In the cosmopolitan city of New York, where the pace of life is relentlessly rapid, teletherapy services are emerging as a potent tool in the arsenal against mental health disorders. This essay aims to explore the impact of these services on the inhabitants of New York City (NYC), focusing on the benefits they offer and the challenges they may pose to the traditional approach to therapy.
Teletherapy, also known as online therapy, e-therapy or cyber therapy, allows mental health professionals to provide therapy and counseling services via digital platforms. This mode of therapy, implemented over the phone or video calls, has been adopted in NYC with an increasing fervor, partly due to necessity in the face of the COVID-19 pandemic, and partly due to a growing recognition of its potential benefits.
The most pronounced impact of teletherapy services in NYC is arguably the improved accessibility of mental health services. In a city where time is a premium and distances can be daunting, the ability to access therapy from the comfort of ones home or office is invaluable. This convenience factor removes a significant barrier to therapy, potentially encouraging more individuals to seek help. Furthermore, teletherapy can reach individuals in underserved areas, where mental health resources are scarce.
Another significant impact of teletherapy is the potential for increased frequency and consistency of sessions. The logistics of commuting to a therapist's office can often result in missed appointments and inconsistent treatment. Teletherapy, by removing geographical constraints, can enable more regular sessions, leading to more effective treatment outcomes.
Moreover, the anonymity provided by teletherapy can also help mitigate the stigma associated with seeking mental health treatment. This can be particularly impactful in NYC, a city known for its high-pressure work environment where mental health issues are often brushed under the carpet.
However, the introduction of teletherapy services is not without its challenges. There are concerns about the quality of the therapeutic relationship in a virtual setting. The nuances of body language, tone, and facial expressions, crucial to therapeutic communication, may be lost in translation. Additionally, issues of privacy and confidentiality, especially with the use of digital platforms, could also arise.
The digital divide is another challenge. Despite NYCs reputation as a global hub, the reality is that not everyone has access to reliable internet and digital devices. This could create a new divide in access to mental health services, with those lacking digital literacy or resources being left behind.
In conclusion, teletherapy services in NYC are making a significant impact on the way mental health services are delivered and accessed. While they offer numerous benefits, including improved accessibility and convenience, challenges related to the quality of therapy, privacy, and digital access need to be addressed. As we continue to navigate this digital age, it is imperative to ensure that these services are developed in a way that maximizes their potential benefits while minimizing their drawbacks, ensuring every New Yorker has the opportunity to access the mental health support they need.
With an estimated population in 2024 of 8,478,072[5][6] distributed over 300.46 square miles (778.2 km2),[4] the city is the most densely populated major city in the United States. New York City has more than double the population of Los Angeles, the nation's second-most populous city.[20] With more than 20.1 million people in its metropolitan statistical area[21] and 23.5 million in its combined statistical area as of 2020, New York City is one of the world's most populous megacities.[22] The city and its metropolitan area are the premier gateway for legal immigration to the United States. As many as 800 languages are spoken in New York City,[23] making it the most linguistically diverse city in the world. In 2021, the city was home to nearly 3.1 million residents born outside the United States,[20] the largest foreign-born population of any city in the world.[24]
The first documented visit into New York Harbor by a European was in 1524 by explorer Giovanni da Verrazzano.[41] He claimed the area for France and named it Nouvelle Angoulême (New Angoulême).[42] A Spanish expedition, led by the Portuguese captain Estêvão Gomes sailing for Emperor Charles V, arrived in New York Harbor in January 1525 and charted the mouth of the Hudson River, which he named Río de San Antonio ('Saint Anthony's River').[43]
Hudson claimed the region for the Dutch East India Company. In 1614, the area between Cape Cod and Delaware Bay was claimed by the Netherlands and called Nieuw-Nederland ('New Netherland'). The first non–Native American inhabitant of what became New York City was Juan Rodriguez, a merchant from Santo Domingo who arrived in Manhattan during the winter of 1613–14, trapping for pelts and trading with the local population as a representative of the Dutch.[46][47]
The colony of New Amsterdam extended from the southern tip of Manhattan to modern-day Wall Street, where a 12-foot (3.7 m) wooden stockade was built in 1653 to protect against Native American and English raids.[50] In 1626, the Dutch colonial Director-General Peter Minuit, as charged by the Dutch West India Company, purchased the island of Manhattan from the Canarsie, a small Lenape band,[51] for "the value of 60 guilders"[52] (about $900 in 2018).[53] A frequently told but disproved legend claims that Manhattan was purchased for $24 worth of glass beads.[54][55]
Following the purchase, New Amsterdam grew slowly.[25] To attract settlers, the Dutch instituted the patroon system in 1628, whereby wealthy Dutchmen (patroons, or patrons) who brought 50 colonists to New Netherland would be awarded land, local political autonomy, and rights to participate in the lucrative fur trade. This program had little success.[56]
Since 1621, the Dutch West India Company had operated as a monopoly in New Netherland, on authority granted by the Dutch States General. In 1639–1640, in an effort to bolster economic growth, the Dutch West India Company relinquished its monopoly over the fur trade, leading to growth in the production and trade of food, timber, tobacco, and slaves (particularly with the Dutch West Indies).[25][57]
In 1647, Peter Stuyvesant began his tenure as the last Director-General of New Netherland. During his tenure, the population of New Netherland grew from 2,000 to 8,000.[58][59] Stuyvesant has been credited with improving law and order; however, he earned a reputation as a despotic leader. He instituted regulations on liquor sales, attempted to assert control over the Dutch Reformed Church, and blocked other religious groups from establishing houses of worship.[60]
Fort George and New York with British warships, c. 1731
In 1664, unable to summon any significant resistance, Stuyvesant surrendered New Amsterdam to English troops, led by Colonel Richard Nicolls, without bloodshed.[60][61] The terms of the surrender permitted Dutch residents to remain in the colony and allowed for religious freedom.[62]
In 1667, during negotiations leading to the Treaty of Breda after the Second Anglo-Dutch War, the victorious Dutch decided to keep the nascent plantation colony of what is now Suriname, which they had gained from the English,[63] and in return the English kept New Amsterdam. The settlement was promptly renamed "New York" after the Duke of York (the future King James II and VII).[64] The duke gave part of the colony to proprietors George Carteret and John Berkeley.[65]
Several intertribal wars among the Native Americans and epidemics brought on by contact with the Europeans caused sizeable population losses for the Lenape between 1660 and 1670.[69] By 1700, the Lenape population had diminished to 200.[70] New York experienced several yellow fever epidemics in the 18th century, losing ten percent of its population in 1702 alone.[71][72]
In the early 18th century, New York grew in importance as a trading port while as a part of the colony of New York.[73] It became a center of slavery, with 42% of households enslaving Africans by 1730.[74] Most were domestic slaves; others were hired out as labor. Slavery became integrally tied to New York's economy through the labor of slaves throughout the port, and the banking and shipping industries trading with the American South. During construction in Foley Square in the 1990s, the African Burying Ground was discovered; the cemetery included 10,000 to 20,000 graves of colonial-era Africans, some enslaved and some free.[75]
The Stamp Act Congress met in New York in October 1765, as the Sons of Liberty organization emerged in the city and skirmished over the next ten years with British troops stationed there.[78] The Battle of Long Island, the largest battle of the American Revolutionary War, was fought in August 1776 within modern-day Brooklyn.[79] A British rout of the Continental Army at the Battle of Fort Washington in November 1776 eliminated the last American stronghold in Manhattan, causing George Washington and his forces to retreat across the Hudson River to New Jersey, pursued by British forces.[80][81]
After the battle, in which the Americans were defeated, the British made the city their military and political base of operations in North America.[82] The city was a haven for Loyalist refugees and escaped slaves who joined the British lines for freedom promised by the Crown, with as many as 10,000 escaped slaves crowded into the city during the British occupation, the largest such community on the continent.[83][84] When the British forces evacuated New York at the close of the war in 1783, they transported thousands of freedmen for resettlement in Nova Scotia, England, and the Caribbean.[85]
The attempt at a peaceful solution to the war took place at the Conference House on Staten Island between American delegates, including Benjamin Franklin, and British general Lord Howe on September 11, 1776.[86] Shortly after the British occupation began, the Great Fire of New York destroyed nearly 500 buildings, about a quarter of the structures in the city, including Trinity Church.[87][88]
In 1790, for the first time, New York City surpassed Philadelphia as the nation's largest city. At the end of 1790, the national capital was moved to Philadelphia, where it remained while the new capital in Washington, D.C. was being constructed.[91][92]
During the 19th century, New York City's population grew from 60,000 to 3.43 million.[93] Under New York State's gradual emancipation act of 1799, children of slave mothers were to be eventually liberated but to be held in indentured servitude until their mid-to-late twenties.[94][95] Together with slaves freed by their masters after the Revolutionary War and escaped slaves, a significant free-Black population gradually developed in Manhattan. The New York Manumission Society worked for abolition and established the African Free School to educate Black children.[96] It was not until 1827 that slavery was completely abolished in the state.[97] Free Blacks struggled with discrimination and interracial abolitionist activism continued. New York City's population jumped from 123,706 in 1820 (10,886 of whom were Black and of which 518 were enslaved) to 312,710 by 1840 (16,358 of whom were Black).[98]
The Great Irish Famine brought a large influx of Irish immigrants, of whom more than 200,000 were living in New York by 1860, representing over a quarter of the city's population.[105] Extensive immigration from the German provinces meant that Germans comprised another 25% of New York's population by 1860.[106][107]
Democratic Party candidates were consistently elected to local office, increasing the city's ties to the South and its dominant party. In 1861, Mayor Fernando Wood called on the aldermen to declare independence from Albany and the United States after the South seceded, but his proposal was not acted on.[96] Anger at new military conscription laws during the American Civil War (1861–1865), which spared wealthier men who could afford to hire a substitute, led to the Draft Riots of 1863, whose most visible participants were ethnic Irish working class.[96]
The draft riots deteriorated into attacks on New York's elite, followed by attacks on Black New Yorkers after fierce competition for a decade between Irish immigrants and Black people for work. Rioters burned the Colored Orphan Asylum to the ground.[106] At least 120 people were killed.[108] Eleven Black men were lynched over five days, and the riots forced hundreds of Blacks to flee. The Black population in Manhattan fell below 10,000 by 1865. The White working class had established dominance.[106][108] It was one of the worst incidents of civil unrest in American history.[109]
In 1886, the Statue of Liberty, a gift from France, was dedicated in New York Harbor. The statue welcomed 14 million immigrants as they arrived via Ellis Island by ship in the late 19th and early 20th centuries, and is a symbol of the United States and American ideals of liberty and peace.[110][111]
In 1898, the City of New York was formed with the consolidation of Brooklyn (until then a separate city), the County of New York (which then included parts of the Bronx), the County of Richmond, and the western portion of the County of Queens.[112] The opening of the New York City Subway in 1904, first built as separate private systems, helped bind the new city together.[113] Throughout the first half of the 20th century, the city became a world center for industry, commerce, and communication.[114]
New York's non-White population was 36,620 in 1890.[117] New York City was a prime destination in the early 20th century for Blacks during the Great Migration from the American South, and by 1916, New York City had the largest urban African diaspora in North America.[118] The Harlem Renaissance of literary and cultural life flourished during the era of Prohibition.[119] The larger economic boom generated construction of skyscrapers competing in height.[120]
New York City became the most populous urbanized area in the world in the early 1920s, overtaking London. The metropolitan area surpassed 10 million in the early 1930s, becoming the first megacity.[121] The Great Depression saw the election of reformer Fiorello La Guardia as mayor and the fall of Tammany Hall after eighty years of political dominance.[122]
October 1975 New York Daily News front page on President Ford's refusal to help the city avert bankruptcy
In the 1970s, job losses due to industrial restructuring caused New York City to suffer from economic problems and rising crime rates.[134] Growing fiscal deficits in 1975 led the city to appeal to the federal government for financial aid; President Gerald Ford gave a speech denying the request, which was paraphrased on the front page of the New York Daily News as "FORD TO CITY: DROP DEAD".[135] The Municipal Assistance Corporation was formed and granted oversight authority over the city's finances.[136] While a resurgence in the financial industry greatly improved the city's economic health in the 1980s, New York's crime rate continued to increase through that decade and into the beginning of the 1990s.[137]
New York City's population exceeded 8 million for the first time in the 2000 census;[138] further records were set in the 2010 and 2020 censuses.[139] Important new economic sectors, such as Silicon Alley, emerged.[140]
The year 2000 was celebrated with fanfare in Times Square.[141] New York City suffered the bulk of the economic damage and largest loss of human life in the aftermath of the September 11, 2001, attacks.[142] Two of the four hijacked airliners were flown into the twin towers of the World Trade Center, resulting in the collapse of both buildings and the deaths of 2,753 people, including 343 first responders from the New York City Fire Department and 71 law enforcement officers.[143]
New York City was heavily impacted by Hurricane Sandy in October 2012, including flooding that led to the days-long shutdown of the subway system,[151] and flooding of all East River subway tunnels and of all road tunnels entering Manhattan except the Lincoln Tunnel.[152] The New York Stock Exchange closed for two days due to weather for the first time since the Great Blizzard of 1888.[153] At least 43 people died in New York City as a result of Sandy, and the economic losses in New York City were estimated to be roughly $19 billion.[154] The disaster spawned long-term efforts towards infrastructural projects to counter climate change and rising seas, with $15 billion in federal funding received through 2022 towards those resiliency efforts.[155][156]
In March 2020, the first case of COVID-19 in the city was confirmed.[157] With its population density and extensive exposure to global travelers, the city rapidly replaced Wuhan, China as the global epicenter of the pandemic during the early phase, straining the city's healthcare infrastructure.[158][159] Through March 2023, New York City recorded more than 80,000 deaths from COVID-19-related complications.[160]
New York City lies in the northeastern United States, in southeastern New York State, approximately halfway between Washington, D.C. and Boston. Its location at the mouth of the Hudson River, which feeds into a naturally sheltered harbor and then into the Atlantic Ocean, has helped the city become a significant trading port. Most of the city is built on the three islands of Long Island, Manhattan, and Staten Island.
During the Wisconsin glaciation, 75,000 to 11,000 years ago, the New York City area was situated at the edge of a large ice sheet.[161] The erosive forward movement of the ice (and its subsequent retreat) contributed to the separation of what is now Long Island and Staten Island. That action left bedrock at a relatively shallow depth, providing a solid foundation for most of Manhattan's skyscrapers.[162]
The Hudson River flows through the Hudson Valley into New York Bay. Between New York City and Troy, New York, the river is an estuary.[163] The Hudson River separates the city from New Jersey. The East River—a tidal strait—flows from Long Island Sound and separates the Bronx and Manhattan from Long Island. The Harlem River, another tidal strait between the East and Hudson rivers, separates most of Manhattan from the Bronx. The Bronx River, which flows through the Bronx and Westchester County, is the only entirely freshwater river in the city.[164][importance?]
The city's land has been altered substantially by human intervention, with considerable land reclamation along the waterfronts since Dutch colonial times; reclamation is most prominent in Lower Manhattan, with developments such as Battery Park City in the 1970s and 1980s.[165] Some of the natural relief in topography has been evened out, especially in Manhattan.[166]
The city's total area is 468.484 square miles (1,213.37 km2). 302.643 sq mi (783.84 km2) of the city is land and 165.841 sq mi (429.53 km2) of it is water.[167][168] The highest point in the city is Todt Hill on Staten Island, which, at 409.8 feet (124.9 m) above sea level, is the highest point on the eastern seaboard south of Maine.[169] The summit of the ridge is mostly covered in woodlands as part of the Staten Island Greenbelt.[170]
New York City is sometimes referred to collectively as the Five Boroughs.[171] Each borough is coextensive with a respective county of New York State, making New York City one of the U.S. municipalities in multiple counties.
Brooklyn (Kings County), on the western tip of Long Island, is the city's most populous borough. Brooklyn is known for its cultural, social, and ethnic diversity, an independent art scene, distinct neighborhoods, and a distinctive architectural heritage. Downtown Brooklyn is the largest central core neighborhood in the Outer Boroughs. The borough has a long beachfront shoreline including Coney Island, established in the 1870s as one of the earliest amusement grounds in the United States[176]Marine Park and Prospect Park are the two largest parks in Brooklyn.[177] Since 2010, Brooklyn has evolved into a thriving hub of entrepreneurship and high technologystartup firms,[178][179] and of postmodern art and design.[179][180] Brooklyn is also home to Fort Hamilton, the U.S. military's only active duty installation within New York City,[181] aside from Coast Guard operations. The facility was established in 1825 on the site of a battery used during the American Revolution, and it is one of America's longest-serving military forts.[182]
Staten Island (Richmond County) is the most suburban in character of the five boroughs. It is connected to Brooklyn by the Verrazzano-Narrows Bridge, and to Manhattan by way of the free Staten Island Ferry. In central Staten Island, the Staten Island Greenbelt spans approximately 2,500 acres (10 km2), including 28 miles (45 km) of walking trails and one of the last undisturbed forests in the city.[193] Designated in 1984 to protect the island's natural lands, the Greenbelt comprises seven city parks.
Under the Köppen climate classification, New York City has a humid subtropical climate (Cfa), and is the northernmost major city on the North American continent with this categorization. The suburbs to the immediate north and west are in the transitional zone between humid subtropical and humid continental climates (Dfa).[194][195] The city receives an average of 49.5 inches (1,260 mm) of precipitation annually, which is relatively evenly spread throughout the year. New York averages over 2,500 hours of sunshine annually.[196]
Winters are chilly and damp, and prevailing wind patterns that blow sea breezes offshore temper the moderating effects of the Atlantic Ocean; yet the Atlantic and the partial shielding from colder air by the Appalachian Mountains keep the city warmer in the winter than inland North American cities at similar or lesser latitudes.[197] The daily mean temperature in January, the area's coldest month, is 33.3 °F (0.7 °C).[198] Temperatures usually drop to 10 °F (−12 °C) several times per winter,[199] yet can also reach 60 °F (16 °C) for several days even in the coldest winter month. Spring and autumn are unpredictable and can range from cool to warm, although they are usually mild with low humidity. Summers are typically hot and humid, with a daily mean temperature of 77.5 °F (25.3 °C) in July.[198]
Nighttime temperatures are 9.5 °F (5.3 °C) degrees higher for the average city resident due to the urban heat island effect, caused by paved streets and tall buildings.[200] Daytime temperatures exceed 90 °F (32 °C) on average of 17 days each summer and in some years exceed 100 °F (38 °C), although this is a rare occurrence, last noted on July 18, 2012.[201][202][203][204] Similarly, readings of 0 °F (−18 °C) are extremely rare, last occurring on February 14, 2016.[205] Extreme temperatures have ranged from 106 °F (41 °C), recorded on July 9, 1936, down to −15 °F (−26 °C) on February 9, 1934;[198] the coldest recorded wind chill was −37 °F (−38 °C) on the same day as the all-time record low.[206] Average winter snowfall between 1991 and 2020 was 29.8 inches (76 cm); this varies considerably between years. The record cold daily maximum was 2 °F (−17 °C) on December 30, 1917, while, conversely, the record warm daily minimum was 87 °F (31 °C), on July 2, 1903.[201] The average water temperature of the nearby Atlantic Ocean ranges from 39.7 °F (4.3 °C) in February to 74.1 °F (23.4 °C) in August.[207]
Hurricanes and tropical storms are rare in the New York area.[208] Hurricane Sandy brought a destructive storm surge to New York City on the evening of October 29, 2012, flooding numerous streets, tunnels, and subway lines in Lower Manhattan and other areas of the city and cutting off electricity in many parts of the city and its suburbs.[209] The storm and its profound impacts have prompted the discussion of constructing seawalls and other coastal barriers around the shorelines of the city and the metropolitan area to minimize the risk of destructive consequences from another such event in the future.[155]
New York City has over 28,000 acres (110 km2) of municipal parkland and 14 miles (23 km) of public beaches.[217] The largest municipal park in the city is Pelham Bay Park in the Bronx, with 2,772 acres (1,122 ha),[192][218] and the most visited urban park is the Central Park, and one of the most filmed and visited locations in the world, with 42 million visitors in 2023.[219]
Environmental issues in New York City are affected by the city's size, density, abundant public transportation infrastructure, and its location at the mouth of the Hudson River. For example, it is one of the country's biggest sources of pollution and has the lowest per-capita greenhouse gas emissions rate and electricity usage. Governors Island is planned to host a US$1billion research and education center to make New York City the global leader in addressing the climate crisis.[222]
New York's high rate of public transit use, more than 610,000 daily cycling trips as of 2022[update],[225] and many pedestrian commuters make it the most energy-efficient major city in the United States.[226] Walk and bicycle modes of travel account for 21% of all modes for trips in the city; nationally, the rate for metro regions is about 8%.[227] In both 2011 and 2015, Walk Score named New York City the most walkable large city in the United States,[228][229][230] and in 2018, Stacker ranked New York the most walkable American city.[231]Citibank sponsored public bicycles for the city's bike-share project, which became known as Citi Bike, in 2013.[232] New York City's numerical "in-season cycling indicator" of bicycling in the city had hit an all-time high of 437 when measured in 2014.[233]
The New York City drinking water supply is extracted from the protected Catskill Mountains watershed.[234] As a result of the watershed's integrity and undisturbed natural water filtration system, New York is one of only four major cities in the United States the majority of whose drinking water is pure enough not to require water treatment.[235] The city's municipal water system is the nation's largest, moving more than 1 billion U.S. gallons (3.8 billion liters) of water daily from a watershed covering 1,900 square miles (4,900 km2)[236][237]
According to the 2016 World Health Organization Global Urban Ambient Air Pollution Database,[238] the annual average concentration in New York City's air of particulate matter measuring 2.5micrometers or less (PM2.5) was 7.0micrograms per cubic meter, or 3.0micrograms within the recommended limit of the WHO Air Quality Guidelines for the annual mean PM2.5.[239] The New York City Department of Health and Mental Hygiene, in partnership with Queens College, conducts the New York Community Air Survey to measure pollutants at about 150 locations.[240]
New York City is the most populous city in the United States,[244] with 8,804,190 residents as of the 2020 census, its highest decennial count ever, incorporating more immigration into the city than outmigration since the 2010 census.[4][245][246] More than twice as many people live in New York City as in Los Angeles, the second-most populous American city.[247] The city's population in 2020 was 35.9% White, 22.7% Black, 14.6% Asian, 10.5% Mixed, 0.7% Native American and 0.1% Pacific Islander; 28.4% identified themselves as Hispanic or Latino.[4]
Between 2010 and 2020, New York City gained 629,000 residents, more than the total gains over the same decade of the next four largest American cities (Los Angeles, Chicago, Houston, and Phoenix) combined.[248][249] The city's population density of 27,744.1 inhabitants per square mile (10,712.1/km2) makes it the densest of any American municipality with a population above 100,000.[173] Manhattan's population density is 70,450.8 inhabitants per square mile (27,201.2/km2), the highest of any county in the United States.[173]
Based on data from the 2020 census, New York City comprises about 43.6% of the state's population of 20,202,320,[4] and about 39% of the population of the New York metropolitan area.[250] The majority of New York City residents in 2020 (5,141,539 or 58.4%) were living in Brooklyn or Queens, the two boroughs on Long Island.[251] As many as 800 languages are spoken in New York,[23][252][253][254] and the New York City metropolitan statistical area has the largest foreign-born population of any metropolitan region in the world. The New York region continues to be by far the leading metropolitan gateway for legal immigrants admitted into the United States, substantially exceeding the combined totals of Los Angeles and Miami.[255] Nearly seven times as many young professionals applied for jobs in New York City in 2023 as compared to 2019, making New York the most popular destination for recent college graduates.[256]
Based on American Community Survey data from 2018 to 2022, approximately 36.3% of the city's population is foreign born (compared to 13.7% nationwide),[4] and 40% of all children are born to mothers who are immigrants.[260] Throughout its history, New York has been a major port of entry for immigrants.[261][262] No single country or region of origin dominates.[261] Queens has the largest Asian American and Andean populations in the United States, and is also the most ethnically and linguistically diverse urban area in the world.[263][185]
Stonewall 50 – WorldPride NYC 2019 was the largest international Pride celebration in history, commemorating the 50th anniversary of the Stonewall uprising, with 150,000 participants and five million spectators attending in Manhattan alone.[290] New York City is home to the largest transgender population in the world, estimated at more than 50,000 in 2018, concentrated in Manhattan, Brooklyn, and Queens; however, until the June 1969 Stonewall riots, this community had felt marginalized and neglected by the gay community.[289][133] Brooklyn Liberation March, the largest transgender-rights demonstration in LGBT history, took place on June 14, 2020, stretching from Grand Army Plaza to Fort Greene, Brooklyn, focused on supporting Black transgender lives, drawing an estimated 15,000 to 20,000 participants.[291][292]
Islam ranks as the third-largest religion in New York City, following Christianity and Judaism, with estimates ranging between 600,000 and 1,000,000 observers of Islam, including 10% of the city's public school children.[297] 22.3% of American Muslims live in New York City, with 1.5 million Muslims in the greater New York metropolitan area, the largest metropolitan Muslim population in the Western Hemisphere[298]—and the most ethnically diverse Muslim population of any city in the world.[299]Powers Street Mosque in Brooklyn is one of the oldest continuously operating mosques in the United States, and represents the first Islamic organization in both the city and the state.[300][301]
Following these three largest religious groups in New York City are Hinduism, Buddhism, Sikhism, Zoroastrianism, and others. As of 2023, 24% of Greater New Yorkers identified with no organized religious affiliation, and 4% were self-identified atheists.[302]
Many Fortune 500 corporations are headquartered in New York City,[309] as are a large number of multinational corporations. New York City has been ranked first among cities across the globe in attracting capital, business, and tourists.[310][311] New York City's role as the top global center for the advertising industry is metonymously reflected as Madison Avenue.[312] The city's fashion industry provides approximately 180,000 employees with $11 billion in annual wages.[313]
Significant other economic sectors include universities and non-profit institutions. Manufacturing declined over the 20th century but still accounts for significant employment. The city's apparel and garment industry, historically centered on the Garment District in Manhattan, peaked in 1950, when more than 323,000 workers were employed in the industry in New York. In 2015, fewer than 23,000 New York City residents were employed in the industry, although revival efforts were underway,[314] and the American fashion industry continues to be metonymized as Seventh Avenue.[315] In 2017, the city had 205,592 employer firms, of which 22.0% were owned by women, 31.3% were minority-owned and 2.7% were owned by veterans.[4]
In 2022, the gross domestic product of New York City was US$1.053 trillion, of which $781 billion (74%) was produced by Manhattan.[9] Like other large cities, New York City has a degree of income disparity, as indicated by its Gini coefficient of 0.55 as of 2022.[316][317] In November 2023, the city had total employment of over 4.75 million of which more than a quarter were in education and health services.[318] Manhattan, which accounted for more than half of the city's jobs, had an average weekly wage of $2,590 in the second quarter of 2023, ranking fourth-highest among the nation's 360 largest counties.[319] New York City is one of the relatively few American cities levying an income tax (about 3%) on its residents;[320][321][322] despite this tax levy, New York City in 2024 was home by a significant margin to the highest number of billionaires of any city in the world, with a total of 110.[35]
Manhattan contained over 500 million square feet (46.5 million m2) of office space in 2018,[329] making New York City the largest office market in the world,[330][331] while Midtown Manhattan, with 400 million square feet (37.2 million m2) in 2018,[329] is the largest central business district in the world.[332]
New York is a top-tier global technology hub.[13][333]Silicon Alley, once a metonym for the sphere encompassing the metropolitan region's high technology industries,[334] is no longer a relevant moniker as the city's tech environment has expanded dramatically both in location and in scope since at least 2003, when tech business appeared in more places in Manhattan and in other boroughs, and not much silicon was involved.[334][335] New York City's current tech sphere encompasses the array of applications involving universal applications of artificial intelligence (AI),[336][337] broadband internet,[338]new media, financial technology (fintech) and cryptocurrency, biotechnology, game design, and other fields within information technology that are supported by its entrepreneurship ecosystem and venture capital investments. Technology-driven startup companies and entrepreneurial employment are growing in New York City and the region. The technology sector has been claiming a greater share of New York City's economy since 2010.[339]Tech:NYC, founded in 2016, is a non-profit organization which represents New York City's technology industry with government, civic institutions, in business, and in the media, and whose primary goals are to further augment New York's substantial tech talent base and to advocate for policies that will nurture tech companies to grow in the city.[340]
New York City's AI sector raised US$483.6 million in venture capital investment in 2022.[341] In 2023, New York unveiled the first comprehensive initiative to create both a framework of rules and a chatbot to regulate the use of AI within the sphere of city government.[342]
New York City real estate is a safe haven for global investors.[31] The total value of all New York City property was assessed at US$1.479 trillion for the 2017 fiscal year, an increase of 6.1% from the previous year. Of the total market value, single family homes accounted for $765 billion (51.7%); condominiums, co-ops, and apartment buildings totaled $351 billion (23.7%); and commercial properties were valued at $317 billion (21.4%).[345][346]Fifth Avenue in Midtown Manhattan commands the highest retail rents in the world, at $2,000 per square foot ($22,000/m2) in 2023.[347]
New York City has one of the highest costs of living in the world, which is exacerbated by the city's housing shortage.[348][349] In 2023, one-bedroom apartments in Manhattan rented at a median monthly price of US$4,443.[350] The median house price city-wide is over $1 million as of 2023.[351] With 33,000 units available in 2023 among the city's 2.3 million rentable apartments, the vacancy rate was 1.4%, the lowest level since 1968 and a rate that is indicative of a shortage of available units, especially among those with rents below a monthly rental of $1,650, where less than 1% of units were available.[352] Perennially high demand has pushed median monthly one-bedroom apartment rents in New York City to over US$4,000 and two-bedroom rents to over $5,000, the highest in the United States by a significant margin.[33]
Times Square is one of the world's leading tourist attractions with 50 million tourists annually.[219]
Tourism is a vital industry for New York City, and New York City Tourism + Conventions represents the city's official bureau of tourism.[353] New York has witnessed a growing combined volume of international and domestic tourists, with as many as 66.6 million visitors to the city per year, including as many as 13.5 million international visitors, with the highest numbers from the United Kingdom, Canada, Brazil, and China.[354] Multiple sources have called New York the most photographed city in the world.[355][356][357]I Love New York (stylized I ❤ NY) is both a logo and a song that are the basis of an advertising campaign and have been used since 1977 to promote tourism in New York City,[358] and later to promote New York State as well. The trademarked logo is owned by New York State Empire State Development.[359]
Many districts and monuments in New York City are major landmarks, including three of the world's ten-most-visited tourist attractions in 2023.[360] A record 66.6 million tourists visited New York City in 2019, bringing in $47.4 billion in tourism revenue. Visitor numbers dropped by two-thirds in 2020 during the pandemic, rebounding to 63.3 million in 2023.[354][361] Major landmarks in New York City include the Metropolitan Museum of Art, the Statue of Liberty, the Empire State Building, and Central Park.[362] Times Square is the brightly illuminated hub of the Broadway Theater District,[363] and a major center of the world's entertainment industry,[364] attracting 50 million visitors annually to one of the world's busiest pedestrian intersections.[219] According to The Broadway League, shows on Broadway sold approximately US$1.54 billion worth of tickets in both the 2022–2023 and the 2023–2024 seasons. Both seasons featured theater attendance of approximately 12.3 million each.[365]
As of 2019[update], New York City was the second-largest center for filmmaking and television production in the United States, producing about 200 feature films annually. The industry employed more than 100,000 people in 2019, generating $12.2 billion in wages and a total economic impact of $64.1 billion.[379] By volume, New York is the world leader in independent film production—one-third of all American independent films are produced there.[380][371]
New York is a major center for non-commercial educational media. NYC Media is the official public radio, television, and online media network and broadcasting service of New York City,[381] and has produced several original Emmy Award-winning shows covering music and culture in city neighborhoods and city government. The oldest public-access television channel in the United States is the Manhattan Neighborhood Network, founded in 1971.[382]WNET is the city's major public television station and produces a third of national Public Broadcasting Service (PBS) television programming.[383]WNYC, a public radio station owned by the city until 1997,[384] has the largest public radio audience in the United States.[385]
One of the most common traits attributed to New York City is its fast pace,[398][399][400] which spawned the term New York minute.[401] New York City's residents are prominently known for their resilience historically, and more recently related to their management of the impacts of the September 11 terrorist attacks and the COVID-19 pandemic.[402][403][404] New York was voted the world's most resilient city in 2021 and 2022, per Time Out's global poll of urban residents.[403]
Broadway theatre is one of the premier forms of English-language theatre in the world, named after Broadway, the major thoroughfare that crosses Times Square,[407] sometimes referred to as "The Great White Way".[408][409][410]
Forty-one venues mostly in Midtown Manhattan's Theatre District, each with at least 500 seats, are classified as Broadway theatres.[411] The 2018–19 Broadway theatre season set records with total attendance of 14.8 million and gross revenue of $1.83 billion[412] Recovering from closures forced by the COVID-19 pandemic, 2022–23 revenues rebounded to $1.58 billion with total attendance of 12.3 million.[413][414] The Tony Awards recognizes excellence in live Broadway theatre and are presented at an annual ceremony in Manhattan.[415]
The New York area is home to a distinctive regional accent and speech pattern called the New York dialect, alternatively known as Brooklynese or New Yorkese. It has been considered one of the most recognizable accents within American English.[416] The traditional New York area speech pattern is known for its rapid delivery, and its accent is characterized as non-rhotic so that the sound [ɹ] does not appear at the end of a syllable or immediately before a consonant, therefore the pronunciation of the city name as "New Yawk".[417] The classic version of the New York City dialect is centered on middle- and working-class New Yorkers. The influx of non-European immigrants in recent decades has led to changes in this distinctive dialect,[417] and the traditional form of this speech pattern is no longer as prevalent.[417]
New York has architecturally noteworthy buildings in a wide range of styles and from distinct time periods, from the Dutch Colonial Pieter Claesen Wyckoff House in Brooklyn, the oldest section of which dates to 1656, to the modern One World Trade Center, the skyscraper at Ground Zero in Lower Manhattan and the most expensive office tower in the world by construction cost.[418]
Manhattan's skyline, with its many skyscrapers, has been recognized as an iconic symbol of the city,[419][420][421] and the city has been home to several of the tallest buildings in the world. As of 2019[update], New York City had 6,455 high-rise buildings, the third most in the world after Hong Kong and Seoul.[422]
The character of New York's large residential districts is often defined by the elegant brownstone rowhouses and townhouses and shabby tenements that were built during a period of rapid expansion from 1870 to 1930.[423] Stone and brick became the city's building materials of choice after the construction of wood-frame houses was limited in the aftermath of the Great Fire of 1835.[424]
In contrast, New York City also has neighborhoods that are less densely populated and feature free-standing dwellings. In neighborhoods such as Riverdale (in the Bronx), Ditmas Park (in Brooklyn), and Douglaston (in Queens), large single-family homes are common in various architectural styles such as Tudor Revival and Victorian.[425][426][427]
New York City has more than 2,000 arts and cultural organizations and more than 500 art galleries.[429] The city government funds the arts with a larger annual budget than the National Endowment for the Arts.[429] The city is also home to hundreds of cultural institutions and historic sites. Museum Mile is the name for a section of Fifth Avenue running from 82nd to 105th streets on the Upper East Side of Manhattan,[430] in the upper portion of Carnegie Hill.[431]
Nine museums occupy this section of Fifth Avenue, making it one of the densest displays of high culture in the world.[432] Its art museums include the Guggenheim, Metropolitan Museum of Art, Neue Galerie New York, and The Africa Center. In addition to other programming, the museums collaborate for the annual Museum Mile Festival, held each year in June, to promote the museums and increase visitation.[433] Many of the world's most lucrative art auctions are held in New York City.[434][435]
NYFW sets the tone for the global fashion industry.[447] New York's fashion district encompasses roughly 30 city blocks in Midtown Manhattan,[448] clustered around a stretch of Seventh Avenue nicknamed Fashion Avenue.[449] New York's fashion calendar also includes Couture Fashion Week to showcase haute couture styles.[450] The Met Gala is often described as "Fashion's biggest night".[451]
New York City is well known for its street parades, the majority in Manhattan. The primary orientation of the annual street parades is typically from north to south, marching along major avenues. The annual Macy's Thanksgiving Day Parade is the world's largest parade,[452] beginning alongside Central Park and proceeding southward to the flagship Macy's Herald Square store;[453] the parade is viewed on telecasts worldwide and draws millions of spectators in person.[452] Other notable parades including the annual New York City St. Patrick's Day Parade in March, the NYC LGBT Pride March in June, the LGBT-inspired Greenwich Village Halloween Parade in October, and numerous parades commemorating the independence days of many nations. Ticker-tape parades celebrating championships won by sports teams as well as other accomplishments march northward along the Canyon of Heroes on Broadway from Bowling Green to City Hall Park in Lower Manhattan.
The city has played host to more than 40 major professional teams in the five sports and their respective competing leagues. Four of the ten most expensive stadiums ever built worldwide (MetLife Stadium, the new Yankee Stadium, Madison Square Garden, and Citi Field) are in the New York metropolitan area.[462]
More than a million students, the highest number of any city in the United States,[487] are enrolled in New York City's more than 120 higher education institutions, with more than half a million in the City University of New York (CUNY) system alone as of 2020[update].[488] According to Academic Ranking of World Universities, New York City has, on average, the best higher education institutions of any global city.[489]
NYC Health + Hospitals (HHC) is a public-benefit corporation established in 1969 which operates the city's public hospitals and a network of outpatient clinics.[500][501] As of 2021[update], HHC is the largest American municipal healthcare system with $10.9 billion in annual revenues.[502] HHC serves 1.4 million patients, including more than 475,000 uninsured city residents.[503] HHC operates eleven acute-care hospitals, four skilled nursing facilities, six diagnostic and treatment centers, and more than 70 community-based primary care sites, serving primarily the city's poor and working-class residents.[504][505] HHC's MetroPlus Health Plan is one of New York City's largest providers of government-sponsored health insurance, enrolling 670,000 city residents as of June 2022.[506]
HHC's facilities annually provides service to millions of New Yorkers, interpreted in more than 190 languages.[507] The best-known hospital in the HHC system is Bellevue Hospital, the oldest public hospital in the United States, established in 1736.[508] Bellevue is the designated hospital for treatment of the president and other world leaders should they require care while in New York City.[509]
The city banned smoking in most parts of restaurants in 1995 and prohibited smoking in bars, restaurants and places of public employment in 2003.[510]Pharmacies are banned from selling smoked and vaped products in New York State.[511]
New York City enforces a right-to-shelter law guaranteeing shelter to anyone who needs it, regardless of their immigration, socioeconomic, or housing status, which entails providing adequate shelter and food.[512] As a result, while New York has the highest total homeless population of American cities, only 5% were unsheltered by the city, representing a significantly lower percentage of outdoor homelessness than in other cities.[513] As of 2023, there were 92,824 homeless people sleeping nightly in the shelter system.[514]
The New York Police Department (NYPD) is the largest police force in the United States, with more than 36,000 sworn officers.[515] Members of the NYPD are frequently referred to by politicians, the media, and their own police cars by the nickname, New York's Finest.[516]
The city saw a spike in crime in the 1970s through 1990s.[517] Crime overall has trended downward in New York City since the 1990s;[518] violent crime decreased more than 75% from 1993 to 2005, and continued decreasing during periods when the nation as a whole saw increases.[519] The NYPD's stop-and-frisk program was declared unconstitutional in 2013 as a "policy of indirect racial profiling" of Black and Mixed residents,[520] although claims of disparate impact continued in subsequent years.[521] The stop-and-frisk program had been widely credited as being behind the decline in crime, though rates continued dropping in the years after the program ended.[522][523]
The city set a record high of 2,245 murders in 1990 and hit a near-70-year record low of 289 in 2018.[524] The number of murders and the rate of 3.3 per 100,000 residents in 2017 was the lowest since 1951.[525] New York City recorded 386 murders in 2023, a decline of 12% from the previous year.[526][527] New York City had one of the lowest homicide rates among the ten largest U.S. cities at 5.5 per 100,000 residents in 2021.[528]
Organized crime has long been associated with New York City, beginning with the Forty Thieves and the Roach Guards in the Five Points neighborhood in the 1820s, followed by the Tongs in the same neighborhood, which ultimately evolved into Chinatown, Manhattan. The 20th century saw a rise in the Mafia, dominated by the Five Families, as well as in gangs, including the Black Spades.[530] The Mafia and gang presence has declined in the city in the 21st century.[531][532]
Mass transit in New York City, most of which runs 24 hours a day, accounts for one in every three users of mass transit in the country, and two-thirds of the nation's rail riders live in the New York City metropolitan area.[538][539]
New York City's public bus fleet runs 24/7 and is the largest in North America.[540] The New York City bus system serves the most passengers of any city in the nation: In 2022, MTA New York City Transit's buses served 483.5 million trips, while MTA Regional Bus Operations handled 100.3 million trips.[541]
The Port Authority Bus Terminal is the city's main intercity bus terminal and the world's busiest bus station, serving 250,000 passengers on 7,000 buses each workday in a building opened in 1950 that was designed to accommodate 60,000 daily passengers. A 2021 plan announced by the Port Authority would spend $10 billion to expand capacity and modernize the facility.[537][542][536] In 2024, the Port Authority announced plans for a new terminal that would feature a glass atrium at a new main entrance on 41st Street.[543][544]
Public transport is widely used in New York City. 54.6% of New Yorkers commuted to work in 2005 using mass transit.[548] This is in contrast to the rest of the country, where 91% of commuters travel in automobiles to their workplace.[549] According to the New York City Comptroller, workers in the New York City area spend an average of 6hours and 18 minutes getting to work each week, the longest commute time in the nation among large cities.[550] New York is the only American city in which a majority (52%) of households do not have a car; only 22% of Manhattanites own a car.[551] Due to their high usage of mass transit, New Yorkers spend less of their household income on transportation than the national average, saving $19 billion annually on transportation compared to other urban Americans.[552]
New York City's commuter rail network is the largest in North America.[538] The rail network, connecting New York City to its suburbs, consists of the Long Island Rail Road, Metro-North Railroad, and New Jersey Transit. The combined systems converge at Grand Central Terminal and New York Penn Station and contain more than 250 stations and 20 rail lines.[538] The elevated AirTrain JFK in Queens connects JFK International Airport to the New York City Subway and the Long Island Rail Road.[553] For inter-city rail, New York City is served by Amtrak, whose busiest station by a significant margin is Penn Station on the West Side of Manhattan, from which Amtrak provides connections to Boston, Philadelphia, and Washington, D.C. along the Northeast Corridor, and long-distance train service to other North American cities.[554]
The Staten Island Ferry is the world's busiest ferry, carrying more than 23 million passengers from July 2015 through June 2016 on a 5.2-mile (8.4 km) route between Staten Island and Lower Manhattan and running 24/7.[568][569] Other ferry systems shuttle commuters between Manhattan and other locales within the city and the metropolitan area. NYC Ferry, a NYCEDC initiative with routes planned to travel to all five boroughs, was launched in 2017.[570]
Identified by their color and taxi medallion, the city's 13,587 yellow taxicabs are the only vehicles allowed to pick up riders making street hails throughout the city.[571]Apple green-colored boro taxis can pick up street hails in Upper Manhattan and the four outer boroughs.[572] Long dominated by yellow taxis, high-volume for-hire vehicles from Uber and Lyft have provided the most trips in the city since December 2016, when the for-hire vehicles and cabs each had about 10.5 million trips. By October 2023, the 78,000 vehicles-for-hire combined for 20.3 million trips, while 3.5 million trips were in yellow taxis.[573][574]
Citi Bike bike share service, which started in May 2013
New York City has mixed cycling conditions which include urban density, relatively flat terrain, congested roadways with stop-and-go traffic, and many pedestrians. The city's large cycling population includes utility cyclists, such as delivery and messenger services; recreational cycling clubs; and an increasing number of commuters. Cycling is increasingly popular in New York City; in 2022 there were approximately 61,200 people who commuted daily using a bicycle and 610,000 daily bike trips, both nearly doubling over the previous decade.[225] As of 2022[update], New York City had 1,525 miles (2,454 km) of bike lanes, including 644 miles (1,036 km) of segregated or "protected" bike lanes citywide.[225]
Streets are also a defining feature of the city. New York has been found to lead the world in urban automobile traffic congestion.[30] The Commissioners' Plan of 1811 greatly influenced its physical development. New York City has an extensive web of freeways and parkways, which link the city's boroughs to each other and to North Jersey, Westchester County, Long Island, and southwestern Connecticut through bridges and tunnels. Because these highways serve millions of outer borough and suburban residents who commute into Manhattan, it is common for motorists to be stranded for hours in dense traffic congestion that is a daily occurrence, particularly during rush hour.[577][578]Congestion pricing in New York City was activated in January 2025, applying to most motor vehicular traffic using the area of Manhattan south of 60th Street, in an effort to encourage commuters to use rapid transit instead.[579] Unlike the rest of the country, New York State prohibits turns on red lights in cities with a population greater than one million, to reduce collisions and increase pedestrian safety. In New York City, therefore, all turns on red lights are illegal unless a sign permitting such maneuvers is present.[580]
The boroughs of Manhattan and Staten Island are located on islands with the same names, while Queens and Brooklyn are at the west end of the larger Long Island, and the Bronx is on New York State's mainland. Manhattan Island is linked to the outer boroughs and to New Jersey by an extensive network of bridges and tunnels. The 14-lane George Washington Bridge, connecting Manhattan to New Jersey across the Hudson River, is the world's busiest motor vehicle bridge.[581][582] The Verrazzano-Narrows Bridge, spanning the Narrows between Brooklyn and Staten Island, is the longest suspension bridge in the Americas and one of the world's longest.[583][584] The Brooklyn Bridge, with its stone neo-Gothic suspension towers, is an icon of the city; opened in 1883, it was the first steel-wire suspension bridge and was the longest suspension bridge in the world until 1903.[585][586] The Queensboro Bridge "was the longest cantilever span in North America" from 1909 to 1917.[587] The Manhattan Bridge, opened in 1909, "is considered to be the forerunner of modern suspension bridges", and its design "served as the model for the major long-span suspension bridges" of the early 20th century.[588] The Throgs Neck Bridge and Whitestone Bridge connect Queens and the Bronx, while the Triborough Bridge connects Manhattan, Queens, and the Bronx.
The Lincoln Tunnel, which carries 120,000 vehicles a day under the Hudson River between New Jersey and Midtown Manhattan, is the busiest vehicular tunnel in the world.[589] The tunnel was built instead of a bridge to allow unfettered passage of large passenger and cargo ships that sailed through New York Harbor and up the Hudson River to Manhattan's piers. The Holland Tunnel, connecting Lower Manhattan to Jersey City, New Jersey, was the first mechanically ventilated vehicular tunnel when it opened in 1927.[590][591] The Queens–Midtown Tunnel, built to relieve congestion on the bridges connecting Manhattan with Queens and Brooklyn, was the largest non-federal project in its time when it was completed in 1940.[592] The Brooklyn–Battery Tunnel (officially the Hugh L. Carey Tunnel) is the longest continuous underwater vehicular tunnel in North America and runs underneath Battery Park, connecting the Financial District, Manhattan, to Red Hook, Brooklyn.[593]
The city's mayor is Eric Adams, a Democrat who was elected in 2021.[603] The Democratic Party holds the majority of public offices. As of November 2023, 67% of active registered voters in the city are Democrats and 10.2% are Republicans.[604] New York City has not been carried by a Republican presidential candidate since 1924, and no Republican candidate for statewide office has won all five boroughs since the city was incorporated in 1898. In redistricting following the 2020 census, 14 of New York's 26 congressional districts include portions of New York City.[605]
New York City is a significant source of political fundraising.[606] The city has a strong imbalance of payments with the national and state governments. It receives 83 cents in services for every $1 it sends to the federal government in taxes (or annually sends $11.4 billion more than it receives back). City residents and businesses also sent an additional $4.1 billion in the 2009–2010 fiscal year to the state than the city received in return.[607]
In 2006, the sister city program[608] was restructured as New York City Global Partners. New York's historic sister cities are denoted below by the year they joined New York City's partnership network.[609]
^Mean monthly maxima and minima (i.e. the expected highest and lowest temperature readings at any point during the year or given month) calculated based on data at said location from 1991 to 2020
^Official weather observations for Central Park were conducted at the Arsenal at Fifth Avenue and 64th Street from 1869 to 1919, and at Belvedere Castle since 1919.[210]
^1880 & 1890 figures include part of the Bronx. Beginning with 1900, figures are for consolidated city of five boroughs. Sources: 1698–1771,[241] 1790–1990,[98] 2000 and 2010 Censuses,[242] 2020 Census,[243]
^Nigro, Carmen. "So, Why Do We Call It Gotham, Anyway?", New York Public Library, January 25, 2011. Accessed March 3, 2023. "It is here that we learn that the term Gotham is tied to the author Washington Irving, famous for his short stories 'The Legend of Sleepy Hollow,' and 'Rip Van Winkle.' It's also here that we learn Irving was being less than flattering when he nicknamed the city in 1807."
^ ab"DDC New York". Digital Diplomacy Coalition, New York. Archived from the original on July 27, 2018. Retrieved August 11, 2018. Established in 2014, DDC New York has partnered with the United Nations, major tech and social media companies, multiple governments, and NGOs to bring unique programs to the area community.
^ abU.S. Census Bureau History: New York City and the New Year, United States Census Bureau. Accessed January 30, 2024. "In 2021, 3,079,776 New Yorkers identified themselves as foreign-born, including 1,542,413 Latin American, 910,151 Asian, and 443,113 European immigrants.... The 2020 Census found that New York City was home to 8,804,190 people. Los Angeles, CA, was the nation's distant second most populous city with 3,898,747 residents."
^ ab"Congestion pricing in New York gets the go-ahead after all. Maybe". The Economist. November 21, 2024. Retrieved November 21, 2024. But traffic is bad most days, with more than 900,000 cars entering Manhattan's central business district. INRIX, a traffic-data firm, found that New York City leads the world in urban traffic congestion among the cities scored, with the average driver stationary for 101 hours a year.
^ abGiulia Carbonaro (August 28, 2024). "New York City Rent Hits All-Time High". Newsweek. Retrieved October 17, 2024. Residents are paying a median amount of $4,500 for a one-bedroom apartment in the city, up 12.8 percent compared to a year earlier and 3.4 percent compared to July. Those renting out two-bedroom apartments are not doing much better. According to Zumper, the median two-bedroom rent reached a record high of $5,100 in August, up 13.3 percent year-over-year and 3.7 percent month-over-month...These numbers make New York the most expensive city for people to rent either a one-bedroom or two-bedroom apartment in the entire country. The second-most expensive rental market, by comparison, was Jersey City (NJ), for a median rent of $3,400 for a one-bedroom and of $3,900 for a two-bedroom.
^ abAnnika Grosser (April 30, 2024). "The Cities With The Most Billionaires 2024". Forbes. Retrieved June 15, 2024. New York City once again is home to the most billionaires in the world: It's the primary residence of an estimated 110 billionaires who are worth a collective $694 billion. The Big Apple has long dominated the ranks,
^Robert Frank (July 19, 2024). "The ultra-wealthy just gained $49 trillion in wealth thanks to stocks". CNBC. Retrieved July 20, 2024. New York has the world's largest population of people worth $30 million or more, with 16,630. Hong Kong ranked second, with 12,546, followed by Los Angeles with 8,955 and Tokyo with 6,445.
^"The New York Art Market Report". Arts Economics. Retrieved January 29, 2023. New York is the global headquarters of the art market, with the highest market share by value of art sales in the world. It is also a center of high net worth wealth, has the largest population of millionaires and billionaires globally, as well as being the key financial hub of the US.
^Dutch Colonies, National Park Service. Retrieved May 19, 2007. "Sponsored by the West India Company, 30 families arrived in North America in 1624, establishing a settlement on present-day Manhattan."
^"Pieter Schaghen Letter". S4ulanguages.com. 1626. Retrieved October 28, 2021. "... hebben t'eylant Manhattes van de wilde gekocht, voor de waerde van 60 gulden: is groot 11000 morgen. ..." ("... They have purchased the Island Manhattes from the Indians for the value of 60 guilders. It is 11,000 morgens in size ...)
^Homberger, Eric (2005). The Historical Atlas of New York City: A Visual Celebration of 400 Years of New York City's History. Owl Books. p. 34. ISBN978-0-8050-7842-8.
^Fort Washington, American Battlefield Trust. Accessed December 31, 2023. "Fought on November 16, 1776 on the island of Manhattan, the Battle of Fort Washington was the final devastating chapter in General Washington's disastrous New York Campaign.... Seeing how precarious the American position was, Howe launched a three-pronged assault on Fort Washington and its outer defensive works. The combined British-Hessian assault force of 8,000 men grossly outnumbered the fort's 3,000 defenders.... At 3:00 P.M., after a fruitless attempt to gain gentler surrender terms for his men, Magaw surrendered Fort Washington and its 2,800 surviving defenders to the British."
^"Finding Freedom: Deborah", Museum of the American Revolution, May 4, 2018. Accessed December 31, 2023. "They ran to the British Army which offered freedom to enslaved people owned by rebel masters based on the 1779 Philipsburg Proclamation issued by British General Henry Clinton. Historians estimate that 10,000 enslaved people sought freedom by escaping to the British during the Revolutionary War."
^Trinity Church bicentennial celebration, May 5, 1897, By Trinity Church (New York, N.Y.) p. 37, ISBN 978-1-356-90825-7
^New York City (NYC) The Great Fire of 1776, Baruch College. Accessed December 29, 2023. "The fire started in a wooden building near White Hall Slip, called the Fighting Cocks Tavern, a fun house visited by the city's most disreputable residents. It was fanned by winds south west of the city and spread rapidly into the night, demolishing 493 buildings and houses in the process."
^"January Highlight: Superintending Independence, Part 1", Harvard University Declaration Resources Project, January 4, 2017. Accessed December 29, 2023. "From January 11, 1785 through 1789, the Congress of the Confederation met in New York City, at City Hall (which later became Federal Hall) and at Fraunces Tavern."
^When Did Slavery End in New York State?, New-York Historical Society. Accessed January 16, 2024. "In 1799, New York passed a Gradual Emancipation act that freed slave children born after July 4, 1799, but indentured them until they were young adults. In 1817 a new law passed that would free slaves born before 1799 but not until 1827."
^Waxman, Sarah. "History of Central Park, New York", NY.com. Accessed January 16, 2024. "New York's Central Park is the first urban landscaped park in the United States."
^M.G. Leonard (January 20, 1847). "H. Doc. 29-54 - Paupers and criminals. Memorial of the Corporation of the City of New York, relative to the exportation from abroad of paupers and criminals. January 25, 1847. Read, and referred to the Committee on the Judiciary". GovInfo.gov. U.S. Government Printing Office. pp. 8–9. Retrieved June 22, 2023. 'Leaving their homes,' [immigrants] say, 'with the brightest prospects,' alluring representations presented to them of the blessed state of American life, a few scanty coins in their pockets, though feeling in the enjoyment of rugged health, and surrounded by their young and innocent offspring, little did they imagine the trials to which they would be exposed; but at length they discover to their sorrow, and very natural discontent, that the foul steerage of some ocean-tossed ship is to form the filthy receptacle of persons, crowded too with hordes of human beings, with scarcely space enough to contain the half of them—certainly not more than the quarter of them comfortably; and thus huddled together en masse, they become the "emigrant passengers" destined to this country.
^ abStatue of Liberty, UNESCO. Accessed December 28, 2023. "Inaugurated in 1886, the sculpture stands at the entrance to New York Harbour and has welcomed millions of immigrants to the United States ever since."
^The Immigrant's Statue, Statue of Liberty National Monument. Accessed December 28, 2023. "Between 1886 and 1924, almost 14 million immigrants entered the United States through New York. The Statue of Liberty was a reassuring sign that they had arrived in the land of their dreams."
^Willis, Carol (1995). Form Follows Finance: Skyscrapers and Skylines in New York and Chicago. New York: Princeton Architectural Press. pp. 41, 85, 165. ISBN9781568980447.
^Roberts, Sam. "Infamous 'Drop Dead' Was Never Said by Ford", The New York Times, December 28, 2006. Accessed February 20, 2024. "Mr. Ford, on Oct. 29, 1975, gave a speech denying federal assistance to spare New York from bankruptcy. The front page of The Daily News the next day read: "FORD TO CITY: DROP DEAD."... Moreover, the speech spurred New York's civic, business and labor leaders to rally bankers in the United States and abroad, who feared their own investments would be harmed if New York defaulted on its debt."
^Chan, Sewell. "Felix G. Rohatyn, Financier Who Piloted New York's Rescue, Dies at 91", The New York Times, December 14, 2019. Accessed February 20, 2024. "For nearly two decades, from 1975 to 1993, as chairman of the state-appointed Municipal Assistance Corporation, Mr. Rohatyn had a say, often the final one, over taxes and spending in the nation's largest city, a degree of influence for an unelected official that rankled some critics. His efforts to meld private profit with the public good defined him: In the perception of many his name was synonymous with two institutions — the M.A.C., which was hastily created in 1975 to save the city from insolvency, and Lazard (formerly Lazard Frères), the storied investment firm that started as a dry-goods business in New Orleans in 1848."
^Population - Decennial Census - Census 2000, New York City Department of City Planning. Accessed January 27, 2024. "According to the U.S. Census Bureau, the population of New York City as of April 1, 2000, was 8,008,278, the largest enumerated census population in the city's history. The previous peak was in 1970, when the enumerated population stood at 7,894,862."
^Population, New York City Department of City Planning. Accessed January 27, 2024. "The enumerated population of New York City's was 8,804,190 as of April 1, 2020, a record high population. This is an increase of 629,057 people since the 2010 Census."
^"World Trade Center Transportation Hub". Port Authority of New York and New Jersey. Archived from the original on January 3, 2020. Retrieved February 9, 2017. The state-of-the-art World Trade Center Transportation Hub, completed in 2016, serves 250,000 Port Authority Trans-Hudson (PATH) daily commuters and millions of annual visitors from around the world. At approximately 800,000 square feet, the Hub, designed by internationally acclaimed architect Santiago Calatrava, is the third-largest transportation center in New York City.
^"One World Trade Center". SkyscraperPage.com. Skyscraper Source Media. Retrieved February 9, 2017. The roof height is the same as original One World Trade Center. The building is topped out by a 124-meter (408-foot) spire. So the tower rises 1,776 feet (541-meter) which marks the year of the American declaration of Independence.
^Nocera, Joe (September 14, 2012). "Two Days in September". The New York Times. Retrieved May 6, 2017. On the left, that anger led, a year ago, to the rise of the Occupy Wall Street movement. Thus, Anniversary No. 2: Sept. 17, 2011, was the date Occupy Wall Street took over Zuccotti Park in Lower Manhattan, which soon led to similar actions in cities across the country. The movement's primary issue was income inequality—"We are the 99 percent", they used to chant.
^Flegenheimer, Matt. "Flooded Tunnels May Keep City's Subway Network Closed for Several Days", The New York Times, October 30, 2012. Accessed January 15, 2024. "As the remnants of Hurricane Sandy left the city on Tuesday, transit officials surveyed the damage to the system, which they shut down on Sunday night as a precaution. What they found was an unprecedented assault: flooded tunnels, battered stations and switches and signals likely damaged."
^Superstorm Sandy: The Devastating Impact On The Nation's Largest Transportation Systems, United States Senate Commerce Subcommittee on Surface Transportation, Maritime, Freight, and Ports, December 6, 2012. Accessed January 15, 2024. "The most damaging impact of the storm, from a transportation standpoint, was on the highway, transit, and rail tunnels in and out of Manhattan. All seven of the subway tunnels under the East River flooded, as did the Hudson River subway tunnel, the East River and Hudson River commuter rail tunnels, and the subway tunnels in lower Manhattan. Three of the four highway tunnels into Manhattan flooded, leaving only the Lincoln Tunnel open. While some subway service was restored three days after the storm, the PATH train service to the World Trade Center was only restored on November 26, four weeks after the storm, and subway service between the Rockaway peninsula and Howard Beach is not expected to be re-opened for months."
^Strasburg, Jenny; Cheng, Jonathan; and Bunge, Jacob. "Behind Decision to Close Markets", The Wall Street Journal, October 29, 2012. Accessed January 15, 2024. "Superstorm Sandy forced regulators and exchange operators to keep U.S. stock markets closed Tuesday, in the first weather-related shutdown to last more than one day since the Blizzard of 1888. The decision to close the New York Stock Exchange and other U.S. equity markets for a second straight day—reached by midafternoon Monday—renewed questions about the industry's disaster preparedness."
^"NYC Still Vulnerable to Hurricanes 10 Years After Sandy", Bloomberg Businessweek, October 13, 2022. Accessed January 15, 2024. "Hurricane Sandy swept through New York City in October 2012, leading to 43 deaths and an estimated $19 billion in damages.... New York needs to step up its efforts and spend the $15 billion in federal grants that it received for recovery efforts, a new report by New York City Comptroller Brad Lander released on Thursday said."
^Robinson, David. "COVID-19: How New York City became epicenter of coronavirus pandemic, what that means", The Journal News, March 27, 2020. Accessed January 13, 2024. "New York City's rise this month to become the new coronavirus pandemic's epicenter has far-reaching implications for communities statewide. Most pressing, the rapidly spreading virus that originated in Wuhan, China, threatens to overwhelm New York state's entire medical system, prompting a dire push for thousands of new hospital beds to treat infected New Yorkers. Further, the outbreak, which topped 44,600 confirmed cases statewide as of Friday, including 23,000 in New York City alone, is also devastating the entire state's economy and draining government coffers at all levels.... Why New York City's density, tourism made it vulnerable to coronavirus"
^Sorrentino, Christopher (September 16, 2007). "When He Was Seventeen". The New York Times. Retrieved March 27, 2016. In 1980 there were still the remains of the various downtown revolutions that had reinvigorated New York's music and art scenes and kept Manhattan in the position it had occupied since the 1940s as the cultural center of the world.
^Weather in New York, Climate and Weather. Accessed December 31, 2023. "Sprawling across three islands at the mouth of the Hudson River in the north-eastern United States, New York City's climate benefits from the warm Gulf Stream of the Atlantic Ocean. This, coupled with the protection of the Appalachian Mountains inland, keep the city warmer than other big American cities at similar latitudes."
^Maldonando, Samantha. "How Much Hotter Is NYC's Heat Island Effect Making Your Neighborhood?", The City, July 26, 2023. Accessed December 30, 2023. "The city as a whole feels about 9.5 degrees hotter for the average New Yorker. That's thanks to the human-made surroundings that define the cityscape: tall buildings that limit air circulation, abundant asphalt and pavement and the heat-generating things New Yorkers do fairly close to one another, like running appliances and driving."
^Maps for Jamaica Bay Unit, Gateway National Recreation Area. Accessed January 15, 2024. "Within the Jamaica Bay Unit there are several places to visit. Floyd Bennett Field, Jamaica Bay Wildlife Refuge, Canarsie Pier, Breezy Point, Fort Tilden and Jacob Riis Park."
^ abcAlikpala, Gidget. "The top 10 most visited tourist attractions in the USA", As, September 4, 2023. Accessed January 13, 2024. "Central Park, New York- 42 million annual visitors... Times Square, New York- 50 million annual visitors. At number one is Times Square, one of the most iconic locations in the world."
^New York Water Fact Sheet, United States Environmental Protection Agency. June 2010. Accessed December 29, 2023. "New York City is home to the largest engineered water system in the nation, supplying more than 1 billion gallons of water each day to approximately 9 million people, representing half of the state's population. The city draws its water from reservoirs upstate, supplied by a 1,900-square mile watershed—that's about the size of Delaware."
^The Newest New Yorkers: 2013, New York City Department of City Planning, December 2013. Retrieved February 9, 2017. "The immigrant share of the population has also doubled since 1965, to 37 percent. With foreign-born mothers accounting for 51 percent of all births, approximately 6-in-10 New Yorkers are either immigrants or the children of immigrants."
^Semple, Kirk (June 23, 2011). "Asian New Yorkers Seek Power to Match Numbers". The New York Times. Retrieved July 5, 2011. Asians, a group more commonly associated with the West Coast, are surging in New York, where they have long been eclipsed in the city's kaleidoscopic racial and ethnic mix. For the first time, according to census figures released in the spring, their numbers have topped one million—nearly one in eight New Yorkers—which is more than the Asian population in the cities of San Francisco and Los Angeles combined.
^Vivian Yee (February 22, 2015). "Indictment of New York Officer Divides Chinese-Americans". The New York Times. Retrieved November 17, 2023. Now they are reaching out to the Chinese-language press, contacting lawyers to advise Officer Liang and planning a protest march in New York, a city with the largest Chinese population outside of Asia.
Waxman, Sarah. "The History of New York's Chinatown". Mediabridge Infosystems, Inc. Retrieved August 28, 2022. Manhattan's Chinatown, the largest Chinatown in the United States and the site of the largest concentration of Chinese in the Western Hemisphere, is located on the Lower East Side.
^ abGleason, Will (March 11, 2019). "Citing its diversity and culture, NYC was voted best city in the world in new global survey". Time Out. Retrieved May 19, 2019. After compiling the thoughts of over 30,000 people, both from our NYC readership and half-a-world away, New York was voted the greatest city on the planet for 2019. In a hint as to why this happened, and why now, it also led the categories of most diverse metropolis and best culture.... Since then, it's steadily attracted more and more attendees and, last year, averaged 10,000 people a night. Those thousands of New Yorkers weren't just hungry for new food, but for new points-of-view.... 'We've now been able to represent over 85 countries, and I'm constantly hearing examples of people branching out and trying things they've never heard of before.'
^Moreno, Tonya (February 2, 2017). "U.S. Cities That Levy Income Taxes". The Balance. Archived from the original on March 8, 2017. Retrieved December 20, 2017. Fourteen states and the District of Columbia allow cities, counties, and municipalities to levy their own separate individual income taxes in addition to state income taxes.
^Ward, Peter (March 8, 2018). "The History of New York's Silicon Alley". The Culture Trip. Retrieved August 23, 2023. when the revival began in 2003, tech companies didn't stick to the same areas.
^"AI Strategy"(PDF). City of New York. Retrieved July 27, 2023.
^"New York City Unveils AI Action Plan that Develops Rules Framework". PYMNTS. October 16, 2023. Retrieved November 8, 2023. This comprehensive initiative is the first for a major U.S. city...As part of the plan, the city has piloted the first citywide AI chatbot to help business owners navigate government.
^"Department of Finance Publishes Fiscal Year 2017 Tentative Assessment Roll"(PDF). New York City Department of Finance. January 15, 2016. Retrieved November 26, 2021. Today, Jacques Jiha, Commissioner for the Department of Finance, announced the publication of the Tentative Property Assessment Roll for fiscal year 2017, which shows the total Market Value for the upcoming year at about $1.072 trillion, an increase of $102.5 billion, or 10.6 percent from the 2016 Fiscal Year.
^Horowitz, Alex; and Staveski, Adam. "New York's Housing Shortage Pushes Up Rents and Homelessness", The Pew Charitable Trusts, May 25, 2023. Accessed March 17, 2024. "Housing construction in New York City and its suburbs has lagged far behind that of other major cities and their suburbs, resulting in low housing availability and a vacancy rate of just 3%. New York City's housing stock has only increased 4% since 2010, not nearly enough to keep up with its 22% increase in jobs. And from 2017 to 2021, New York City permitted 13 homes for every 1,000 residents in 2017, while Boston added 28, Washington, D.C., added 43, and Seattle added 67."
^"NYC & Company is now New York City Tourism + Conventions", Travel Weekly, March 28, 2023. Accessed January 17, 2024. "New York City's official destination marketing organization has changed its name to New York City Tourism + Conventions, dropping the NYC & Company name it's held since 1999."
^ abThe Tourism Industry in New York City Reigniting the Return, New York State ComptrollerThomas DiNapoli, April 2021. Accessed December 29, 2023. "After reaching a record high of 66.6 million visitors in 2019 and generating $47.4 billion in spending, the number of visitors to New York City dropped by 67 percent and their spending declined by 73 percent in 2020.... New York City hosted 66.6 million visitors in 2019 (about 25 percent of the State's 265.5 million visitors that year), a tenth-consecutive annual record. In 2020, the pandemic and related behavioral and governmental restrictions caused the number to drop to 22.3 million, a 67 percent reduction (see Figure 1)."
^"History in Photos: New York is the Most Photographed City in the World". January 19, 2022. Retrieved December 4, 2022. Not eliminate how many photos you have done well with your digital cameras, cell phones, and smartphones. And also in the professional area, New York has a non-sealing charm for filmmakers and photographers..Every year, there are 40,000 shoots for advertising, cinema films, TV shows, series, music videos, documentation. New York is considered the most photographed city in the world. And yet photographers, again and again, manage to take a new perspective in the megacity, to avoid an unusual motif to create an optics that fascinates.
^David, Greg. "Tourists Are Back to NYC in Big Numbers", The City, September 5, 2023. Accessed December 29, 2023. "But the city will not surpass its 2019 record of 66.6 million visitors because once-numerous travelers from China remain few and far between and Americans are flocking to Europe in unprecedented numbers.... Still, the numbers show a rebound with the official forecast from the tourism agency NYC & Co. still predicting 63.3 million visitors this year, up 12% from last year."
^Milliot, Jim. "New Report Finds NYC Publishing, Bookselling Jobs Fell Between 2010 and 2020", Publishers Weekly, December 1, 2022. Accessed January 30, 2024. "According to the study, book publishers generated $9.2 billion of economic output in 2020, ahead of the other publishing sub-sectors: periodical publishers ($6.3 billion); internet publishers ($2.8 billion); and newspaper publishers (2.5 billion).... The number of people employed in New York publishing houses dipped by 1.7% between 2010 and 2020, falling to 11,500."
^Allan Nevins, The Evening Post: Century of Journalism, Boni and Liveright, 1922, p. 17.
^New York Post, Library of Congress. Accessed January 13, 2024. "The New York Post is an American daily newspaper, primarily distributed in New York City and its surrounding area. It is the 13th-oldest and seventh-most-widely circulated newspaper in the United States. Established in 1801 by federalist and Founding Father Alexander Hamilton, it became a respected broadsheet in the 19th century, under the name New York Evening Post."
^New York City Film and Television Industry Economic Impact Study 2021, New York City Mayor's Office of Media and Entertainment. Accessed January 30, 2024. "In 2019, New York City's film and television industry was directly responsible for 100,200 jobs, $12.2 billion in wages, and $64.1 billion in direct economic output."
^Thirteen/WNET, NYC Arts. Accessed January 30, 2024. "Channel Thirteen is the flagship television station of the Public Broadcasting Service—a national, commercial-free, viewer-supported network known for its productions of top-notch programming in the arts and culture (Masterpiece Theater; Great Performances), science and nature (NOVA; Stephen Hawking's Universe), news and public affairs (News Hour with Jim Lehrer; ITN World News) and the humanities (The 1900 House; The American President). Thirteen/WNET produces about a third of the prime-time public-television programming aired in the United States, for which it often taps the unmatched cultural resources of New York City."
^Darrow, Peter H. "Going Public: The Story of WNYC's Journey to Independence", WNYC, May 10, 2018. Accessed January 30, 2024. "From July 1924 until January 1997 WNYC was owned and operated by the City of New York. This is the story of how it became a self-supporting independent non-profit organization."
^Chauvin, Kelsy (March 15, 2019). "15 Things NOT to Do in New York City". Fodor's. Retrieved March 23, 2019. There are more than 8.6 million citizens of New York City, and they're pretty much all in a hurry. They're also shrewd, outspoken, and proudly able to survive in a metropolis that tends to punish the meek. The buzzing subway system alone is a symbol of how this city works: part ballet, part battlefield. Residents and visitors alike can see why New York is considered the greatest city in the world.
^Poliak, Shira. "Adjusting To New York City". Sun Sentinel. Archived from the original on December 3, 2015. Retrieved November 1, 2015. Additionally, the fast-paced lifestyle of New York City demands adjusting.
^Londré, Felicia Hardison; Watermeier, Daniel J. (1998). The History of North American Theater: From Pre-Columbian Times to the Present. Continuum. ISBN978-0-8264-1079-5. OCLC1024855967.
^Stephen Watt, and Gary A. Richardson, American Drama: Colonial to Contemporary (1994).
^McBeth, VR (September 25, 2006). "The Great White Way". TimesSquare.com. Archived from the original on May 4, 2011. Retrieved December 4, 2021. Coined in 1901 by O.J. Gude, the designer of many prominent advertising displays, to describe the new light show that beckoned along Broadway, The Great White Way is a phrase known worldwide to describe Broadway's profusion of theaters in Times Square.
^Frequently Asked Questions, Tony Awards. Accessed January 15, 2024. "Only Broadway productions that open in designated Broadway theatres in Manhattan are eligible for Tonys."
^Newman, Michael (2005). "New York Talk". In Wolfram, Walt; Ward, Ben (eds.). American Voices. Blackwell. pp. 82–87. ISBN978-1-4051-2109-5.
^Fazzare, Elizabeth. "What Makes NYC's Skyline So Iconic? 17 Buildings to Know", Architectural Digest, May 23, 2023. Accessed February 13, 2024. "When it comes to recognizable skylines, New York City's tops the list.... Super-talls and their historic neighbors have helped shape the iconic urban silhouette we associate with the city today."
^Hakela, Deepti. "Rising to new heights; Skinny skyscrapers are transforming NYC's iconic skyline", The Day, February 28, 2016. Accessed February 13, 2024, via Newspapers.com. "In New York City there's no escaping the pressure to be taller and thinner — not even for the skyscrapers Changes in building technology and materials in recent years have made it possible to build slender towers that are among the tallest in the world And some of these cloud-puncturing beanstalks are poised to transform the city's iconic skyline."
^Plunz, Richard A. (1990). "Chapters 3 [Rich and Poor] & 4 [Beyond the Tenement]". History of Housing in New York City: Dwelling Type and Change in the American Metropolis. Columbia University Press. ISBN978-0-231-06297-8.
^"Global Center of Fashion". NYCEDC. Retrieved November 10, 2024. With the industry employing 4.6 percent of the city's private sector workforce, fashion is a major driver of New York City's economy.
^Naeme Elzein (August 22, 2023). "New York Fashion Week 2023 | Retailers bring the runway to real-life". Lightspeed. Retrieved November 26, 2023. Starting with world renown designers reading the winds of change through to buyers forecasting trends that feel 'right now', New York Fashion Week is the first big domino to fall in a succession of actions resulting in what ends up in your closet.
^Diana Juarez (October 4, 2023). "The Economic Impact of New York Fashion Week". The Fordham Ram. Retrieved November 26, 2023. New York Fashion Week (NYFW) is an iconic event that not only sets the global fashion industry's tone but also plays a pivotal role in contributing to the economic vitality of the city. Beyond the glitz, glamor and gorgeous soirées of the runway, NYFW profoundly impacts various sectors of the economy, including tourism, retail, hospitalityurl and media.
^New York 1984 Paralympic Summer Games, National Paralympic Heritage Trust. Accessed January 18, 2024. "The New York Games were set to run from 17th - 29th June and the Stoke Mandeville Games from 22nd July - 1st August."
^Bondy Filip. "New York City and Environs Land Goodwill Games for '98", The New York Times, October 16, 1992. Accessed January 18, 2024. "New York City, New Jersey and Long Island were awarded the 1998 Goodwill Games last night, an intriguing but risky choice by the Games' selection committee. Six years from now, the area will be called upon to play host to thousands of international athletes and fans who have every right to expect upgraded athletic facilities and a convenient ride to the arena."
^Zinser, Lynn. "Olympic Committee Chooses London for 2012 Summer Games",The New York Times, July 6, 2005. Accessed January 19, 2023. "London won the 2012 Olympic Summer Games on Wednesday in a surprising upset over the front-running Paris after ardent last-minute lobbying by Prime Minister Tony Blair..... The British capitalized on a desire to hold the Games in Western Europe and surpassed four finalists, including New York, which was knocked out in the second round of voting, earlier than most expected."
^"So Many Seats, So Many Tax Breaks", The New York Times, July 11, 1028. Accessed January 18, 2024. "Yankee Stadium Location: Bronx Year Opened: 2009 Seats: 47,422. The stadium cost more than $2.3 billion to build.... Citi Field Location: Queens; Year Opened: 2009; Seats: 41,800. The project cost about $830.6 million with $134.91 million coming from the New York Mets, and $614.3 million in public money and tax breaks."
^Butler, Sarah Lorge. "New York City Was the World's Largest Marathon in 2023", Runner's World, November 7, 2023. Accessed January 17, 2024. "If you were one of the 51,933 people who started the New York City Marathon on November 5, chances are very high that you also finished it. According to New York Road Runners, 51,402 runners finished the marathon, a 98.9 percent completion rate.... They hailed from all 50 states and 148 countries."
^Metzler, Brian. "The Famous Millrose Games Delivers Speed, Records, and the Wanamaker Mile", Outside, February 13, 2023. Accessed January 17, 2024. "With his dominating performance in the Wanamaker Mile, Nuguse might have signaled a new era in the classic imperial distance — the quest for the world's first sub-3:47 mile on an indoor track.... In the final race of the 115th Millrose Games at The Armory Track & Field Center, Nuguse made it look relatively easy."
^Healthcare, New York City Economic Development Corporation. Accessed January 17, 2024. "New York City is home to the largest public healthcare system in the US, world-class private medical centers, and a robust, cutting-edge R&D landscape."
^Health + Hospitals NYC, (NYC H+H), New York City Green Book. Accessed January 16, 2024. "Description: A public benefit Corporation created by State Legislature, July 1, 1969, to operate the City's municipal hospitals. Operates facilities in all five boroughs, providing general, chronic, ambulatory and skilled nursing care and a wide variety of specialized patient care services. All employees are public employees."
^Frequently Asked Questions, NYC Health + Hospitals. Accessed January 16, 2024. "Where are your facilities located? NYC Health + Hospitals includes 11 acute care hospitals, four skilled nursing facilities, six large diagnostic and treatment centers and more than 70 community-based clinics. These facilities are within seven geographically based networks throughout the New York City metropolitan area."
^Miller, Kenneth. The Public Option, Columbia University School of Nursing, November 12, 2023. Accessed January 16, 2024. "HHC is the largest municipal health system in the United States, serving 1.4 million patients—mostly low-income or working-class people on Medicaid or Medicare. About one-third are uninsured, and many are undocumented. A public benefit corporation, HHC operates 11 acute care hospitals, five nursing homes, six diagnostic and treatment centers, and more than 70 primary care centers across New York's five boroughs."
^MetroPlus Health Plan: COVID-19 Enrollment Trends, New York State ComptrollerThomas P. DiNapoli, September 2022. Accessed January 16, 2024. "MetroPlus Health Plan is a prepaid health services plan and a wholly owned subsidiary of NYC Health + Hospitals (H+H).... MetroPlus enrollment reached a record high of 670,915, an increase of 159,284 members (31 percent) between February 2020 and June 2022, the period impacted by the COVID-19 pandemic (see Figure 1)."
^Fiani, Brian; Covarrubias, Claudia; Jarrah, Ryan; Kondilis, Athanasios; and Doan, Thao M. "Bellevue Hospital, the Oldest Public Health Center in the United States of America", World Neurosurgery, August 28, 2022. Accessed January 16, 2024. "Bellevue Hospital is known as the oldest public hospital in the United States of America. Although its historical beginnings date back to the 1600s, it was officially founded on the second floor of the New York City Almshouse in 1736, 40 years before the American Revolution."
^Roberts, Sam. "Colin McCord, Who Helped Impose a Smoking Ban, Dies at 94", The New York Times, April 7, 2023. Accessed January 16, 2024. "Dr. McCord successfully lobbied for a ban on smoking in workplaces, restaurants and bars while he was an assistant health commissioner in Mayor Michael R. Bloomberg's administration. The ban, which took effect in 2003, was later expanded and replicated in jurisdictions around the world. New York had banned smoking in most restaurants in 1995, but the city continued to allow smoking in bars and the bar areas of restaurants."
^Basic Facts About Homelessness: New York City, Coalition for the Homeless, updated December 2023. Accessed January 13, 2024. 'In recent years, homelessness in New York City has reached the highest levels since the Great Depression of the 1930s. In November 2023, there were 92,824 homeless people, including 33,365 homeless children, sleeping each night in New York City's main municipal shelter system. A total of 23,945 single adults slept in shelters each night in November 2023."
^Kershner, Ellen. "The Largest Police Departments In The US", WorldAtlas, August 3, 2020. Accessed January 17, 2024. "Established in 1845, The New York City Police Department (NYPD) is one of the most well-known law enforcement agencies in the world. As the largest in the United States, it currently has about 36,008 full-time active officers and 19,000 civilian employees. This is almost three times as many as the country's second-largest police department in Chicago."
^Williams, Keith. "We Know They're New York's Finest. But Why?", The New York Times, May 4, 2017. Accessed January 17, 2024. "The Police Department's slogan also came from a phrase with military origins: “the finest police force on the planet,” an adaptation of Gen. Joseph Hooker's 1863 claim that the Union forces were 'the finest army on the planet.' A similar phrase referring to police officers appeared in The Times in 1865. The police chief George Washington Matsell promoted the nickname in the early 1870s, Mr. Popik wrote; the 1882 play 'One of the Finest' cemented the label, which was condensed to 'New York's Finest' by 1889."
^Goldstein, Joseph. 'Judge Rejects New York's Stop-and-Frisk Policy", The New York Times, August 12, 2013. Accessed January 17, 2024. "But the judge, Shira A. Scheindlin, found that the Police Department resorted to a 'policy of indirect racial profiling' as it increased the number of stops in minority communities. That has led to officers' routinely stopping 'blacks and Hispanics who would not have been stopped if they were white.'"
^Katersky, Aaron; Grant, Teddy. "NYPD safety team making high number of unlawful stops, mostly people of color: Report", ABC News, June 5, 2023. January 17, 2024. "A decade after the New York Police Department's stop-and-frisk tactic was deemed unconstitutional, the police are still unlawfully stopping and searching many people, particularly men of color, according to a new report issued Monday by a court-appointed monitor. The monitor, Mylan Denerstein, faulted certain units of the NYPD's Neighborhood Safety Teams (NST), which are meant to combat gun violence in high-crime areas.... Shortly after a U.S. District Court judge ruled in 2013 the policy violated the Constitution, then-NYC Mayor Michael Bloomberg, in an op-ed in the Washington Post, pushed back against claims that stop-and-frisk promoted racial profiling."
^Ehrenfreund, Max. "Donald Trump claims New York's stop-and-frisk policy reduced crime. The data disagree.", The Washington Post, September 22, 2016. Accessed January 17, 2024. "In 1990, there were nearly 31 homicides in the city for every 100,000 people — more than the average for other major American cities even in a year of frequent violence across the country. A decade later, that figure had declined by nearly 75 percent, to 8.4 homicides per 100,000 people. As New York police abruptly moved away from the practice of stop-and-frisk toward the end of Kelly's tenure in 2013, the rate of homicide continued to decline as it had previously."
^Badger, Emily. "The Lasting Effects of Stop-and-Frisk in Bloomberg's New York", The New York Times, March 2, 2020, updated November 30, 2020. Accessed January 17, 2024. "In the years since Michael Bloomberg left the mayor's office in New York, the legacy of stop-and-frisk policing widely used during his administration has become clearer. Crime in the city continued to decline, suggesting that the aggressive use of police stops wasn't so essential to New York's safety after all."
^Kanno-Youngs, Zolan. "New York City's Murder Rate Hit New Low in 2018", The Wall Street Journal, January 3, 2019. Accessed January 15, 2024. "The New York Police Department recorded 289 murders in 2018, three fewer than the 292 recorded in 2017. Mayor Bill de Blasio said it was the fewest number of homicides in nearly 70 years. Overall, major crime in the city fell by 1.3% from 97,089 to 95,844, police said. There were 2,245 people murdered in New York City in 1990."
^"Fewest Annual Murders and Shooting Incidents Ever Recorded in the Modern Era; Lowest per-capita murder rate since 1951", New York City Police Department, press release dated January 5, 2018. Accessed January 15, 2024. "With the close of 2017, New York City marks three new crime reduction benchmarks: the first time the total number of index crimes has fallen below 100,000; the first time the number of shooting incidents has fallen below 800; and the first time the total number of murders has fallen below 300. This reduction in murders has resulted in the lowest per-capita murder rate in nearly 70 years."
^"NYPD Announces December 2023, End-of-Year Citywide Crime Statistics", New York City Police Department, press release dated January 4, 2024. Accessed January 15, 2024. "Murders – which rose for four consecutive years before the current administration was installed – fell by 11.9% (386 vs. 438) in 2023 compared to 2022, and by 33.3% (24 vs. 36) in December 2023, compared to the same month a year prior."
^ abWilson, Colleen. "Port Authority Bus Terminal was once a marvel. Will the next one meet commuters' needs?", The Record, June 30, 2021. Accessed January 4, 2024. "Becoming the busiest bus terminal in the world doesn't happen without also bearing the brunt of blame every time a commute goes horribly wrong — deserved or otherwise.... The popularity of bus commuting over the Hudson River has steadily risen over the last seven decades, with some 260,000 people a day coming through the terminal pre-pandemic.... A more efficient terminal should improve some of the delays through the Lincoln Tunnel and exclusive bus lane (XBL), the dedicated lane in the morning that converges all buses into a single lane from I-495 into the Lincoln Tunnel from New Jersey."
^McGeehan, Patrick; and Hu, Winnie. "'Notorious' Port Authority Bus Terminal May Get a $10 Billion Overhaul", The New York Times, January 21, 2021, updated September 23, 2021. Accessed January 4, 2024. "The bus terminal plan, which has been in the works for more than seven contentious years, would cost as much as $10 billion and could take a decade to complete.... More than 250,000 people passed through it on a typical weekday before the pandemic, according to the Port Authority.... The bus terminal, a brick hulk perched at the mouth of the Lincoln Tunnel, has long exceeded its capacity — when it opened in late 1950, it was expected to handle 60,000 passengers a day."
^Hill, John. "Renderings of New Midtown Bus Terminal Revealed", World Architects, February 5, 2024. Accessed February 13, 2024. "Not surprisingly, the two renderings included in last week's announcement show the main terminal and are accompanied by photos of the existing to depict a dramatic departure from the current situation. Compare the existing intersection of 8th Avenue and 41st Street (below) with a rendering of the same (above), in which a portion of 41st Street would be closed to create an 'iconic' atrium entrance."
^Weinberger, Rachel; Kaehny, John; Rufo, Matthew (2010). "U.S. Parking Policies: An Overview of Management Strategies"(PDF). Institute for Transportation and Development Policy. p. 62. Retrieved June 11, 2011. New York City is the largest, densest and most transit- and pedestrian-oriented city in the United States. It is the only U.S. city in which a majority of households do not have a car. Despite this, New York City is very much an American city in the way it under prices and under uses curbside parking meters. Meter rates are far lower than in other leading world cities, and New York suffers from high levels of cruising and double parking (p. 62) ... Nationally 90% of households own automobiles. New Yorkers own fewer at 48% with only 22% of Manhattan residents owning automobiles (p. 78)
^Staten Island Railway Timetable, Metropolitan Transportation Authority, effective January 2020. Accessed January 15, 2024. "MTA Staten Island Railway – service runs 24 hours a day between the St George and Tottenville terminals. At the St George terminal, customers can make connections with Staten Island Ferry service to Manhattan."
^"10 things we bet you didn't know about Grand Central". Signum International AG. Grand Central Terminal is spread over 49 acres, has 44 platforms and 67 tracks on two levels. It is the world's largest train station by number of platforms and area occupied.
^Reed, Ted. "In a Queens Miracle, New York LaGuardia Airport Goes From Loser to Winner", Airline Weekly, March 21, 2023. Accessed January 15, 2023. "Throughout a troubled 2022, the pandemic exposed many fragilities in a troubled United States airline industry, but it also enabled a widely recognized miracle in the $8 billion resurrection of New York LaGuardia Airport. Once widely viewed as a hellhole, LaGuardia was transformed.... Transformation involved rebuilding two terminals, each costing about $4 billion, as well as about five miles of roadway. Terminal B has 35 gates, occupied by American and four other airlines. Work began in 2016 and was completed on July 8, 2022, the exact day specified in a bond offering six years earlier. Terminal C, occupied and financed by Delta Air Lines, will have 37 gates. Work began in 2017 and is largely finished, with completion by the end of the year."
^via Associated Press. "Biden Compares La Guardia Airport to 'Third World'", The New York Times, February 6, 2014. Accessed January 15, 2024. "Vice President Joseph R. Biden says La Guardia Airport in New York could use some major improvements — and that is putting it mildly. Mr. Biden said that if he blindfolded someone and took him to La Guardia, the person would think he was in 'some third world country.'"
^The Project, A Whole New LGA. Accessed January 15, 2024. "The $8 billion project, two-thirds of which is funded through private financing and existing passenger fees, broke ground in 2016."
^Yellow Cab, New York City Taxi and Limousine Commission. Accessed January 14, 2024. "Taxicabs are the only vehicles that have the right to pick up street-hailing and prearranged passengers anywhere in New York City. By law, there are 13,587 taxis in New York City and each taxi must have a medallion affixed to it."
^Green Cab, New York City Taxi and Limousine Commission. Accessed January 14, 2024. "Street-hail Liveries, also known as green cabs, are For-Hire Vehicles that are permitted to accept street-hails. In exchange, Street-Hail Liveries may not operate in the Hail Exclusionary Zone, south of West 110th St and East 96th St."
^History, Roosevelt Island Operating Corporation. Accessed January 13, 2024. "The original Roosevelt Island aerial tramway - the first tram in the country to be used for urban transportation – was opened in May 1976."
^Aerial Tramway Vital Statistics, Roosevelt Island Operating Corporation. Accessed January 13, 2024. "The Tram travels between the Manhattan station at 2nd Avenue between 59th and 60th streets and the Tram station on Roosevelt Island. It travels a distance of 3,140 feet at a speed of up to 17 miles per hour in less than three (3) minutes. It rises to a maximum height of 230 feet and can carry a maximum of 109 passengers plus an attendant per cabin. The system annually transports more than two million passengers."
^"Today in History – June 12: Roebling and the Brooklyn Bridge", Library of Congress. Accessed July 30, 2023. "The Brooklyn Bridge, Roebling's last and greatest achievement, spans New York's East River to connect Manhattan with Brooklyn. When completed in 1883, the bridge, with its massive stone towers and a main span of 1,595.5 feet between them, was by far the longest suspension bridge in the world."
^"Williamsburg Bridge", American Society of Civil Engineers. Accessed July 30, 2023. "When opened in 1903, the 1,600 foot long main span of the Williamsburg Bridge was the world's longest suspension span, surpassing the nearby Brooklyn Bridge by only 4.5 feet."
^"Queensboro Bridge", American Society of Civil Engineers. Accessed July 30, 2023. "The Queensboro Bridge was the longest cantilever span in North America (1,182 feet) from 1909 until the Quebec Bridge opened in 1917 and the longest in the United States until 1930."
^"Manhattan Bridge", American Society of Civil Engineers Metropolitan Section. Accessed July 30, 2023. "As the first suspension bridge to use the deflection theory, it is considered to be the forerunner of modern suspension bridges and served as the model for the major long-span suspension bridges built in the first half of the twentieth century."
^Hugh L. Carey Tunnel, Metropolitan Transportation Authority, updated July 10, 2023. Accessed January 16, 2024. "When the Hugh L. Carey Tunnel (formerly Brooklyn-Battery Tunnel) opened in 1950, it was the longest continuous underwater vehicular tunnel in North America. It still is.... On the Brooklyn side is the community of South Brooklyn, comprising the Red Hook, Columbia Terrace, Carroll Gardens, Cobble Hill, and Boerum Hill districts.... The Manhattan end of the tunnel leads to the Wall Street area, the South Street Seaport, City Hall/Civic Center, Battery Park City, the World Trade Center site, and the World Financial Center."
^Welcome, District Court for the Southern District of New York. Accessed January 15, 2024. "The United States District Court for the Southern District of New York encompasses the counties of New York, Bronx, Westchester, Rockland, Putnam, Orange, Dutchess, and Sullivan and draws jurors from those counties."
^Home Page, District Court for the Eastern District of New York. Accessed January 15, 2024. "The district comprises the counties of Kings, Nassau, Queens, Richmond, and Suffolk and concurrently with the Southern District, the waters within the counties of Bronx and New York."
^Boschma, Janie; Rigdon, Renée; Manley, Byron; and Cohen, Ethan. "Redistricting in New York", CNN, November 8, 2022. Accessed January 15, 2024.
^Lincoln, Taylor. The Wells of the Congress, Public Citizen, January 18, 2022. Accessed January 13, 2024. "Eight of the 10 zip codes giving the most in maxed-out contributions are located in New York City and, specifically, in Manhattan."
Holli, Melvin G., and Jones, Peter d'A., eds. Biographical Dictionary of American Mayors, 1820–1980 (Greenwood Press, 1981) short scholarly biographies each of the city's mayors 1820 to 1980. online; see index at p. 410 for list.
Core cities are metropolitan core cities of at least a million people. The other areas are urban areas of cities that have an urban area of 150,000+ or of a metropolitan area of at least 250,000+. Satellite cities are in italics.
Psychotherapy (also psychological therapy, talk therapy, or talking therapy) is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome problems. Psychotherapy aims to improve an individual's well-being and mental health, to resolve or mitigate troublesome behaviors, beliefs, compulsions, thoughts, or emotions, and to improve relationships and social skills.[1] Numerous types of psychotherapy have been designed either for individual adults, families, or children and adolescents. Some types of psychotherapy are considered evidence-based for treating diagnosed mental disorders; other types have been criticized as pseudoscience.[2]
There are hundreds of psychotherapy techniques, some being minor variations; others are based on very different conceptions of psychology.[3] Most approaches involve one-to-one sessions, between the client and therapist, but some are conducted with groups,[4] including couples and families.
The term psychotherapy is derived from Ancient Greekpsyche (ψυχή meaning "breath; spirit; soul") and therapeia (θεραπεία "healing; medical treatment"). The Oxford English Dictionary defines it as "The treatment of disorders of the mind or personality by psychological means...", however, in earlier use, it denoted the treatment of disease through hypnotic suggestion.[5][citation needed] Psychotherapy is often dubbed as a "talking therapy" or "talk therapy", particularly for a general audience,[6] though not all forms of psychotherapy rely on verbal communication.[7] Children or adults who do not engage in verbal communication (or not in the usual way) are not excluded from psychotherapy; indeed some types are designed for such cases.[citation needed]
The American Psychological Association adopted a resolution on the effectiveness of psychotherapy in 2012 based on a definition developed by American psychologist John C. Norcross: "Psychotherapy is the informed and intentional application of clinical methods and interpersonal stances derived from established psychological principles for the purpose of assisting people to modify their behaviors, cognitions, emotions, and/or other personal characteristics in directions that the participants deem desirable".[8] Influential editions of a work by psychiatrist Jerome Frank defined psychotherapy as a healing relationship using socially authorized methods in a series of contacts primarily involving words, acts and rituals—which Frank regarded as forms of persuasion and rhetoric.[9] Historically, psychotherapy has sometimes meant "interpretative" (i.e. Freudian) methods, namely psychoanalysis, in contrast with other methods to treat psychiatric disorders such as behavior modification.[10]
Some definitions of counseling overlap with psychotherapy (particularly in non-directive client-centered approaches), or counseling may refer to guidance for everyday problems in specific areas, typically for shorter durations with a less medical or "professional" focus.[11]Somatotherapy refers to the use of physical changes as injuries and illnesses, and sociotherapy to the use of a person's social environment to effect therapeutic change.[12] Psychotherapy may address spirituality as a significant part of someone's mental / psychological life, and some forms are derived from spiritual philosophies, but practices based on treating the spiritual as a separate dimension are not necessarily considered as traditional or 'legitimate' forms of psychotherapy.[13]
Psychotherapy may be delivered in person (one on one, or with couples, with families, or, in groups) or via telephone counseling or online counseling (see also § Telepsychotherapy).[14] There have also been developments in computer-assisted therapy, such as virtual reality therapy for behavioral exposure, multimedia programs to teach cognitive techniques, and handheld devices for improved monitoring or putting ideas into practice (see also § Computer-supported).[14][15]
Most forms of psychotherapy use spoken conversation. Some also use various other forms of communication such as the written word, artwork, drama, narrative story or music. Psychotherapy with children and their parents often involves play, dramatization (i.e. role-play), and drawing, with a co-constructed narrative from these non-verbal and displaced modes of interacting.[16]
Psychotherapists traditionally may be mental health professionals like psychologists and psychiatrists; professionals from other backgrounds (family therapists, social workers, nurses, etc.) who have trained in a specific psychotherapy; or (in some cases) academic or scientifically trained professionals. In addition to the training, many countries require psychotherapist to register with a professional body in order to be permitted to offer services.
Psychiatrists are trained first as physicians, and as such they may prescribe prescription medication; and specialist psychiatric training begins after medical school in psychiatric residencies: however, their specialty is in mental disorders or forms of mental illness.[17]Clinical psychologists have specialist doctoral degrees in psychology with some clinical and research components. Other clinical practitioners, social workers, mental health counselors, pastoral counselors, and nurses with a specialization in mental health, also often conduct psychotherapy. Many of the wide variety of psychotherapy training programs and institutional settings are multi-professional. In most countries, psychotherapy training is completed at a postgraduate level, often at a master's degree (or doctoral) level, over four years, with significant clinical supervision and clinical placements. Mental health professionals that choose to specialize in psychotherapeutic work also require a program of continuing professional education after basic professional training.[18]
A listing of the extensive professional competencies of a European psychotherapist was developed by the European Association of Psychotherapy (EAP) in 2013.[19]
As sensitive and deeply personal topics are often discussed during psychotherapy, therapists are expected, and usually legally bound, to respect client or patient confidentiality. The critical importance of client confidentiality—and the limited circumstances in which it may need to be broken for the protection of clients or others—is enshrined in the regulatory psychotherapeutic organizations' codes of ethical practice.[20] Examples of when it is typically accepted to break confidentiality include when the therapist has knowledge that a child or elder is being physically abused; when there is a direct, clear and imminent threat of serious physical harm to self or to a specific individual. In some countries psychotherapists are required by law to be mandated reporters.[21]
As of 2015, there are still a lot of variations between different European countries about the regulation and delivery of psychotherapy. Several countries have no regulation of the practice or no protection of the title. Some have a system of voluntary registration, with independent professional organizations, while other countries attempt to restrict the practice of psychotherapy to 'mental health professionals' (psychologists and psychiatrists) with state-certified training. The titles that are protected also vary.[22] The European Association for Psychotherapy (EAP) established the 1990 Strasbourg Declaration on Psychotherapy, which is dedicated to establishing an independent profession of psychotherapy in Europe, with pan-European standards.[23] The EAP has already made significant contacts with the European Union & European Commission towards this end.
Given that the European Union has a primary policy about the free movement of labor within Europe, European legislation can overrule national regulations that are, in essence, forms of restrictive practices.
In Germany, the practice of psychotherapy for adults is restricted to qualified psychologists and physicians (including psychiatrists) who have completed several years of specialist practical training and certification in psychotherapy.[24] As psychoanalysis, psychodynamic therapy, and cognitive behavioral therapy meet the requirements of German health insurance companies, mental health professionals regularly opt for one of these three specializations in their postgraduate training. For psychologists, this includes three years of full-time practical training (4,200 hours), encompassing a year-long internship at an accredited psychiatric institution, six months of clinical work at an outpatient facility, 600 hours of supervised psychotherapy in an outpatient setting, and at least 600 hours of theoretical seminars.[25]Social workers may complete the specialist training for child and teenage clients.[26] Similarly in Italy, the practice of psychotherapy is restricted to graduates in psychology or medicine who have completed four years of recognised specialist training.[27][28] Sweden has a similar restriction on the title "psychotherapist", which may only be used by professionals who have gone through a post-graduate training in psychotherapy and then applied for a licence, issued by the National Board of Health and Welfare.[29]
Legislation in France restricts the use of the title "psychotherapist" to professionals on the National Register of Psychotherapists,[30] which requires a training in clinical psychopathology and a period of internship which is only open to physicians or titulars of a master's degree in psychology or psychoanalysis.[31]
Austria and Switzerland (2011) have laws that recognize multi-disciplinary functional approaches.[citation needed]
In the United Kingdom, the government and Health and Care Professions Council considered mandatory legal registration but decided that it was best left to professional bodies to regulate themselves, so the Professional Standards Authority for Health and Social Care (PSA) launched an Accredited Voluntary Registers scheme.[32][33][34][35][36] Counseling and psychotherapy are not protected titles in the United Kingdom. Counsellors and psychotherapists who have trained and qualify to a certain standard (usually a level 4 Diploma) can apply to be members of the professional bodies who are listed on the PSA Accredited Registers.
In some states, counselors or therapists must be licensed to use certain words and titles on self-identification or advertising. In some other states, the restrictions on practice are more closely associated with the charging of fees. Licensing and regulation are performed by various states. Presentation of practice as licensed, but without such a license, is generally illegal.[37] Without a license, for example, a practitioner cannot bill insurance companies.[38] Information about state licensure of psychologists is provided by the American Psychological Association.[39]
In addition to state laws, the American Psychological Association requires its members to adhere to its published Ethical Principles of Psychologists and Code of Conduct.[40] The American Board of Professional Psychology examines and certifies "psychologists who demonstrate competence in approved specialty areas in professional psychology".[41]
Regulation of psychotherapy is in the jurisdiction of, and varies among, the provinces and territories.
In Quebec, psychotherapy is a regulated activity which is restricted to psychologists, medical doctors, and holders of a psychotherapy permit issued by the Ordre des psychologues du Québec, the Quebec order of psychologists. Members of certain specified professions, including social workers, couple and family therapists, occupational therapists, guidance counsellors, criminologists, sexologists, psychoeducators, and registered nurses may obtain a psychotherapy permit by completing certain educational and practice requirements; their professional oversight is provided by their own professional orders. Some other professionals who were practising psychotherapy before the current system came into force continue to hold psychotherapy permits alone.[42]
On 1 July 2019, Ontario's Missing Persons Act came into effect, with the purpose of giving police more power to investigate missing persons. It allows police to require (as opposed to permit) health professionals, including psychotherapists, to share otherwise confidential documents about their client, if there is reason to believe their client is missing.[43][44] Some have expressed concern that this legislation undermines psychotherapy confidentiality and could be abused maliciously by police,[45] while others have praised the act for how it respects privacy and includes checks and balances.[46]
Psychotherapy can be said to have been practiced through the ages, as medics, philosophers, spiritual practitioners and people in general used psychological methods to heal others.[47][48]
In the Western tradition, by the 19th century, a moral treatment movement (then meaning morale or mental) developed based on non-invasive non-restraint therapeutic methods.[49] Another influential movement was started by Franz Mesmer (1734–1815) and his student Armand-Marie-Jacques de Chastenet, Marquis of Puységur (1751–1825). Called Mesmerism or animal magnetism, it would have a strong influence on the rise of dynamic psychology and psychiatry as well as theories about hypnosis.[50][51] In 1853, Walter Cooper Dendy introduced the term "psycho-therapeia" regarding how physicians might influence the mental states of patients and thus their bodily ailments, for example by creating opposing emotions to promote mental balance.[52][53]Daniel Hack Tuke cited the term and wrote about "psycho-therapeutics" in 1872 in his book Illustrations of the Influence of the Mind upon the Body in Health and Disease, in which he also proposed making a science of animal magnetism.[54][55]Hippolyte Bernheim and colleagues in the "Nancy School" developed the concept of "psychotherapy" in the sense of using the mind to heal the body through hypnotism, yet further.[54] Charles Lloyd Tuckey's 1889 work, Psycho-therapeutics, or Treatment by Hypnotism and Suggestion popularized the work of the Nancy School in English.[54][56] Also in 1889 a clinic used the word in its title for the first time, when Frederik van Eeden and Albert Willem van Renterghem in Amsterdam renamed theirs "Clinique de Psycho-thérapeutique Suggestive" after visiting Nancy.[54] During this time, travelling stage hypnosis became popular, and such activities added to the scientific controversies around the use of hypnosis in medicine.[54] Also in 1892, at the second congress of experimental psychology, van Eeden attempted to take the credit for the term psychotherapy and to distance the term from hypnosis.[54] In 1896, the German journal Zeitschrift für Hypnotismus, Suggestionstherapie, Suggestionslehre und verwandte psychologische Forschungen changed its name to Zeitschrift für Hypnotismus, Psychotherapie sowie andere psychophysiologische und psychopathologische Forschungen, which is probably the first journal to use the term.[54] Thus psychotherapy initially meant "the treatment of disease by psychic or hypnotic influence, or by suggestion".[5]
Freud, seated left of picture with Jung seated at the right of the picture. 1909
Sigmund Freud visited the Nancy School and his early neurological practice involved the use of hypnotism. However following the work of his mentor Josef Breuer—in particular a case where symptoms appeared partially resolved by what the patient, Bertha Pappenheim, dubbed a "talking cure"—Freud began focusing on conditions that appeared to have psychological causes originating in childhood experiences and the unconscious mind. He went on to develop techniques such as free association, dream interpretation, transference and analysis of the id, ego and superego. His popular reputation as the father of psychotherapy was established by his use of the distinct term "psychoanalysis", tied to an overarching system of theories and methods, and by the effective work of his followers in rewriting history.[54] Many theorists, including Alfred Adler, Carl Jung, Karen Horney, Anna Freud, Otto Rank, Erik Erikson, Melanie Klein and Heinz Kohut, built upon Freud's fundamental ideas and often developed their own systems of psychotherapy. These were all later categorized as psychodynamic, meaning anything that involved the psyche's conscious/unconscious influence on external relationships and the self. Sessions tended to number into the hundreds over several years.
Some therapeutic approaches developed out of the European school of existential philosophy. Concerned mainly with the individual's ability to develop and preserve a sense of meaning and purpose throughout life, major contributors to the field (e.g., Irvin Yalom, Rollo May) and Europe (Viktor Frankl, Ludwig Binswanger, Medard Boss, R.D.Laing, Emmy van Deurzen) attempted to create therapies sensitive to common "life crises" springing from the essential bleakness of human self-awareness, previously accessible only through the complex writings of existential philosophers (e.g., Søren Kierkegaard, Jean-Paul Sartre, Gabriel Marcel, Martin Heidegger, Friedrich Nietzsche). The uniqueness of the patient-therapist relationship thus also forms a vehicle for therapeutic inquiry. A related body of thought in psychotherapy started in the 1950s with Carl Rogers. Based also on the works of Abraham Maslow and his hierarchy of human needs, Rogers brought person-centered psychotherapy into mainstream focus. The primary requirement was that the client receive three core "conditions" from his counselor or therapist: unconditional positive regard, sometimes described as "prizing" the client's humanity; congruence [authenticity/genuineness/transparency]; and empathic understanding. This type of interaction was thought to enable clients to fully experience and express themselves, and thus develop according to their innate potential.[59] Others developed the approach, like Fritz and Laura Perls in the creation of Gestalt therapy, as well as Marshall Rosenberg, founder of Nonviolent Communication, and Eric Berne, founder of transactional analysis. Later these fields of psychotherapy would become what is known as humanistic psychotherapy today. Self-help groups and books became widespread.
During the 1950s, Albert Ellis originated rational emotive behavior therapy (REBT). Independently a few years later, psychiatrist Aaron T. Beck developed a form of psychotherapy known as cognitive therapy. Both of these included relatively short, structured and present-focused techniques aimed at identifying and changing a person's beliefs, appraisals and reaction-patterns, by contrast with the more long-lasting insight-based approach of psychodynamic or humanistic therapies. Beck's approach used primarily the socratic method, and links have been drawn between ancient stoic philosophy and these cognitive therapies.[60]
Cognitive and behavioral therapy approaches were increasingly combined and grouped under the umbrella term cognitive behavioral therapy (CBT) in the 1970s. Many approaches within CBT are oriented towards active/directive yet collaborative empiricism (a form of reality-testing), and assessing and modifying core beliefs and dysfunctional schemas. These approaches gained widespread acceptance as a primary treatment for numerous disorders. A "third wave" of cognitive and behavioral therapies developed, including acceptance and commitment therapy and dialectical behavior therapy, which expanded the concepts to other disorders and/or added novel components and mindfulness exercises. However the "third wave" concept has been criticized as not essentially different from other therapies and having roots in earlier ones as well.[61] Counseling methods developed include solution-focused therapy and systemic coaching.
Postmodern psychotherapies such as narrative therapy and coherence therapy do not impose definitions of mental health and illness, but rather see the goal of therapy as something constructed by the client and therapist in a social context. Systemic therapy also developed, which focuses on family and group dynamics—and transpersonal psychology, which focuses on the spiritual facet of human experience. Other orientations developed in the last three decades include feminist therapy, brief therapy, somatic psychology, expressive therapy, applied positive psychology and the human givens approach. A survey of over 2,500 US therapists in 2006 revealed the most utilized models of therapy and the ten most influential therapists of the previous quarter-century.[62]
There are hundreds of psychotherapy approaches or schools of thought. By 1980 there were more than 250;[63] by 1996 more than 450;[64] and at the start of the 21st century there were over a thousand different named psychotherapies—some being minor variations while others are based on very different conceptions of psychology, ethics (how to live) or technique.[65][66] In practice therapy is often not of one pure type but draws from a number of perspectives and schools—known as an integrative or eclectic approach.[67][68] The importance of the therapeutic relationship, also known as therapeutic alliance, between client and therapist is often regarded as crucial to psychotherapy. Common factors theory addresses this and other core aspects thought to be responsible for effective psychotherapy. Sigmund Freud (1856–1939), a Viennese neurologist who studied with Jean-Martin Charcot in 1885, is often considered the father of modern psychotherapy. His methods included analyzing his patient's dreams in search of important hidden insights into their unconscious minds. Other major elements of his methods, which changed throughout the years, included identification of childhood sexuality, the role of anxiety as a manifestation of inner conflict, the differentiation of parts of the psyche (id, ego, superego), transference and countertransference (the patient's projections onto the therapist, and the therapist's emotional responses to that). Some of his concepts were too broad to be amenable to empirical testing and invalidation, and he was critiqued for this by Jaspers. Numerous major figures elaborated and refined Freud's therapeutic techniques including Melanie Klein, Donald Winnicott, and others. Since the 1960s, however, the use of Freudian-based analysis for the treatment of mental disorders has declined substantially. Different types of psychotherapy have been created along with the advent of clinical trials to test them scientifically. These incorporate subjective treatments (after Beck), behavioral treatments (after Skinner and Wolpe) and additional time-constrained and centered structures, for example, interpersonal psychotherapy. In youth issue and in schizophrenia, the systems of family treatment hold esteem. A portion of the thoughts emerging from therapy are presently pervasive and some are a piece of the tool set of ordinary clinical practice. They are not just medications, they additionally help to understand complex conduct.
Psychotherapies are categorized in several different ways. A distinction can be made between those based on a medical model and those based on a humanistic model. In the medical model, the client is seen as unwell and the therapist employs their skill to help the client back to health. The extensive use of the DSM-IV, the diagnostic and statistical manual of mental disorders in the United States is an example of a medically exclusive model. The humanistic or non-medical model in contrast strives to depathologise the human condition. The therapist attempts to create a relational environment conducive to experiential learning and help build the client's confidence in their own natural process resulting in a deeper understanding of themselves. The therapist may see themselves as a facilitator/helper.
Therapies are sometimes classified according to their duration; a small number of sessions over a few weeks or months may be classified as brief therapy (or short-term therapy), others, where regular sessions take place for years, may be classified as long-term.
Some practitioners distinguish between more "uncovering" (or "depth") approaches and more "supportive" psychotherapy. Uncovering psychotherapy emphasizes facilitating the client's insight into the roots of their difficulties. The best-known example is classical psychoanalysis. Supportive psychotherapy by contrast stresses strengthening the client's coping mechanisms and often providing encouragement and advice, as well as reality-testing and limit-setting where necessary. Depending on the client's issues and situation, a more supportive or more uncovering approach may be optimal.[70]
These psychotherapies, also known as "experiential", are based on humanistic psychology and emerged in reaction to both behaviorism and psychoanalysis, being dubbed the "third force". They are primarily concerned with the human development and needs of the individual, with an emphasis on subjective meaning, a rejection of determinism, and a concern for positive growth rather than pathology.[71] Some posit an inherent human capacity to maximize potential, "the self-actualizing tendency"; the task of therapy is to create a relational environment where this tendency might flourish.[72] Humanistic psychology can, in turn, be rooted in existentialism—the belief that human beings can only find meaning by creating it. This is the goal of existential therapy. Existential therapy is in turn philosophically associated with phenomenology.[73][74]
Person-centered therapy, also known as client-centered, focuses on the therapist showing openness, empathy and "unconditional positive regard", to help clients express and develop their own self.[75]
Humanistic Psychodrama (HPD) is based on the human image of humanistic psychology.[76] So all rules and methods follow the axioms of humanistic psychology. The HPD sees itself as development-oriented psychotherapy and has completely moved away from the psychoanalytic catharsis theory.[77] Self-awareness and self-realization are essential aspects in the therapeutic process. Subjective experiences, feelings and thoughts and one's own experiences are the starting point for a change or reorientation in experience and behavior in the direction of more self-acceptance and satisfaction. Dealing with the biography of the individual is closely related to the sociometry of the group.[78]
Gestalt therapy, originally called "concentration therapy", is an existential/experiential form that facilitates awareness in the various contexts of life, by moving from talking about relatively remote situations to action and direct current experience. Derived from various influences, including an overhaul of psychoanalysis, it stands on top of essentially four load-bearing theoretical walls: phenomenological method, dialogical relationship, field-theoretical strategies, and experimental freedom.[79]
A briefer form of humanistic therapy is the human givens approach, introduced in 1998–99.[80] It is a solution-focused intervention based on identifying emotional needs—such as for security, autonomy and social connection—and using various educational and psychological methods to help people meet those needs more fully or appropriately.[81][82][83][84]
Insight-oriented psychotherapies focus on revealing or interpreting unconscious processes. Most commonly referring to psychodynamic therapy, of which psychoanalysis is the oldest and most intensive form, these applications of depth psychology encourage the verbalization of all the patient's thoughts, including free associations, fantasies, and dreams, from which the analyst formulates the nature of the past and present unconscious conflicts which are causing the patient's symptoms and character problems.
Behavior therapies use behavioral techniques, including applied behavior analysis (also known as behavior modification), to change maladaptive patterns of behavior to improve emotional responses, cognitions, and interactions with others. Functional analytic psychotherapy is one form of this approach. By nature, behavioral therapies are empirical (data-driven), contextual (focused on the environment and context), functional (interested in the effect or consequence a behavior ultimately has), probabilistic (viewing behavior as statistically predictable), monistic (rejecting mind-body dualism and treating the person as a unit), and relational (analyzing bidirectional interactions).[88]
Cognitive therapy focuses directly on changing the thoughts, in order to improve the emotions and behaviors.
Cognitive behavioral therapy attempts to combine the above two approaches, focused on the construction and reconstruction of people's cognitions, emotions and behaviors. Generally in CBT, the therapist, through a wide array of modalities, helps clients assess, recognize and deal with problematic and dysfunctional ways of thinking, emoting and behaving.
Interpersonal psychotherapy (IPT) is a relatively brief form of psychotherapy (deriving from both CBT and psychodynamic approaches) that has been increasingly studied and endorsed by guidelines for some conditions. It focuses on the links between mood and social circumstances, helping to build social skills and social support.[89] It aims to foster adaptation to current interpersonal roles and situations.
Exposure and response prevention (ERP) is primarily deployed by therapists in the treatment of OCD.[90] The American Psychiatric Association (APA) state that CBT drawing primarily on behavioral techniques (such as ERP) has the "strongest evidence base" among psychosocial interventions.[91] By confronting feared scenarios (i.e., exposure) and refraining from performing rituals (i.e., responsive prevention), patients may gradually feel less distress in confronting feared stimuli, while also feeling less inclination to use rituals to relieve that distress. Typically, ERP is delivered in "hierarchical fashion", meaning patients confront increasingly anxiety-provoking stimuli as they progress through a course of treatment.[92][93]
Systemic therapy seeks to address people not just individually, as is often the focus of other forms of therapy, but in relationship, dealing with the interactions of groups, their patterns and dynamics (includes family therapy and marriage counseling). Community psychology is a type of systemic psychology.
The term group therapy was first used around 1920 by Jacob L. Moreno, whose main contribution was the development of psychodrama, in which groups were used as both cast and audience for the exploration of individual problems by reenactment under the direction of the leader. The more analytic and exploratory use of groups in both hospital and out-patient settings was pioneered by a few European psychoanalysts who emigrated to the US, such as Paul Schilder, who treated severely neurotic and mildly psychotic out-patients in small groups at Bellevue Hospital, New York. The power of groups was most influentially demonstrated in Britain during the Second World War, when several psychoanalysts and psychiatrists proved the value of group methods for officer selection in the War Office Selection Boards. A chance to run an Army psychiatric unit on group lines was then given to several of these pioneers, notably Wilfred Bion and Rickman, followed by S. H. Foulkes, Main, and Bridger. The Northfield Hospital in Birmingham gave its name to what came to be called the two "Northfield Experiments", which provided the impetus for the development since the war of both social therapy, that is, the therapeutic community movement, and the use of small groups for the treatment of neurotic and personality disorders. Today group therapy is used in clinical settings and in private practice settings.[95]
Expressive psychotherapy is a form of therapy that utilizes artistic expression (via improvisational, compositional, re-creative, and receptive experiences) as its core means of treating clients. Expressive psychotherapists use the different disciplines of the creative arts as therapeutic interventions. This includes the modalities dance therapy, drama therapy, art therapy, music therapy, writing therapy, among others.[96] This may include techniques such as affect labeling. Expressive psychotherapists believe that often the most effective way of treating a client is through the expression of imagination in creative work and integrating and processing what issues are raised in the act.
Also known as post-structuralist or constructivist. Narrative therapy gives attention to each person's "dominant story" through therapeutic conversations, which also may involve exploring unhelpful ideas and how they came to prominence. Possible social and cultural influences may be explored if the client deems it helpful. Coherence therapy posits multiple levels of mental constructs that create symptoms as a way to strive for self-protection or self-realization. Feminist therapy does not accept that there is one single or correct way of looking at reality and therefore is considered a postmodernist approach.[97]
Transpersonal psychology addresses the client in the context of a spiritual understanding of consciousness.[98]Positive psychotherapy (PPT) (since 1968) is a method in the field of humanistic and psychodynamic psychotherapy and is based on a positive image of humans, with a health-promoting, resource-oriented and conflict-centered approach.
Psychedelic therapy are therapeutic practices involving psychedelic drugs, such as LSD, psilocybin, DMT, and MDMA.[112] In psychedelic therapy, in contrast to conventional psychiatric medication taken by the patient regularly or as needed, patients generally remain in an extended psychotherapy session during the acute psychedelic activity with additional sessions both before and after in order to help integrate experiences with the psychedelics.[113][114] Psychedelic therapy has been compared with the shamanic healing rituals of indigenous people. Researchers identified two main differences: the first is the shamanic belief that multiple realities exist and can be explored through altered states of consciousness, and second the belief that spirits encountered in dreams and visions are real.[115][114] The charitable initiative Founders Pledge has written a research report on cost-effective giving opportunities for funding psychedelic-assisted mental health treatments.[116][117]
Body psychotherapy, part of the field of somatic psychology, focuses on the link between the mind and the body and tries to access deeper levels of the psyche through greater awareness of the physical body and emotions. There are various body-oriented approaches, such as Reichian (Wilhelm Reich) character-analytic vegetotherapy and orgonomy; neo-Reichian bioenergetic analysis; somatic experiencing; integrative body psychotherapy; Ron Kurtz's Hakomi psychotherapy; sensorimotor psychotherapy; Biosynthesis psychotherapy; and Biodynamic psychotherapy. These approaches are not to be confused with body work or body-therapies that seek to improve primarily physical health through direct work (touch and manipulation) on the body, rather than through directly psychological methods.
Some non-Western indigenous therapies have been developed. In African countries this includes harmony restoration therapy, meseron therapy and systemic therapies based on the Ubuntu philosophy.[118][119][120]
Psychotherapy needs to be adapted to meet the developmental needs of children. Depending on age, it is generally held to be one part of an effective strategy to help the needs of a child within the family setting.[122] Child psychotherapy training programs necessarily include courses in human development. Since children often do not have the ability to articulate thoughts and feelings, psychotherapists will use a variety of media such as musical instruments, sand and toys, crayons, paint, clay, puppets, bibliocounseling (books), or board games. The use of play therapy is often rooted in psychodynamic theory, but other approaches also exist.
In addition to therapy for the child, sometimes instead of it, children may benefit if their parents work with a therapist, take parenting classes, attend grief counseling, or take other action to resolve stressful situations that affect the child. Parent management training is a highly effective form of psychotherapy that teaches parenting skills to reduce their child's behavior problems.
In many cases a different psychotherapist will work with the care taker of the child, while a colleague works with the child.[123] Therefore, contemporary thinking on working with the younger age group has leaned towards working with parent and child simultaneously, as well as individually as needed.[124][125]
Research on computer-supported and computer-based interventions has increased significantly over the course of the last two decades.[126][127] The following applications frequently have been investigated:
Virtual reality: VR is a computer-generated scenario that simulates experience. The immersive environment, used for simulated exposure, can be similar to the real world or it can be fantastical, creating a new experience.[128][129]
Computer-based interventions (or online interventions or internet interventions): These interventions can be described as interactive self-help. They usually entail a combination of text, audio or video elements.[130][131]
Computer-supported therapy (or blended therapy): Classical psychotherapy is supported by means of online or software application elements. The feasibility of such interventions has been investigated for individual[132] and group therapy.[133][134]
Telepsychiatry can be effective in treating people with mental health conditions. In the short-term it can be as acceptable and effective as face-to-face care.[137] Research also suggests comparable therapeutic factors, such as changes in problematic thinking or behaviour. [138]
It can improve access to mental health services for some but might also represent a barrier for those lacking access to a suitable device, the internet or the necessary digital skills. Factors such as poverty that are associated with lack of internet access are also associated with greater risk of mental health problems, making digital exclusion an important problem of telemental health services.[137]
During the COVID-19 pandemic mental health services were adapted to telemental health in high-income countries. It proved effective and acceptable for use in an emergency situation but there were concerns regarding its long-term implementation.[139]
There is considerable controversy about whether, or when, psychotherapy efficacy is best evaluated by randomized controlled trials or more individualized idiographic methods.[140]
One issue with trials is what to use as a placebo treatment group or non-treatment control group. Often, this group includes patients on a waiting list, or those receiving some kind of regular non-specific contact or support. Researchers must consider how best to match the use of inert tablets or sham treatments in placebo-controlled studies in pharmaceutical trials. Several interpretations and differing assumptions and language remain.[141] Another issue is the attempt to standardize and manualize therapies and link them to specific symptoms of diagnostic categories, making them more amenable to research. Some report that this may reduce efficacy or gloss over individual needs. Fonagy and Roth's opinion is that the benefits of the evidence-based approach outweighs the difficulties.[142]
There are several formal frameworks for evaluating whether a psychotherapist is a good fit for a patient. One example is the Scarsdale Psychotherapy Self-Evaluation (SPSE).[143] However, some scales, such as the SPS, elicit information specific to certain schools of psychotherapy alone (e.g. the superego).
Many psychotherapists believe that the nuances of psychotherapy cannot be captured by questionnaire-style observation, and prefer to rely on their own clinical experiences and conceptual arguments to support the type of treatment they practice. Psychodynamic therapists increasingly believe that evidence-based approaches are appropriate to their methods and assumptions, and have increasingly accepted the challenge to implement evidence-based approaches in their methods.[144]
A pioneer in investigating the results of different psychological therapies was psychologist Hans Eysenck, who argued that psychotherapy does not produce any improvement in patients. He held that behavior therapy is the only effective one. However, it was revealed that Eysenck (who died in 1997) falsified data in his studies about this subject, fabricating data that would indicate that behavioral therapy enables achievements that are impossible to believe. Fourteen of his papers were retracted by journals in 2020, and journals issued 64 statements of concern about publications by him. Rod Buchanan, a biographer of Eysenck, has argued that 87 publications by Eysenck should be retracted.[145][146][147][148][149][150][151]
The response rate of psychotherapy varies, no reliable changes due to psychotherapy can be found in up to 33% of patients.[152]
Large-scale international reviews of scientific studies have concluded that psychotherapy is effective for numerous conditions.[8][22] A 2022 meta-analysis of meta-analyses found that effect sizes reported for both psychotherapies and pharmacotherapies, compared to treatment-as-usual or placebo, were small for most disorders and treatments, and concluded that a "paradigm shift in research" was needed to advance the field and improve treatment strategies for mental disorders.[153]
One line of research consistently found that supposedly different forms of psychotherapy show similar effectiveness. According to the 2008 edition of The Handbook of Counseling Psychology: "Meta-analyses of psychotherapy studies have consistently demonstrated that there are no substantial differences in outcomes among treatments".[154] The handbook stated that "little evidence suggests that any one treatment consistently outperforms any other for any specific psychological disorders".[154] This is sometimes called the Dodo bird verdict after a scene/section in Alice in Wonderland where every competitor in a race was called a winner and is given prizes.
Further analyses seek to identify the factors that the psychotherapies have in common that seem to account for this, known as common factors theory; for example the quality of the therapeutic relationship, interpretation of problem, and the confrontation of painful emotions.[155][156][157][158]
Outcome studies have been critiqued for being too removed from real-world practice in that they use carefully selected therapists who have been extensively trained and monitored, and patients who may be non-representative of typical patients by virtue of strict inclusionary/exclusionary criteria. Such concerns impact the replication of research results and the ability to generalize from them to practicing therapists.[156][159]
However, specific therapies have been tested for use with specific disorders,[160] and regulatory organizations in both the UK and US make recommendations for different conditions.[161][162][163]
The Helsinki Psychotherapy Study was one of several large long-term clinical trials of psychotherapies that have taken place. Anxious and depressed patients in two short-term therapies (solution-focused and brief psychodynamic) improved faster, but five years long-term psychotherapy and psychoanalysis gave greater benefits. Several patient and therapist factors appear to predict suitability for different psychotherapies.[164]
A 2014 meta analysis over 11,000 patients reveals that Interpersonal Psychotherapy (IPT) is of comparable effectiveness to CBT for depression but is inferior to the latter for eating disorders.[166] For children and adolescents, interpersonal psychotherapy and CBT are the best methods according to a 2014 meta analysis of almost 4000 patients.[167]
Research on adverse effects of psychotherapy has been limited, yet worsening of symptoms may be expected to occur in 3% to 15% of patients, with variability across patient and therapist characteristics.[168][169][170] Potential problems include deterioration of symptoms or developing new symptoms, strains in other relationships, social stigma, and therapy dependence.[171] Some techniques or therapists may carry more risks than others, and some client characteristics may make them more vulnerable.[169] Side-effects from properly conducted therapy should be distinguished from harms caused by malpractice.[171]
Patient adherence to a course of psychotherapy—continuing to attend sessions or complete tasks—is a major issue.
The dropout level—early termination—ranges from around 30% to 60%, depending partly on how it is defined. The range is lower for research settings for various reasons, such as the selection of clients and how they are inducted. Early termination is associated on average with various demographic and clinical characteristics of clients, therapists and treatment interactions.[172][173] The high level of dropout has raised some criticism about the relevance and efficacy of psychotherapy.[174]
Most psychologists use between-session tasks in their general therapy work, and cognitive behavioral therapies in particular use and see them as an "active ingredient". It is not clear how often clients do not complete them, but it is thought to be a pervasive phenomenon.[172]
From the other side, the adherence of therapists to therapy protocols and techniques—known as "treatment integrity" or "fidelity"—has also been studied, with complex mixed results.[175] In general, however, it is a hallmark of evidence-based psychotherapy to use fidelity monitoring as part of therapy outcome trials and ongoing quality assurance in clinical implementation.
It is not yet understood how psychotherapies can succeed in treating mental illnesses.[176] Different therapeutic approaches may be associated with particular theories about what needs to change in a person for a successful therapeutic outcome.
In general, processes of emotional arousal and memory have long been held to play an important role. One theory combining these aspects proposes that permanent change occurs to the extent that the neuropsychological mechanism of memory reconsolidation is triggered and is able to incorporate new emotional experiences.[177][178][179][180]
Some critics are skeptical of the healing power of psychotherapeutic relationships.[181][182][183] Some dismiss psychotherapy altogether in the sense of a scientific discipline requiring professional practitioners,[184] instead favoring either nonprofessional help[184] or biomedical treatments.[185] Others have pointed out ways in which the values and techniques of therapists can be harmful as well as helpful to clients (or indirectly to other people in a client's life).[186]
Many resources available to a person experiencing emotional distress—the friendly support of friends, peers, family members, clergy contacts, personal reading, healthy exercise, research, and independent coping—all present considerable value. Critics note that humans have been dealing with crises, navigating severe social problems and finding solutions to life problems long before the advent of psychotherapy.[187]
On the other hand, some argue psychotherapy is under-utilized and under-researched by contemporary psychiatry despite offering more promise than stagnant medication development. In 2015, the US National Institute of Mental Health allocated only 5.4% of its budget to new clinical trials of psychotherapies (medication trials are largely funded by pharmaceutical companies), despite plentiful evidence they can work and that patients are more likely to prefer them.[188]
Further critiques have emerged from feminist, constructionist and discourse-analytical sources.[189][190][191] Key to these is the issue of power.[190][192] In this regard there is a concern that clients are persuaded—both inside and outside the consulting room—to understand themselves and their difficulties in ways that are consistent with therapeutic ideas.[182][190] This means that alternative ideas (e.g., feminist,[193] economic,[194] spiritual[195]) are sometimes implicitly undermined.[196] Critics suggest that we idealize the situation when we think of therapy only as a helping relationship—arguing instead that it is fundamentally a political practice, in that some cultural ideas and practices are supported while others are undermined or disqualified, and that while it is seldom intended, the therapist–client relationship always participates in society's power relations and political dynamics.[182][197][198] A noted academic who espoused this criticism was Michel Foucault.[199]
^McAleavey, Andrew A.; Castonguay, Louis G. (2015). "The Process of Change in Psychotherapy: Common and Unique Factors". In Gelo, Omar C. G.; Pritz, Alfred; Rieken, Bernd (eds.). Psychotherapy Research. Vienna; New York: Springer-Verlag. pp. 293–310 (293). doi:10.1007/978-3-7091-1382-0_15. ISBN9783709113813. OCLC899738605. Though there are hundreds if not thousands of different kinds of psychotherapy, in many ways some are quite similar—they share some common factors.
^Schechter, Daniel S.; Coates, Susan W. (2006). "Relationally and Developmentally Focused Interventions with Young Children and Their Caregivers Affected by the Events of 9/11". In Neria, Yuval; Gross, Raz; Marshall, Randall; et al. (eds.). 9/11: Mental Health in the Wake of Terrorist Attacks. Cambridge University Press. pp. 402–27. ISBN9781139457729.
^Carlson ET, Dain N (December 1960). "The psychotherapy that was moral treatment". The American Journal of Psychiatry. 117 (6): 519–24. doi:10.1176/ajp.117.6.519. PMID13690826.
^Ellenberger, H. F. (1970). The discovery of the unconscious: The history and evolution of dynamic psychiatry. New York: Basic Books.
^Gielen, U. P., & Raymond, J. (2015). The curious birth of psychological healing in the Western World (1775–1825): From Gaßner to Mesmer to Puységur. In G. Rich & U. P. Gielen (Eds.), Pathfinders in international psychology (pp. 25–51). Charlotte, NC: Information Age Publishing.
^Robertson, Daniel (2010). The Philosophy of Cognitive–Behavioural Therapy: Stoicism as Rational and Cognitive Psychotherapy. London: Karnac. p. xix. ISBN9781855757561.
^Hofmann, Stefan G. (1 December 2008). "Acceptance and Commitment Therapy: New Wave or Morita Therapy?". Clinical Psychology: Science and Practice. 15 (4): 280–285. doi:10.1111/j.1468-2850.2008.00138.x. ISSN1468-2850.
^Roth, Anthony; Fonagy, Peter (2005) [1996]. What Works for Whom? A Critical Review of Psychotherapy Research (revised ed.). Guilford Press. ISBN9781572306509.[page needed]
^Maslow, A.H. (2011) "Toward A Psychology of Being" – Reprint of 1962 Edition, Martino Fine Books.
^Stefaroi, P. (2012) "The Humanistic Approach in Psychology & Psychotherapy, Sociology & Social Work, Pedagogy & Education, Management and Art: Personal Development and Community Development", Charleston SC, US: CreateSpace, ISBN978-1535271646.
^Deurzen, E., Kenward, R. (2005) "Dictionary of Existential Psychotherapy and Counseling", SAGE Publications.
^Gessmann, H.W. (1996) "Humanistische Psychologie und Humanistisches Psychodrama. In: Humanistisches Psychodrama Band 4, (Hrsg.), Verlag des PIB, Duisburg
^Rogers, C. R. (1951) "Client-Centered Therapy: Its Current Practice, Implications, and Theory", Boston: Houghton Mifflin.
^H.-W. Gessmann: Humanistische Psychologie und Humanistisches Psychodrama. In: Humanistisches Psychodrama. Band IV, Verlag des Psychotherapeutischen Instituts Bergerhausen, Duisburg 1996, S. 27–76.
^H.-W. Gessmann: Erste Überlegungen zur Überwindung des Katharsisbegriffs im Humanistischen Psychodrama. In: Internationale Zeitschrift für Humanistisches Psychodrama. 5. Jahrgang, Heft 2, Dez 1999, Verlag des Psychotherapeutischen Instituts Bergerhausen, Duisburg, S. 5–26, ISSN 0949-3018
^H.-W. Gessmann: Die Humanistische Psychologie und das Humanistische Psychodrama. In: Humanistisches Psychodrama. Band IV, Verlag des Psychotherapeutischen Instituts Bergerhausen, Duisburg 1996, ISBN3-928524-31-3.
^Wheeler, G. (1991) "Gestalt reconsidered", New York: Gardner Press.
^Griffin, Joe; Tyrrell, Ivan (1998). Psychotherapy, Counselling and the Human Givens (Organising Idea). European Therapy Studies Institute. ISBN978-1899398959.
^Najavits, Lisa M. (2009). "Seeking Safety: an implementation guide". In Springer, David W.; Rubin, Allen (eds.). Substance abuse treatment for youth and adults. Clinician's guide to evidence-based practice series. Hoboken, NJ: John Wiley & Sons. pp. 311–347. ISBN9780470244531. OCLC303076493.
^Gessmann, Hans-Werner (2011). "Empirischer Beitrag zur Prüfung der Wirksamkeit psychodramatischer Gruppenpsychotherapie bei NeurosepatientInnen (ICD-10: F3, F4)" [The effects of psychodramatic group psychotherapy with neurosis patients — An empirical contribution (ICD-10: F3, F4)]. Zeitschrift für Psychodrama und Soziometrie (in German). 10 (1 suppl): 69–87. doi:10.1007/s11620-011-0128-3. S2CID141232001.
^Wynd, Christine A. (2005). "Guided health imagery for smoking cessation and long-term abstinence". Journal of Nursing Scholarship. 37 (3): 245–50. doi:10.1111/j.1547-5069.2005.00042.x. PMID16235865.
^Ahijevych, Karen; Yerardi, Ruth; Nedilsky, Nancy (October 2000). "Descriptive outcomes of the American Lung Association of Ohio hypnotherapy smoking cessation program". The International Journal of Clinical and Experimental Hypnosis. 48 (4): 374–87. doi:10.1080/00207140008410367. PMID11011498. S2CID1116717.
^Pekala, Ronald J.; Maurer, Ronald; Kumar, V.K.; Elliott, Nancy C.; et al. (April 2004). "Self-hypnosis relapse prevention training with chronic drug/alcohol users: effects on self-esteem, affect, and relapse". The American Journal of Clinical Hypnosis. 46 (4): 281–97. doi:10.1080/00029157.2004.10403613. PMID15190730. S2CID38903485.
^O'Neill, Lucy M.; Barnier, Amanda J.; McConkey, Kevin (1999). "Treating anxiety with self-hypnosis and relaxation". Contemporary Hypnosis. 16 (2): 68–80. doi:10.1002/ch.154.
^Ellner, Michael; Aurbach, Robert (2009). "Hypnosis in disability settings"(PDF). IAIABC Journal. 46 (2): 57–75. Archived from the original(PDF) on 13 July 2012. Retrieved 29 April 2013.
^Callen, Kenneth E. (July 1983). "Auto-hypnosis in long distance runners". The American Journal of Clinical Hypnosis. 26 (1): 30–6. doi:10.1080/00029157.1983.10404135. PMID6678109.
^Metzner, R (1998). "Hallucinogenic drugs and plants in psychotherapy and shamanism". Journal of Psychoactive Drugs. 30 (4): 333–41. doi:10.1080/02791072.1998.10399709. PMID9924839.
^Berger, Thomas (2017). "The therapeutic alliance in internet interventions: A narrative review and suggestions for future research". Psychotherapy Research. 27 (5): 511–524. doi:10.1080/10503307.2015.1119908. PMID26732852. S2CID4769067 – via Taylor & Francis Online.
^Eysenck, H. J. & Grossarth-Maticek, R. (1991). Creative novation behaviour therapy as a prophylactic treatment for cancer and coronary heart disease: II. Effects of treatment. Behaviour Research and Therapy, 29, 1, 17–31. https://doi.org/10.1016/S0005-7967(09)80003-X
^Marks, D. F. (2019). The Hans Eysenck affair: Time to correct the scientific record. Journal of Health Psychology, 1–12.
^Marks, D. F. & Buchanan, R. D. (2020). King's College London's enquiry into Hans J. Eysenck's 'unsafe' publications must be properly completed. Journal of Health Psychology, 25, 1, 3–6.
^Nolen-Hoeksema, Susan (2014). Abnormal Psychology (Sixth ed.). University in New Haven, Connecticut: McGraw-Hill Higher Education. pp. 53–54. ISBN978-0077349165.
^ abFarquharson, Lorna (2020). "Adverse effects of psychological therapies". In Tribe, Rachel; Morrissey, Jean (eds.). The handbook of professional, ethical and research practice for psychologists, counsellors, psychotherapists and psychiatrists (3rd ed.). Abingdon; New York: Routledge. pp. 129–140. doi:10.4324/9780429428838-11. ISBN9781138352070. OCLC1130376524. S2CID216525848. 5–10% of all clients experience adverse effects of therapy (Crawford et al., 2016; Lambert, 2013; Hatfield et al, 2010; Hannan et al., 2005). However, there can be considerable variability across therapists (Saxon et al., 2017; Mohr, 1995) and according to client characteristics (Saxon et al., 2017; Crawford et al., 2016; Mohr, 1995).
Dorpat, Theodore L. (1996). Gaslighting, the double whammy, interrogation, and other methods of covert control in psychotherapy and psychoanalysis. Northvale, NJ: Jason Aronson. ISBN978-1568218281. OCLC34548677.
Basseches, Michael (April 1997). "A developmental perspective on psychotherapy process, psychotherapists' expertise, and 'meaning-making conflict' within therapeutic relationships: part II". Journal of Adult Development. 4 (2): 85–106. doi:10.1007/BF02510083. S2CID143991100. Basseches coined the term "theoretical abuse" as a parallel to "sexual abuse" in psychotherapy.
^House, Richard (June 2012). "Psychotherapy, politics and the 'common factor' of power". Psychotherapy and Politics International. 10 (2): 157–160. doi:10.1002/ppi.1260.
^McLellan, Betty (August 1999). "The prostitution of psychotherapy: a feminist critique". British Journal of Guidance & Counselling. 27 (3): 325–337. doi:10.1080/03069889908256274.
^Pavón-Cuéllar, David (October 2014). "The Freudo-Marxist tradition and the critique of psychotherapeutic ideology". Psychotherapy and Politics International. 12 (3): 208–219. doi:10.1002/ppi.1336.
^Moodley, Roy; West, William (2005). Integrating traditional healing practices into counseling and psychotherapy. Multicultural aspects of counseling and psychotherapy. Vol. 22. Thousand Oaks, CA: SAGE Publications. ISBN978-0761930464. OCLC57283684.
^House, Richard (August 1999). "'Limits to therapy and counselling': deconstructing a professional ideology". British Journal of Guidance & Counselling. 27 (3): 377–392. doi:10.1080/03069889908256278.
Guilfoyle, Michael (February 2005). "From therapeutic power to resistance? Therapy and cultural hegemony". Theory & Psychology. 15 (1): 101–124. doi:10.1177/0959354305049748. S2CID145491324. Foucault's views have been used to highlight problems of power in a variety of 'mental health' fields: in nursing (e.g. Clinton & Hazelton, 2002), social work (e.g. Foote & Frank, 1999), psychiatry (e.g. Ali, 2002), and in the cross-disciplinary practices of psychotherapy (most notably in narrative therapy—e.g. Flaskas & Humphreys, 1993; Swann, 1999; White & Epston, 1990). However, there is no single 'Foucauldian' approach to power, or indeed to therapy, and his ideas are used, as he intended, more in the manner of a 'tool kit' of ideas than as a coherent theoretical account.
Bloch, Sidney (2006). Introduction to the Psychotherapies (4th ed.). Oxford University Press. ISBN0198520921.
Carter, Robert T., ed. (2005). Handbook of Racial-Cultural Psychology and Counseling. OCLC54905669. Two volumes.
Corey, Gerald (2015). Theory and Practice of Counseling and Psychotherapy (10th ed.). Cengage Learning. ISBN9781305263727.
Cozolino, Louis (2017). The Neuroscience of Psychotherapy: Healing the Social Brain (3rd ed.). National Geographic Books. ISBN9780393712643.
DeBord, Kurt A.; Fischer, Ann R.; Bieschke, Kathleen J.; Perez, Ruperto M., eds. (2017). Handbook of Sexual Orientation and Gender Diversity in Counseling and Psychotherapy. American Psychological Association. ISBN9781433823060.
Foschi, Renato; Innamorati, Marco (2023). A Critical History of Psychotherapy. Routledge, Taylor & Francis. ISBN9781032364025. Two volumes.
Hofmann, Stefan G., ed. (2017). International Perspectives on Psychotherapy. Springer. ISBN9783319561936.
Jongsma, Arthur E.; Peterson, L. Mark; Bruce, Timothy J. (2021). The Complete Adult Psychotherapy Treatment Planner (6th ed.). John Wiley & Sons. ISBN978-1118067864.
Prochaska, James O.; Norcross, John C. (2018). Systems of Psychotherapy: A Transtheoretical Analysis (9th ed.). Oxford University Press. ISBN9780190880415.
Rastogi, Mudita; Wieling, Elizabeth, eds. (2005). Voices of Color: First-Person Accounts of Ethnic Minority Therapists. ISBN0761928901.
Slavney, Phillip R. (2005). Psychotherapy: An Introduction for Psychiatry Residents and Other Mental Health Trainees. JHU Press. ISBN0801880963.
Wampold, Bruce E. (2019). The Basics of Psychotherapy: An Introduction to Theory and Practice (2nd ed.). American Psychological Association. ISBN9781433830198.
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