A Voice of Optimism: An Interview with Bernard Arons, MD, FAGPA,
Lisa Mahon, PhD, CGP, FAGPA

Bernard Arons, MD, FAGPA, Director of the U.S. Center for Mental Health Services (CMHS) and a longstanding member and fellow of AGPA, was honored by the Group Psychotherapy Foundation with the presentation of its Humanitarian Award. Dr Arons was acknowledged for his effectiveness in advancing recognition of the efficacy of group psychotherapy and for his contribution to the growth and funding of both clinical and research investigations. His helpfulness in obtaining a grant for AGPA on the reduction of violence among school-aged children was specifically noted. 

In his Plenary Address at AGPA’s Annual Conference in Boston, Dr. Arons presented an optimistic view of our growing understanding of diversity within the behavioral sciences. He noted that we are in a period of synthesis that will enhance mental health and promote the prevention of mental illness. 

Historically, scientific inquiry has produced disparate information between biology and psychology and within the group field. Multiple models of group psychotherapy, including psychoanalysis, self-psychology, gestalt, systems, and interpersonal theory, have emerged. Mental health professionals need to meet the challenge of integrating such diverse information. A new synergistic understanding of human behavior and treatment of mental health is emerging. We are already on the cutting edge of blending such areas as psychopharmacology and psychotherapy, and neuroscience and behavioral science. 

After his Plenary presentation, Dr. Arons offered a view of the future direction of mental health.

What has been your personal experience with group psychotherapy, both during your training and after your training?
My training program in psychiatry included a rich and comprehensive program in group psychotherapy. John Borriello, PhD, oversaw a multiyear curriculum with a combination of didactic courses, experiential learning, and closely supervised group therapy opportunities leading to a certificate in group psychotherapy. He also encouraged trainees to attend AGPA meetings and get a sense of what was happening throughout the country and throughout the world. I led therapy groups at St. Elizabeth’s Hospital, in addition to outpatient groups at clinics in the Washington, DC, area and in a private practice. 

You seem to have a special affinity for group psychotherapy and AGPA. Why is this?
The multidisciplinary nature of AGPA provides a richness of experience in meetings that I find enlightening. For the most part, AGPA keeps a focus on the task. While AGPA, as all groups, is subject to political infighting, personal differences, and the like, I find that AGPA generally keeps a focus on advancing the field, finding common concerns and concentrating on them. 

What are the prospects for group psychotherapy and mental health services in the current environment?
I feel quite positive about the prospects for group psychotherapy and mental health in general. I think there is growing understanding of the importance of mental health in the context of overall health. Some of the work documenting better outcomes for physical illness with psychotherapy is gaining visibility. Of course, we are seeing greater emphasis on short-term approaches, integration of medication and therapy, and markedly reduced hospital stays. 

In your Plenary presentation, you stated that “Group therapists bring something special—knowledge and skills.” How do you envision group therapists using these skills and making a larger contribution with their knowledge?
Group psychotherapists can bring their unique insights about the dynamics of group relationships beyond psychotherapy situations to the public policy arena. Most accomplishments in today’s society involve overlapping challenges, reflecting the goals of many stakeholders. Often, the result is that the most difficult issues are left untouched. The significant contributions involve addressing different and often opposing needs and interests. I see the knowledge and skills of group therapists as a critical asset in the process of producing substantive accomplishments in the public arena.

How much difference does it make that George Bush was elected and not Al Gore? What will be the impact of the change from a Democratic to a Republican Administration? 
One thing we learned from the process of putting together the Surgeon General's Report on Mental Health is that concern about mental disorders and interest in promotion of mental health is not the property or interest of one political party. The process of illness and recovery knows no boundaries, whether geographical or political. 

What can we do as individuals and as an organization to position ourselves favorably in the current environment?
The best thing we must do is learn the lesson that AGPA highlighted at its Annual Meeting in Boston—that we are serving a diverse population that spans more experiences and needs than any one of us can understand well. Our first job is to be open and to listen. Our job also is to be flexible; a “stamped out” approach is of little value in today’s world. We will position ourselves favorably only if we reflect the insights that diversity teaches us—that we can make a contribution to society when we can address the needs of many, while at the same time recognizing the unique backgrounds and needs of particular groups. 

What about the future of managed care? How it will evolve? Are we on the way to a two-tiered service delivery system of the sort that exists in Great Britain and Canada?
I think we’re in the midst of tremendous and ongoing changes in the mental health field. I do not think the era of intrusive utilization review will continue much longer. There will be continued experimentation with various approaches to overseeing mental health care and controlling costs, but, eventually, these will give way to general practice guidelines with flexible oversight. The United States seldom follows the models of other countries, but we like to fashion our own, often complicated, solutions to problems. 

Are there areas of mental health prevention and treatment of mental illness that you believe mental health professionals, particularly group professionals, have neglected? 
We continue to know much more about mental illness and how to treat it than about mental health and how to promote it. I think that is the next major frontier for mental health professionals. We are gaining an ally in our campaign for mental health, and that is consumers of mental health services. Consumer advocacy groups have taken an active part in the movement to improve treatment and policies, and their participation in promoting mental health is a tremendous resource for those who care about mental health services.

To familiarize yourself more with Dr. Aron’s work and that of the Center for Mental Health Services, visit its website at www.mentalhealth.org.

This article was published in the June/July 2001 issue of The Group Circle.