Interventions with children are changing a great deal. With adults, (the population with whom I work,) what we have so far is a better understanding of why and how psychotherapy works, a better understanding and appreciation for therapies such as EMDR and Neurolinguistic Programming, and more realistic expectations.
Amos,
The impact of decision and choice are huge. However, that tangle of hardwiring and experience strongly effects self-awareness, the capacity for insight, and the capacity to make effective use of insight. Each of us have 'blindspots' where we do not perceive choices that others see, where we mistake belief for 'absolute' or cling to our version of 'reality', or 'truth' come hell or high water, in spite of all evidence to the contrary.