August 5th, 2008
Talk therapy becomes a luxury
Have you been to a therapist lately and just gotten pills?
It’s becoming the norm. (Hector Elizondo, right, took on the role of the psychiatrist on Monk this season following the death of Stanley Kamel.)
A study published this week in the AMA’s Archives of General Psychiatry, conducted through Columbia and Beth Israel Hospitals, found the percentage of “talk hour” visits declined by a third from 1996-2005.
Instead, over 7 in 10 visits by 2004-2005 were just 15-minute “med checks.”
Some stories on the study suggested the profession made this happen, but the authors, Ramin Mojtabai and Mark Olfson, were clear about the cause in their abstract.
It’s insurance which has made pills more profitable than talk.
Psychiatrists who provided psychotherapy to all of their patients relied more extensively on self-pay patients, had fewer managed-care visits, and prescribed medications in fewer of their visits compared with psychiatrists who provided psychotherapy less often.
It’s true that talk therapy is hard to measure, and sometimes ineffective. Too little work is done matching patients to therapists’ therapeutic styles.
I personally wasted five years on a standard talk therapy regimen before finding someone whose “coaching ” technique worked for my ADHD.
My kids were treated with medicine for their ADHD before adolescence, when talk therapy began delivering serious benefits. Neither takes medicine today.
Meanwhile the long-term effectiveness of drugs like anti-depressants remains unclear, with one recent study showing they’re worthless except for the worst cases. And we all know about the ongoing “Ritalin Wars” surrounding ADHD.
The mind is the most complex organ ever created. Treating it is as much art as science. There are no guarantees with any treatment regimen.
So why are insurers forcing pills down your throat?
Dana Blankenhorn has been a business journalist since 1978, and has covered technology since 1982. He launched the Interactive Age Daily, the first daily coverage of the Internet to launch with a magazine, in September 1994. See his full profile and disclosure of his industry affiliations.
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