It’s more profitable for insurance companies to have Reuven talk to a psychiatrist for 10-15 minutes every month or two for medication management than to have Reuven talk to the therapist for 50 minute sessions every week.
For those of the psychoanalytic school (if I were to become a therapist, or a clinical psychologist, I’d be interested in Freudian modalities; I already completed some graduate coursework in counseling psychology), therapy does involve lying on the couch, and according to Object Relations (see Otto Kerner), the role of the mother and father do matter.