Tuesday, October 9, 2012

IPS Speakers Explore Barriers to Psychotherapy

Why don’t many psychiatrists do psychotherapy even though it works?

That’s a question Eric Plakun, M.D., and Joyce C. West, Ph.D., M.P.P., explored in a workshop at APA’s Institute on Psychiatric Services in New York. Plakun is a former chair of APA's Committee on Psychotherapy by Psychiatrists (now sunsetted) and director of admissions and professional relations at the Austen Riggs Center. West (pictured above) is policy research director for the American Psychiatric Institute for Research and Education (APIRE).

Plakun and West presented data from an APIRE survey of 394 psychiatrists. For respondents' "last typical work week," 48 percent said they provided psychopharmacology alone, 41 percent said they provided both pharmacology and psychotherapy, and 7 percent said they provided psychotherapy alone. (Five percent said they provided "other services.")

More than two-thirds said financial issues were prominent barriers to providing psychotherapy. The survey also found that psychiatrists who were more likely to provide psychotherapy were over 65 and worked in solo practice settings with 50 percent or more of patients who were self-pay or 50 percent or more who were privately insured. Psychiatrists who provided a significant amount of psychotherapy were also less likely to report that medical debt affected their practice of psychotherapy.

"It is quite a powerful finding that it is older psychiatrists who are preserving psychotherapy as a provision by psychiatrists, and it speaks to a problem of a lost generation in training,” Plakun said. “There is a lost generation that was trained at the point of the deepest commitment to biological reductionism. That’s part of the reason why the Committee on Psychotherapy by Psychiatrists was originally formed. There was a recognition...that psychotherapy was in danger of being a skill lost in the practicing of psychiatrists and the training of residents."

For more information about psychotherapy by psychiatrists, see Psychiatric News here. To view a video of Plakun discussing the survey after the IPS session, go here.
(Image: Mark Moran)


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