Changes in Psychological Services Consistent
with the renewed respect for the biology of behavior,
clinical psychology moved closer to an identity as
a medical discipline. The medically oriented treat-
ment of emotional disturbances by antianxiety, anti-
psychotic, or antidepressive medication became
widespread, almost standard. Psychotherapy was of-
ten deemed advisable as well. In the 1980’s, most psy-
chotherapy was paid for and controlled by such
third parties such as health maintenance organiza-
tions (HMOs). HMOs demanded clear treatment
plans oriented to fast and measurable results. Many
hospitalized patients received medication without
follow-up therapy. An unfortunate spin-off of this
medicalization was that a large number of institu-
tionalized patients, once medicated, became suffi-
ciently free of flamboyant symptoms to be released.
Still passive, withdrawn, without friends or incomes,
and often discontinuing medication, many former
patients became resigned to living on the streets,
thus swelling the ranks of the homeless.
The cognitive psychotherapy of Dr. Aaron Beck
became especially popular. Beck assumed that un-
derlying such symptoms as phobias, depressions,
and compulsions were hidden, irrational assump-
tions. Cognitive therapists, therefore, shared with
Freudian psychoanalysts the conviction that patients
suffer from illusions. Unlike psychoanalysts, how-
ever, cognitive therapists were forceful and direct in
encouraging changes in irrational thought patterns.
The therapist would first explore with the patient his
or her irrational belief system; then the therapist
would assign homework confronting the patient with
life situations testing the validity or exposing the in-
validity of these beliefs.
In the 1980’s, the most common presenting prob-
lems of patients shifted. Youth with learning disor-
ders, especially those with difficulties in sustaining
attention, were seen with greater frequency. Because
of demographic changes, psychologists grew more
concerned with the problems of single and divorced
adults, blended households, custody disputes, two-
wage-earner households, and the elderly. Depres-
sions among adolescents and young adults became
more common. Programs dealing with substance de-
pendency grew apace. As use of fixed sentences for
criminal acts expanded, programs aimed at rehabili-
tating offenders contracted. After John Hinckley, Jr.,
who attempted to assassinate President Ronald Rea-
gan, was found “not guilty by reason of insanity,” the
public demanded the criteria for insanity pleas be
tightened. “You do the crime, you do the time” re-
flected the mood of the era.
Impact Trends within psychology during the de-
cade reflected the conservative temper of the times.
Targeted, cost-conscious psychotherapy may yield
insights less deep than classic approaches, but it con-
fers measurable improvement for more people. Re-
search in the decade to come included a genome
(gene-mapping) project, the results of which fur-
ther supported the significance of hereditary fac-
tors. Of course, social factors and culture must still
be considered, since the potential bestowed by he-
redity can be modified for good or ill by environ-
mental input. Cases abound where a felicitous family
situation has moved a potential schizophrenic or de-
linquent away from the trajectory of genetic doom.
Nurture still counts, but the enduring lesson of the
1980’s is that so does nature.
Further Reading
Gelman, David. “Cognitive Therapy for Troubled
Couples.”Newsweek, January 9, 1989. Describes
this popular therapy applied to typical problems
of the 1980’s.
Loehlin, John C., et al. “Human Behavior Genetics.”
Annual Review of Psychology39 (1988): 101-133. Re-
views the several types of research establishing the
importance of heredity in identity.
McRae, Robert, and Paul Costa.Personality in Adult-
hood. New York: Guilford Press, 1990. Discusses
the massive research culminating in five-factor
theory and the meaning of the factors.
Thomas E. DeWolfeSee also Androgyny; Conservatism in U.S. politics;
Crack epidemic; Crime; Demographics of the
United States; Domestic violence; Feminism; Genet-
ics research; Health care in the United States;
Health maintenance organizations (HMOs); Home-
lessness; Medicine; Prozac; Reagan assassination at-
tempt; Science and technology.782 Psychology The Eighties in America