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A psychiatrist criticises the psychiatric publishing industry

Posts Tagged ‘Tami Green’

Psychiatric Drugs Replacing Talk Therapy

As drugs move in, talk therapy moves out

By Erica Westly   

In the 1960s, the heyday of psychoanalysis, psychiatrists often saw their patients five days a week. But the number of psychiatrists today who focus on talk therapy is dwindling, according to a recent study that analyzed trends in psychiatry offices across the U.S. The study’s authors determined that between 1996 and 2005 the percentage of psychiatry office visits involving psychotherapy decreased from about 44.4 percent—already a significant decline from the 1980s—to 28.9 percent.

One of the main causes for this 35 percent reduction in psychotherapy, the study’s authors say, is the increasing availability of psychiatric medications with few adverse effects. As patient demand for these medications has increased over the years, they argue, many psychiatrists have had their hands full managing patients’ prescriptions, leaving the talk therapy—if it happens at all—to nonmedical therapists, such as psychologists and social workers. The authors suggest that insurance companies may encourage this arrangement by reimbursing less for psychotherapy sessions and more for medication management sessions, which tend to be shorter.

All these changes, the authors point out, have left psychiatrists wondering what their place is in the mental health field. “I think what these data show is a profession in transition,” says Mark Olfson, a psychiatrist and public health researcher at Columbia University and co-author of the study. “The role of the psychiatrist is changing, and the impact of that on patient outcomes is really an open question.”

Historically, psychiatrists have managed all aspects of patients’ care, and many psychiatrists who trained heavily in psychoanalytical techniques contend that such an all-­inclusive care model works best for patients. Others favor a split-care model, preferring to handle the medical side of patient care and delegating psychotherapy to nonmedical professionals. “We find there are really two kinds of psychiatrists now,” says Ramin Mojtabai, the study’s other author and a researcher at Johns Hopkins University’s Bloomberg School of Public Health.

It is not yet clear whether one care model benefits patients more than the other does, although some studies indicate, at least for disorders such as depression, that a combination of both psychotherapy and medication works better than either treatment alone. So psychiatrists who want to be involved in their patients’ psychotherapy need to make some changes to keep treatment financially feasible for patients, Olfson says. Many psychiatrists have started forming group practices with psychologists, which allows them to play a role in their patients’ therapy with fewer reimbursement issues from insurance companies.

Both patients and clinicians stand to gain from an office environment that integrates the biomedical perspective of psychiatrists with the more behavioral perspective of psychologists, says Mojtabai, who holds degrees in both disciplines. “Psychologists and psychiatrists look at problems somewhat differently and can work well together to help the patient,” he notes.

Note: This article was originally printed with the title, “Psychiatry in Flux”.

Source: Scientific American

 

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What is Biopsychiatry actually treating?


There is no such thing as normal. How can abnormal be judged in any meaningful way when normal isn’t well-defined. What is biopsychiatry actually treating? The method of treatment is medication. But, what is the medication actually treating? Dispensing psychiatric medication to patients – mental health consumers – is treating the very diagnostic pathology whose criteria are defined and categorized in the DSM by a very select group from the very same profession. Who is regulating this? Any governing body other than the psychiatric profession supposedly regulating itself? Biopsychiatry is in bed with Big Pharma. Who can this possibly benefit? How can it be more about the well-being of patients than about the making of money?

Blowing a hole in the purported “science” of biopsychiatry is simple. The first premise you need to re-frame is that of mental illness and mental health. If they are constructs that don’t actually translate the way that psychiatry claims they do, then how do all of these categories of pathological mental illnesses even hold water?

There is no such thing as normal. Mental Illness is not the opposite of mental health or visa versa. All human experience is on a spectrum. There is balance toward the center of that spectrum and lack of balance at either end of it. The rest is arbitrary really. In the up-coming next version of the bible of psychiatry, the Diagnostic and Statistical Manual (DSM) psychiatry is adding some 20 new disorders. Everything will soon be thought to be a disorder, that guess what, Big Pharma will pass along their funded studies to biopsychiatry to market its pathology to the public in the name of selling more and more medications.

This is not treatment. It is abuse. Abuse of power. It is self-serving. It is “treatment” in the guise of the making of money off the backs of people who do need real human solutions to their real human problems and challenges.

 

 

 

If you’ve been treated by a psychiatrist where therapy is absent but prescriptions are routinely given I’d be interested in hearing from you as to whether you think you are getting any help or not. Are you feeling better? Are you making progress? Are you getting well? Can you feel anything with the meds you are on?

 

You can email me by clicking  on the link in the footer below this post at the bottom of the site.

 

 

© A.J. Mahari, August 9, 2010 – All rights reserved.

 

 

 

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Psychiatry – Making a Killing

Source: Truthfultv on YouTube.com


Join my email list and you will be able to join me in free conference calls and ask me your questions about BPD and recovery or for loved ones ways to cope as a loved one or questions about staying or leaving and much more. I will also be having some free conference calls for subscribers to my newsletter on the general topic of mental illness and how you can really empower yourself if you've been diagnosed with a mental illness in ways that can create positive healthy change in your life.