Psychiatrists Prefer Pills Over Therapy
Posted on: Tuesday, 5 August 2008, 07:35 CDT
U.S. psychiatrists are embracing prescriptions over psychotherapy, according to a study released on Monday.
The shift to quicker visits for medication appears to be linked to better drugs and pressure from manage care companies, which offer monetary incentives for short office visits.
"Psychiatrists get more for three, 15-minute medication management visits than for one 45 minute psychotherapy visit," said Dr. Ramin Mojtabai of Johns Hopkins University in Baltimore. Dr. Mojtabai formerly worked at Beth Israel Medical Center in New York where he conducted the study’s research.
Many forms of psychotherapy are recommended to treat psychiatric illnesses, sometimes in combination with medications.
Mojtabai and colleagues found a sizeable fall in the amount of office-based psychiatrists providing psychotherapy after analyzing data from psychiatrist visits from 1996 through 2005.
According to Mojtabai, office-based visits to psychiatrists offering psychotherapy has gone down 15 percent since 1996-97.
One influence on this trend is that patients who need psychotherapy treatment must receive it from other professionals, said Mojtabai.
The result can be disjointed service, where a patient sees a social worker or psychologist for therapy, and a general physician for drugs.
"Whether it has any impact on the outcome of the disorder, we don't really know," Mojtabai said. "I don't think necessarily that it is harmful. It might not be as efficient."
Dr. Eric Plakun, leader of an American Psychiatric Association committee on psychotherapy, said he first noticed a transition away from psychotherapy 10 years ago, when psychiatrists began to favor “the age of the brain.’
According to Plakun, medical schools began to teach more of the biology of mental illness than traditional psychotherapy. Through time the trend has appeared in practices across the U.S.
It is not clear if patients are receiving therapy from other providers, Plakun said.
"Either way, I'm worried about our patients," he added. "Patients need the best help we can give them."
For Plakun, giving the best to patients means offering a multitude of services including psychotherapy, and not just medication. "If all you have is a hammer, everything looks like a nail," he said.
Mojtabai believes patients are receiving psychotherapy from others. The focus is probably different from the analysis psychiatrists would offer, he added.
"Psychologists and social workers are more likely to provide short-term cognitive behavioral therapy," which focuses on changing harmful behaviors, he said.
The type of psychoanalysis often featured in movies, is available to a select few.
"If you have some hard feelings about your childhood and you live in New York and have a lot of money, you can still find psychiatrists who provide long-term psychotherapy," Mojtabai said.
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Source: redOrbit Staff & Wire Reports
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