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Henry Stein April 16th, 2011 08:59 PM

Psychiatry Turning to Drug Therapy
In a March 5th, 2011 article in the New York Times, reporter Gardiner Harris describes the trend of psychiatrists in the united States giving up talk therapy completely and only prescribing medication. Reduced insurance payments and pressure from hospitals and corporation have resulted in many psychiatrists seeing 1,200 patients for prescription adjustments, in 12-15 minute visits, often several months apart. With a catastrophic loss of intimacy, many psychiatrists cannot even remember their patients' names. A typical psychiatrist now sees 3-4 people in an hour, working an 11-hour day (40 patients/day!). In 2005, only 11 percent of psychiatrists provided talk therapy, leaving the field open to psychologists, marriage & family therapists, and social workers. Sadly, the profession seems to have caved in to a hard-nosed business practice. However, a few adventurous psychiatrists have cut ties with insurers, relying on full payment from clients and word-of-mouth referrals. The article does acknowledge that there is no evidence that psychiatrists provide higher quality talk therapy than psychologists, marriage and family therapists, or social workers. Is it possible that some of these psychiatrists might have been able to sustain a talk therapy practice by getting better training?

George Neeson May 1st, 2011 09:29 PM

Re: Psychiatry Turning to Drug Therapy
In Canada it appears to me that many psychiatrists are not trained to correct the patient's mistakes. Their training has to do with DSM diagnostic resolution of the observed problem. The core argument central to current psychiatric practice is that genetically determined neurotransmitter anomalies are total and sufficient causes of the distresses observed. Therapists more generally accept the notion that the patient's view of world, self and others mediate the nature and release of the transmitters that control affect and thought. It seems to be a causality problem in that psychiatrists too often are trained to ignore the patients conscious and unconscious will to create feelings. What I conclude about modern psychiatry, is that it is much too mechanistic. I also feel it has not subjected its beliefs to the tests of good, hard science, but rather runs with testable, yet still untested assumptions.
There also seems to be too much financial and corporate business pressure for quick and less satisfactory outcomes.

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