Fwd: Psychiatrists Who Rx Drugs Within 15 Min. Get More $$$ than 45 Min Therapy

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ALLIANCE FOR HUMAN RESEARCH PROTECTION Promoting Openness, Full Disclosure, and Accountability http://www.ahrp.org and http://ahrp.blogspot.com FYIWill the failure of psychopharmacology revitalize psychotherapy?Although the failure of psychoactive drugs to provide clinically significantbenefits is documented in controlled trials, psychiatrists cling to thesedrugs.But then, psychiatrists are paid far more for a patient's 15 minuteprescription visit than for spending 45 minutes on psychotherapy.That commercial bias toward drugs--no matter how severe the harm caused topatients--is what "distinguishes" psychiatry from other medical specialties.Psychiatry's most prescribed drugs, the second generation antidepressants(SSRIs), antipsychotics (so-called atypicals), and anti-seizure drugs havefailed to  demonstrate a sustained clinical benefit. However, thedebilitating adverse effects of these drugs are amply documented incontrolled clinical trials and patient outcome studies. Whatever the failures and abuses documented when psychotherapy waspsychiatry's rage--patients' physical health was not undermined by 100lbweight gain, by drug-induced diabetes and hyperglycemia, or drug-inducedsuicide. Little children were not prescribed drugs that caused lethal drugtoxicity--as four year old, Rebecca Riley was.Contact: Vera Hassner Sharavveracare212-595-8974http://abcnews.go.com/print?id=5511707Move Over, Couch: Psych Pills Take OverIn Era of Pills, Fewer Shrinks Doing Talk TherapyBy CARLA K. JOHNSONAssociated Press WriterAug. 4, 2008-CHICAGO (AP) - Cartoons about the psychiatrist's couch were recently thesubject of a museum exhibition. Now, the couch itself may be headed for amuseum.A new study finds a significant decline in psychotherapy practiced by U.S.psychiatrists.The expanded use of pills and insurance policies that favor short officevisits are among the reasons, said lead author Dr. Ramin Mojtabai of JohnsHopkins Bloomberg School of Public Health in Baltimore."The 'couch,' or, more generally, long-term psychoanalytic psychotherapy,was for so long a hallmark of the practice of psychiatry. It no longer is,"Mojtabai said.Today's psychiatrists get reimbursed by insurance companies at a lower ratefor a 45-minute psychotherapy visit than for three 15-minute medicationvisits, he explained.His study found that the percentage of patients' visits to psychiatrists forpsychotherapy, or talk therapy, fell from 44 percent in 1996-97 to 29percent in 2004-05. The percentage of psychiatrists using psychotherapy withall their patients also dropped, from about 19 percent to 11 percent.Psychiatrists who provided talk therapy to everyone had more patients whopaid out of pocket compared to those doctors who provided talk therapy lessoften. And they prescribed fewer pills.As talk therapy declined, TV ads contributed to an "aura of invincibility"around drugs for depression and anxiety, said Charles Barber, a lecturer inpsychiatry at Yale University and author of "Comfortably Numb: HowPsychiatry is Medicating a Nation.""By contrast, there's almost no marketing for psychotherapy, which hascomparable if not better outcomes," said Barber, who was not involved in thestudy.The findings, published in Monday's Archives of General Psychiatry, arebased on an annual survey of office visits to U.S. doctors. Of more than246,000 visits sampled during the 10 years, more than 14,000 were topsychiatrists. The researchers analyzed those psychiatrist visits.The study did not survey visits to psychologists or other mental healthcounselors who are not medical doctors, but who also practice talk therapy.Psychotherapy uses verbal methods to get patients to explore their emotionallife, thoughts or behavior. The goal is to ease symptoms, sometimes throughgetting the patient to change behavior or mental habits.Its benefits can be seen in brain imaging studies, said Dr. Eric Plakun, wholeads an American Psychiatric Association committee working to restoreinterest in psychotherapy by psychiatrists."The couch is far from dead," Plakun said. "The couch turns out to be aneffective 21st century treatment."Talk therapy can be done by psychiatrists less expensively than splittreatment, where a patient sees a doctor for pills and a counselor for talktherapy, Plakun said, citing two prior studies.It also works better than drugs for some patients, such as those withchronic major depression and a history of childhood trauma, he said.Accreditation requirements for psychiatric residency programs are puttingmore emphasis on talk therapy, Plakun said. That may slow the decline of thecouch.The new study doesn't answer an important question: whether otherprofessionals are picking up the slack, said psychologist David Mohr ofNorthwestern University's Feinberg School of Medicine. Psychologists andsocial workers provide counseling but most cannot prescribe drugs, so it'spossible that for patients who require both talk and pills, somecoordination in care may be lost, Mohr said.---On the Net: Archives of General Psychiatry: http://archpsyc.ama-assn.org/American Psychiatric Association: http://www.psych.org/(Copyright 2008 by The Associated Press. .)Copyright C 2008 ABC News Internet VenturesFAIR USE NOTICE: This may contain copyrighted (C ) material the use of whichhas not always been specifically authorized by the copyright owner. Suchmaterial is made available for educational purposes, to advanceunderstanding of human rights, democracy, scientific, moral, ethical, andsocial justice issues, etc. It is believed that this constitutes a 'fairuse' of any such copyrighted material as provided for in Title 17 U.S.C.section 107 of the US Copyright Law. This material is distributed withoutprofit. =====In accordance with Title 17 U.S.C. 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