicians: helping physicians by taking over the work of getting people to stay on their doctor-prescribed plans (adhere to the prescribed regimen).

At BU, there are two Mental-health counseling programs: this one in the medical school campus and the other in the Charles River campus.

The version at the medical school is scientistic and run by some limited individuals, philistines. The worldview is one of neoliberalism. It is more than just whether people have jobs or are non-delinquent. People are diseased if they do not cope with--are unhappy in--neoliberal society. People need to learn to submit to authority more happily; they need to learn to follow rules.

And the program itself embodies this worldview in parallel process. Faculty do not themselves set the curriculum; they defer to a higher power known as CACREP, which is an accreditation service. Whenever therer is a difficult choice, the reply is that "this is required for our accreditation." When accreditation is not specific enough, the faculty then bring in "consultants." When in doubt, hire a consultant to deflect any responsibility from yourself.

Students are treated like they are in the military. The program is more hierarchical than anything I have been a part of. The faculty members insist on being called "doctor," and it is forbidden to treat them as anything other than Gods. (It must be that some of the faculty have backgrounds in the military. Or they think that they are following a medical school model of trying to break people down arbitrarily, a sort of right of passage showing one's ability to tolerate BOHICA.)

Criticism is wholly discouraged. One should only find the positive in whatever one's classmates say. One should never challenge the faculty. Any failure is judged to be a lack of the "comportment" required to be a counselor. (The most important thing for becoming a psychotherapist in this neoliberal world is to be someone who will happily sacrifice their integrity for the sake of arbitrary rules. You can't say they are wrong: cf. the requirement to follow insurance rules).

Faculty teach and model a polite exterior ... comportment ... professionalism ... regulated narcissism and s/m hate. Plus there's the de rigeur "we are professional helpers; the problem with our profession is only that we tend to give too much; we have to mutually remind ourselves to remember to practice self-care!"

Laurie Craigen, Rachel Levy-Bell, Steve Brady, Thom Fields, Rory Berger-Greenstein, Navolta.