Tag Archives: Psychotherapy

What about our care?

Photo credit:  seiuhealthcare775nw

Last week I started a discussion as a result of some news articles I read.

The first article dealt with Dr. Donald Levin who felt that he could not provide both talk-therapy and medical treatment anymore.  Dinah Miller, MD, however, maintains the view that it is essential to receive both treatments from one qualified person.  John M Grohol PsyD introduced the thought that nowadays clinical psychologists,  amongst other mental health workers,  are much better trained in the area of psychotherapy than psychiatrists.

This led me to ask two questions:

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

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

One commenter, A. Karmin, wrote:

Since there are so many approaches to psych, it’s an asset to have various providers 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.

I love how he relates it to a dining experience!  Instead of staying with a health care provider who is not to our taste,  be it a p-doc,  counselor or some other therapist,  we should find one that is.  For this to happen we first need to know what care we need and want,  before we can go looking for it.

This can be as diverse as our food taste,  as Mommylebron’s comment shows:

I have an adult friend who sees a p-doc who is on charge of both her meds and therapy. However, in our case I feel that having one doctor who could cover both areas effectively would make it easier for me to keep up with my daughter’s treatment plan.

Since she is a mom to several children,  having  to go to different doctors for treatment is simply not an option.  So,  she needs to look for a p-doc providing both med and talk therapy with whom she and her daughter feel comfortable.  Unfortunately,  this can be quite a challenge…

Melody observes the following:

I believe it is imperative to have a level of continuity of care between the medication management and the therapeutic treatment to retrain the brain.

I wholeheartedly agree with this statement.  Oftentimes,  since diagnosis tends to happen during a crisis,  the medication treatment is started first.  Once the crisis  has passed or is under control there is room to start a form of therapeutic treatment.

My own care is divided between my counselor who resides in America and my p-doc and GP who live here in the Netherlands.  This is a pretty unusual situation and something the Dutch mental health system couldn’t deal too well with.

My counselor and I were already working together for over three years when I unexpectedly ended up back in my home country.  Through telephone and mostly Skype,  we continue our sessions as I was not willing to give up what we had built up over that time.  I am very grateful that it works very well for me!

I opted out of the Dutch mental health care system and found myself a psychiatrist in private practice,  specialized in mood disorders amongst other things.  My GP happens to know him and both of them have short links with the mental health care system.  Which is a reassuring thought!

With thanks to my commentors 😉


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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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