Whether psychotherapy is cost-effective was an important question during President Clinton's health care reform effort. Lessons from that era remain relevant during current health reform debates.
If psychotherapy has a place in the American health care system of tomorrow, give some credit to psychiatrist Susan Lazar, M.D., and other clinician-researchers who helped establish the evidence base for the cost-effectiveness of psychotherapy beginning more than 16 years ago.
That was when Hillary Rodham Clinton's Health Care Task Force was at work. Though the exact content of health insurance benefit packages hasn't yet been a focus of today's health care debates, a decade and a half ago task force members were weighing the relative value of any health care service as a criterion for inclusion in mandated benefits.
And “value” meant cost-effectiveness—the cost of providing the service compared with the benefits derived from the service.
READ MORE @ PSYCHIATRIC NEWS
Showing posts with label psychotherapy. Show all posts
Showing posts with label psychotherapy. Show all posts
Tuesday, November 24, 2009
Friday, October 3, 2008
Long-term psychotherapy is superior, study finds
Psychotherapy lasting for at least one year is more effective than shorter periods of therapy for people with complex mental disorders, such as personality and chronic disorders, according to a study published today in the Journal of the American Medical Assn. The success of dedicated psychotherapy may matter little, however, because fewer doctors are offering the service and fewer insurers are covering it.
In long-term psychodynamic psychotherapy, the therapist provides continued, close support for the patient while the pair work through problems and interventions. The JAMA study, from researchers in Germany, was an examination of 23 studies on the success of psychotherapy. It found that longer-term therapy (one year or longer) was superior to shorter-term methods in regard to overall outcome and personality functioning. On average, patients with complex mental conditions who were treated long-term were better off than 96% of the patients in the comparison groups.
READ MORE @ LOS ANGELES TIMES
In long-term psychodynamic psychotherapy, the therapist provides continued, close support for the patient while the pair work through problems and interventions. The JAMA study, from researchers in Germany, was an examination of 23 studies on the success of psychotherapy. It found that longer-term therapy (one year or longer) was superior to shorter-term methods in regard to overall outcome and personality functioning. On average, patients with complex mental conditions who were treated long-term were better off than 96% of the patients in the comparison groups.
READ MORE @ LOS ANGELES TIMES
Friday, August 8, 2008
Psychiatrists Prescribing More Drugs, But Not Psychotherapy
A declining number of office-based psychiatrists appear to be providing psychotherapy to their patients, according to a report in the August issue of Archives of General Psychiatry.
Psychotherapy has been part of the practice of psychiatry for generations. "Yet, despite the traditional prominence of psychotherapy in psychiatric practice and training, there are indications of a recent decline in the provision of psychotherapy by US psychiatrists -- a trend attributed to reimbursement policies favouring brief medication management visits rather than psychotherapy and the introduction of newer psychotropic medications with fewer adverse effects," the authors wrote.
Ramin Mojtabai, MD, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, and Mark Olfson, MD, Columbia University Medical Center and New York State Psychiatric Institute, New York, New York, analysed trends in psychotherapy provision using data from national surveys of office-based psychiatrist visits from 1996 through 2005.
READ MORE @ DOCTOR'S GUIDE
Psychotherapy has been part of the practice of psychiatry for generations. "Yet, despite the traditional prominence of psychotherapy in psychiatric practice and training, there are indications of a recent decline in the provision of psychotherapy by US psychiatrists -- a trend attributed to reimbursement policies favouring brief medication management visits rather than psychotherapy and the introduction of newer psychotropic medications with fewer adverse effects," the authors wrote.
Ramin Mojtabai, MD, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, and Mark Olfson, MD, Columbia University Medical Center and New York State Psychiatric Institute, New York, New York, analysed trends in psychotherapy provision using data from national surveys of office-based psychiatrist visits from 1996 through 2005.
READ MORE @ DOCTOR'S GUIDE
Tuesday, August 5, 2008
Medication increasingly replaces psychotherapy, study finds
Fewer patients are undergoing in-depth treatment as antidepressants and other drugs are more widely used. The shift is attributed partly to insurance reimbursement policies.
Wider use of antidepressants and other prescription medications has reduced the role of psychotherapy, once the defining characteristic of psychiatric care, according to an analysis published today.
The percentage of patients who received psychotherapy fell to 28.9% in 2004-05 from 44.4% in 1996-97, the report in Archives of General Psychiatry said.
Researchers attributed the shift to insurance reimbursement policies that favor short medication visits compared with longer psychotherapy sessions, and to the introduction of a new generation of psychotropic medications with fewer side effects.
Although not a surprise to many psychiatrists, the findings were expected to intensify a debate over the increased medicalization of psychiatric care, which in part reflects an emphasis on the biology of mental illness, as opposed to the processes of the mind.
Psychotherapy is an interpersonal intervention that may involve such things as behavior modification and group discussion. It is recommended -- with or without medication -- for major depression, post-traumatic stress disorder, bipolar disorder and other psychiatric illnesses.
READ MORE @ LOS ANGELES TIMES
Wider use of antidepressants and other prescription medications has reduced the role of psychotherapy, once the defining characteristic of psychiatric care, according to an analysis published today.
The percentage of patients who received psychotherapy fell to 28.9% in 2004-05 from 44.4% in 1996-97, the report in Archives of General Psychiatry said.
Researchers attributed the shift to insurance reimbursement policies that favor short medication visits compared with longer psychotherapy sessions, and to the introduction of a new generation of psychotropic medications with fewer side effects.
Although not a surprise to many psychiatrists, the findings were expected to intensify a debate over the increased medicalization of psychiatric care, which in part reflects an emphasis on the biology of mental illness, as opposed to the processes of the mind.
Psychotherapy is an interpersonal intervention that may involve such things as behavior modification and group discussion. It is recommended -- with or without medication -- for major depression, post-traumatic stress disorder, bipolar disorder and other psychiatric illnesses.
READ MORE @ LOS ANGELES TIMES
Tuesday, September 11, 2007
When Antidepressant Drugs Are Not Enough - A New Study On Their Combination With Psychotherapy
A group of Dutch investigators has reported on a new study on the combination of antidepressant drugs and psychotherapy in the September issue of Psychotherapy and Psychosomatics.
Although several forms of effective therapy exist for outpatients suffering from major depressive disorder, many patients do not profit from treatment. Combining psychotherapy and medication may be an effective strategy. However, earlier studies have rarely found a clear advantage for the combination. Where an advantage was found, a possible placebo effect of adding 2 types of treatment could not be ruled out as cause for the superior effect of the combination. A total of 353 patients were screened, of whom 193 were randomized over 4 conditions: nefazodone plus clinical management, interpersonal psychotherapy (IPT), the combination of the two or the combination of IPT and pill-placebo. All patients suffered from major depressive disorder and had a score of at least 14 on the 17-item Hamilton Rating Scale (HAMD).
READ MORE @ INNOVATIONS REPORT
Although several forms of effective therapy exist for outpatients suffering from major depressive disorder, many patients do not profit from treatment. Combining psychotherapy and medication may be an effective strategy. However, earlier studies have rarely found a clear advantage for the combination. Where an advantage was found, a possible placebo effect of adding 2 types of treatment could not be ruled out as cause for the superior effect of the combination. A total of 353 patients were screened, of whom 193 were randomized over 4 conditions: nefazodone plus clinical management, interpersonal psychotherapy (IPT), the combination of the two or the combination of IPT and pill-placebo. All patients suffered from major depressive disorder and had a score of at least 14 on the 17-item Hamilton Rating Scale (HAMD).
READ MORE @ INNOVATIONS REPORT
Monday, July 2, 2007
Suicide attempts decline after depression treatment
In a study of more than 100,000 patients treated for depression, suicide attempts declined during the first month of treatment—whether that treatment consisted of medication, psychotherapy, or both. The findings, published in the July American Journal of Psychiatry, show a similar pattern for populations of adolescents and young adults (up to age 24) as for older adults.
The study sheds new light on the “black box” advisory the FDA placed in 2004 and has revised since then, said a psychiatrist who led the study. The advisory—which has concerned many patients, families, and care providers—warns that suicidal behavior may emerge soon after people younger than 25 start treatment with newer antidepressant medications called selective serotonin reuptake inhibitors (SSRIs). It was spurred by randomized placebo-controlled trials showing that starting to take an SSRI can make thoughts of suicide more common among some teens and young adults.
The study is the first published research to compare the risk of suicide attempts before and after the start of treatment with not only antidepressants but also psychotherapy. It is based on computerized medical and pharmacy records for more than 109,000 patients who started treatment for depression from 1996 to 2005
READ MORE @ EUREKALERT
The study sheds new light on the “black box” advisory the FDA placed in 2004 and has revised since then, said a psychiatrist who led the study. The advisory—which has concerned many patients, families, and care providers—warns that suicidal behavior may emerge soon after people younger than 25 start treatment with newer antidepressant medications called selective serotonin reuptake inhibitors (SSRIs). It was spurred by randomized placebo-controlled trials showing that starting to take an SSRI can make thoughts of suicide more common among some teens and young adults.
The study is the first published research to compare the risk of suicide attempts before and after the start of treatment with not only antidepressants but also psychotherapy. It is based on computerized medical and pharmacy records for more than 109,000 patients who started treatment for depression from 1996 to 2005
READ MORE @ EUREKALERT
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