I agree, fundamental things haven't changed much. However, cultural and social factors significantly impact our mental health. There is research available on these social factors if you Google it. The US, with its advanced economy, science, and technology, being an immigrant country, has benefited from life sciences and medical advancements. Despite this, we grapple with a society that is more complex than most. For instance, a less family-oriented culture and individuals with more mobility mean we receive less support. While support is a crucial factor in counseling treatment. This leads me to think that learning coping strategies through many single one-session counseling sessions might be more useful and practical than opting for a long-term treatment plan that delves into the past to explore correlations :)