What is a Trend
A trend is a direction in organized societal activities that have emerged in response to a perceived need; has persisted for a long period of time; has gained the support of academic, business and political leaders; and has developed a broad-based economic infrastructure to support it. A trend is very different from a fad, which is a popular idea that generates a short burst of widespread interest but fails to win the support of established leadership or develop a broad-based economic infrastructure to support it. Trends usually develop slowly and gain a broad base of support while fads generally emerge quickly and have very localized or limited support. Fads come and go while trends are usually here to stay.
Co-dependence – A Fad Not A Trend
It is difficult at the beginning of a new movement to determine if it will be a fad or a trend. I thought, for example, that the codependency movement would become a trend. I was wrong. Let’s examine why. The concept of co-dependence is based upon a broadly perceived societal problem. Many people have been raised in dysfunctional families and have problems as a result. Severely dysfunctional families create serious problems for children and adults. This looked like good material to start a trend. The concept of co-dependence, however, was relatively new. It emerged from the chemical dependency field in the early 1980’s and rapidly became generalized to anyone experiencing personal problems that stemmed from childhood abuse or neglect. The concept, however, kept changing. It was never clearly defined and as a result, was never integrated into mainstream psychology and psychiatry and never received the widespread support of academic leaders. Without this academic support, business and political leaders were slow to endorse the concept and became progressively more skeptical.
The codependence movement developed a small economic infrastructure to support it, but this was limited to workshop leaders, small publishers, and therapists treating codependent patients. It never established broad-based support among traditional counselors, therapists, or academic and research-oriented psychologists. Without this broad-based support, insurance providers and managed care companies refused to pay for its treatment and it was relegated to a fringe activity rather than a mainstream diagnostic and treatment issue. As a result, the codependency movement became a fad and after a strong burst of popularity moved into decline.
Managed Care – A Trend With Continuing Power
Managed care, on the other hand, is a trend. It developed slowly beginning with concerns about the cost, quality, and accessibility of healthcare in the early 1970’s. A strong research and academic base were established. Efforts were made to cultivate a broad-based support for the need to control cost in the healthcare industry. Skyrocketing health care costs were threatening to bankrupt American government and cripple American businesses in the new world marketplace. This is a powerful perceived need. Academic, business and political leaders were recruited to support the cause and because the economic concerns were so great they responded. As a result, a new managed care industry emerged to meet the demand for cost containment. This industry rapidly grew in size and power and now controls approximately 70% of all healthcare dollars. This managed care industry is setting the agenda for the future of behavioral health care.
Addiction – A Trend Growing In Power
There is a growing worldwide epidemic of drug addiction. This epidemic is so severe and widespread that it cannot be ignored. Governments are responding with policy decisions that create a framework for managing people with alcohol and drug problems. The concern about addiction and its effects upon society is so strong that it has caused the government to invest huge amounts of money in infrastructures for combating the problem. Political and academic leaders are fully on board. Unfortunately, the major policy directions are on a collision course with a science-based approach to addiction prevention and treatment. Let’s look at the policy options.
Policy Position On Addiction
Three major policy directions have emerged: decriminalization, legalization, and public health addiction policy. In my next newsletter, we will explore these policy directions.
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