Roll over, Freud, and tell Woody Allen the news. Today's psychiatrists are writing more prescriptions in favor of good, old-fashioned psychotherapy. And this shift from the couch to the prescription pad apparently reflects financial incentives from managed care and a greater number of available meds, according to a study in theArchives of General Psychiatry.
The researchers analyzed data from national surveys of office-based psychiatrist visits from 1996 through 2005, and found a significant drop in the number of office-based psychiatrists providing psychotherapy. Just 29 percent of office-based visits to psychiatrists involved psychotherapy in 2004 and 2005, down from 44 percent in 1996 and 1997. The decline coincided with changes in reimbursement, increases in managed care, and growth in the prescription of medications.
Visits provided under managed care tended not to include psychotherapy, according to the study, even though various forms of psychotherapy, either alone or in combination with medications, are recommended to treat depression, post-traumatic stress disorder, bipolar disorder and other psychiatric illnesses.
"Psychiatrists get more for three, 15-minute medication management visits than for one 45-minute psychotherapy visit," Ramin Mojtabai of Johns Hopkins University in Baltimore and one of the researchers, tells Reuters. But there is hope for a well-heeled few. "If you have some hard feelings about your childhood and you live in New York and have a lot of money, you can still find psychiatrists who provide long-term psychotherapy."