A heated discussion?

A heated discussion

Photo credit: ktylerconk

About a week ago,  while catching up on my reading,  I came across an interview of Dr Donald Levin by Gardiner Harris.  This extensive interview appeared in the  New York Times on March 5.  The title stated that talk-therapy doesn’t pay  (as in,  insurance doesn’t cover those costs),  so psychiatrists (have to) turn to drug treatment instead.

The title is somewhat misleading as the article mainly revolves around Dr. Donald Levin’s working life.  He started private practice back in 1972, but worked in hospitals from 1985 till 2000,  before starting his private practice again.

As to be expected with the relapse of time, the practice of psychiatry had changed.  For Dr. Donald Levin it meant that where he previously provided medical ánd talk therapy,  he slowly turned solely to dealing with drug treatment.  It appears to me that he blames the system for this situation.

However,  there are still many psychiatrists offering both treatments.  One of them is Dinah Millar M.D.,  who wrote a response to this interview in Psychology Today (March 7),  that psychotherapy and psychiatry are still the best of partners.  She maintains the view that patients get the best of care when only one doctor is involved providing both treatments.

So,  maybe it is more about doing what you believe in,  without letting the amount of earnings stand in the way?

It is unfortunate for all medical doctors that the world of insurance has so much to say about which treatment receives coverage.  I consider it worse though,  for us,  as it greatly influences the choices we can make while  ‘shopping’  for the care we need.

John M Grohol PsyD,  the CEO and founder of the Psych Central website,  expresses in his blog that nowadays clinical psychologists,  amongst other mental health workers,  are much better trained in the area of psychotherapy than psychiatrists.

It is a given that time brings change.  It can be debated,  however,  if all changes are good changes.

Perhaps one of the biggest changes within psychiatry is the appearance of other mental health givers providing different varieties of (talk-)therapy.  Thus the ‘old’ idea that (psycho)therapy is only connected with psychiatrists is – well,  old!

What we should ask ourselves,  is what the consequences of this change are for us and how it influences the care we need and receive.

The question is,  in my opinion,  twofold:

*   What to think of the appearance of other mental health workers providing various types of (talk-)therapy?

*   Is it really better to be treated by one doctor providing talk-therapy as well as medical treatment?

I really like to know what you think!

Please,  share in the comment section or via the  ‘contact me’  page in the left hand top corner.  Thank you!

This post has been followed up with What about our care?


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7 responses to “A heated discussion?

  1. Medication stabilizes the mood, but cannot change the way you think. Most people do not like the idea of taking medication. Even if you get an infection and the prescription says take till completed, most people will take the med till they feel better then stop taking it. Yet, when psych meds are stopped abruptly it leads to a rebound of the mood symptoms, creating a vicious cycle of ups and downs.

    If you break your arm, every doctor will do the same thing, put your arm in a cast. But if you are depressed, there are numerous ways to mange the symptoms. Since there are so many approachs to psych, its an asset to have various proividers to turn to. If one has a negative experience it does not mean they should stop all treatment, rather they need to find a new provider. Kinda like if you go to a bad restaurant, you don’t stop eating, you just find another place to dine. The bottom line is to find the kind of treatment that suits your taste.

    • AKarmin, welcome to my blog!
      Your interview with Anne Elizabeth Moore was an interesting read 🙂
      I simply love your comparison with food (and not only because I love food 🙂 ) – and totally agree! We all have different tastes and needs. Thanks so much for adding your perspective – the more, the better!

  2. mommylebron

    I think this really depends on the patient’s needs. I have a adult friend who sees a pdoc who is on charge of both her meds and therapy but she feels he down plays her need for therapy and only focuses on meds. However, in our case I feel that having one dr who could cover both areas effectively would make it easier for me to keep up with my daughter’s treatment plan.

    • Moomylebron, thanks for adding to the discussion! Yes, I can see how it simplifies your life – there are enough challenges as it is! The next question is then: how easy is it to find a pdoc who adequately addresses both… Hope you have a good pdoc helping you out! It is really our primary care, isn’t it?

  3. I believe it is imperative to have a level of continuity of care between the medication management and the therepeudic treatment to retrain the brain. For my children – as well as my ADHD self – medication is the key to start the vehicle of education, repetition, and practice to propel forward movement. We need BOTH!

    • OK, It’s really weird to see that I wrote this 5hrs from now! I’m in the Twilight Zone…. lol. COOL.

    • Melody, I think you are so right that we need both! And often, since we get diagnosed in a crisis, the first we receive is medication. I totally agree that the second, retraining our brain, has to follow.
      Thanks for adding to the discussion, cool!

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