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Psychiatrists are the least religious of all physicians
by PhysOrg.com
Reposted from:
http://www.physorg.com/news108005993.html
A nationwide survey of the religious beliefs and practices of American physicians has found that the least religious of all medical specialties is psychiatry. Among psychiatrists who have a religion, more than twice as many are Jewish and far fewer are Protestant or Catholic, the two most common religions among physicians overall.
The study, published in the September 2007 issue of Psychiatric Services, also found that religious physicians, especially Protestants, are less likely to refer patients to psychiatrists, and more likely to send them to members of the clergy or to a religious counselor.
"Something about psychiatry, perhaps its historical ties to psychoanalysis and the anti-religious views of the early analysts such as Sigmund Freud, seems to dissuade religious medical students from choosing to specialize in this field," said study author Farr Curlin, MD, assistant professor of medicine at the University of Chicago. "It also seems to discourage religious physicians from referring their patients to psychiatrists."
"Previous surveys have documented the unusual religious profile of psychiatry," he said, "but this is the first study to suggest that that profile leads many physicians to look away from psychiatrists for help in responding to patients' psychological and spiritual suffering."
"Because psychiatrists take care of patients struggling with emotional, personal and relational problems," Curlin said, "the gap between the religiousness of the average psychiatrist and her average patient may make it difficult for them to connect on a human level."
In 2003, to learn about the contribution of religious factors on physicians' clinical practices, Curlin and colleagues surveyed 1,820 practicing physicians from all specialties, including an augmented number of psychiatrists; 1,144 (63%) physicians responded, including 100 psychiatrists.
The survey contained questions about medical specialties, religion, and measures of what the researchers called intrinsic religiosity—the extent to which individuals embrace their religion as the "master motive that guides and gives meaning to their life."
Although 61 percent of all American physicians were either Protestant (39%) or Catholic (22%), only 37 percent of psychiatrists were Protestant (27%) or Catholic (10%). Twenty-nine percent were Jewish, compared to 13 percent of all physicians. Seventeen percent of psychiatrists listed their religion as "none," compared to only 10 percent of all doctors.
Curlin's survey also included this brief vignette, designed to present "ambiguous symptoms of psychological distress" as way measure the willingness of physicians to refer patients to psychiatrists.
"A patient presents to you with continued deep grieving two months after the death of his wife. If you were to refer the patient, to which of the following would you prefer to refer first" (a psychiatrist or psychologist, a clergy member or religious counselor, a health care chaplain, or other)."
Overall, 56 percent of physicians indicated they would refer such a patient to a psychiatrist or psychologist, 25 percent to a clergy member or other religious counselor, 7 percent to a health care chaplain and 12 percent to someone else.
Although Protestant physicians were only half as likely to send the patient to a psychiatrist, Jewish physicians were more likely to do so. Least likely were highly religious Protestants who attended church at least twice a month and looked to God for guidance "a great deal or quite a lot."
"Patients probably seek out, to some extent, physicians who share their views on life's big questions," Curlin said. That may be especially true in psychiatry, where communication is so essential. The mismatch in religious beliefs between psychiatrists and patients may make it difficult for patients suffering from emotional or personal problems to find physicians who share their fundamental belief systems.
Source: University of Chicago
http://www.physorg.com/news108005993.html
A nationwide survey of the religious beliefs and practices of American physicians has found that the least religious of all medical specialties is psychiatry. Among psychiatrists who have a religion, more than twice as many are Jewish and far fewer are Protestant or Catholic, the two most common religions among physicians overall.
The study, published in the September 2007 issue of Psychiatric Services, also found that religious physicians, especially Protestants, are less likely to refer patients to psychiatrists, and more likely to send them to members of the clergy or to a religious counselor.
"Something about psychiatry, perhaps its historical ties to psychoanalysis and the anti-religious views of the early analysts such as Sigmund Freud, seems to dissuade religious medical students from choosing to specialize in this field," said study author Farr Curlin, MD, assistant professor of medicine at the University of Chicago. "It also seems to discourage religious physicians from referring their patients to psychiatrists."
"Previous surveys have documented the unusual religious profile of psychiatry," he said, "but this is the first study to suggest that that profile leads many physicians to look away from psychiatrists for help in responding to patients' psychological and spiritual suffering."
"Because psychiatrists take care of patients struggling with emotional, personal and relational problems," Curlin said, "the gap between the religiousness of the average psychiatrist and her average patient may make it difficult for them to connect on a human level."
In 2003, to learn about the contribution of religious factors on physicians' clinical practices, Curlin and colleagues surveyed 1,820 practicing physicians from all specialties, including an augmented number of psychiatrists; 1,144 (63%) physicians responded, including 100 psychiatrists.
The survey contained questions about medical specialties, religion, and measures of what the researchers called intrinsic religiosity—the extent to which individuals embrace their religion as the "master motive that guides and gives meaning to their life."
Although 61 percent of all American physicians were either Protestant (39%) or Catholic (22%), only 37 percent of psychiatrists were Protestant (27%) or Catholic (10%). Twenty-nine percent were Jewish, compared to 13 percent of all physicians. Seventeen percent of psychiatrists listed their religion as "none," compared to only 10 percent of all doctors.
Curlin's survey also included this brief vignette, designed to present "ambiguous symptoms of psychological distress" as way measure the willingness of physicians to refer patients to psychiatrists.
"A patient presents to you with continued deep grieving two months after the death of his wife. If you were to refer the patient, to which of the following would you prefer to refer first" (a psychiatrist or psychologist, a clergy member or religious counselor, a health care chaplain, or other)."
Overall, 56 percent of physicians indicated they would refer such a patient to a psychiatrist or psychologist, 25 percent to a clergy member or other religious counselor, 7 percent to a health care chaplain and 12 percent to someone else.
Although Protestant physicians were only half as likely to send the patient to a psychiatrist, Jewish physicians were more likely to do so. Least likely were highly religious Protestants who attended church at least twice a month and looked to God for guidance "a great deal or quite a lot."
"Patients probably seek out, to some extent, physicians who share their views on life's big questions," Curlin said. That may be especially true in psychiatry, where communication is so essential. The mismatch in religious beliefs between psychiatrists and patients may make it difficult for patients suffering from emotional or personal problems to find physicians who share their fundamental belief systems.
Source: University of Chicago
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Posted: Monday, September 3, 2007 | PermalinkComments 1 - 37 of 37 |
Reload Comments | Back to Top | Page Numbers2. Comment #67556 by Dr Benway on September 3, 2007 at 7:39 pm
I ask a person, what's your support system? Who do you call when you're feeling down? If a religious group is part of that, and if it's not driving the patient crazy, I'm glad it's there. It sucks to be depressed. Any source of human kindness is welcome. Other Comments by Dr Benway
3. Comment #67560 by oxytocin on September 3, 2007 at 7:44 pm
I've never seen data for Psychologists, but I must say that a surprising number of my colleagues in both academia and in hospital practice endorse a faith of some sort. Not that my experience says anything of substance, of course...I'd like to see the data if there is any.The article also mentioned Freud...I would recommend reading his monograph "The Future of an Illusion", which is a brilliant statement about the nature of religion. Granted, it's not empirically derived, but fascinating nonetheless.
Other Comments by oxytocin
4. Comment #67562 by wolf mechanics on September 3, 2007 at 7:53 pm
"Because psychiatrists take care of patients struggling with emotional, personal and relational problems," Curlin said, "the gap between the religiousness of the average psychiatrist and her average patient may make it difficult for them to connect on a human level."
So whether or not two humans can connect on a human level depends upon a superhuman imaginary friend?
Other Comments by wolf mechanics
5. Comment #67567 by eric.malitz on September 3, 2007 at 8:31 pm
I am beginning as a psychology grad student (for a PsyD) and I'm an atheist. In fact, I am interested in dealing with people who may be 'burdened' by irrational beliefs, including religious. Certainly it seems the potential of psychological damage via religion is very high right now.Other Comments by eric.malitz
6. Comment #67568 by sabre_truth on September 3, 2007 at 8:33 pm
The best counselor I saw when I was dealing with substance abuse issues was my last psychiatrist. The LCC I was seeing at the time was keen on promoting 12 steps. With my psychiatrist, I could express myself with greater understanding, being of a skeptical scientific bent. Unfortunately, the program was set up where they tried to discourage seeing the psychiatrist for counseling, instead only for medication consultation and follow-up. He said that it would be fine if I saw him apart from medication concerns, but of course, it cost 3 times as much for the same amount of time as one of the LCCs or LISWs.Other Comments by sabre_truth
7. Comment #67574 by oxytocin on September 3, 2007 at 9:04 pm
Thanks Beth. I hope that data gets published. Your hypothesis is a sound one...although I would guess that clinical psychologists would still be lower than the general public given the higher level of education. In any case, if true, it would mark another point of departure between psychology and psychiatry...there's some interesting data out there documenting the differences in personality, paradigm, and cognitive style. Not that group differences have been tested, but I would actually be pretty surprised if, on the whole, psychologists weren't more non-theistic than psychiatrists given that we're trained as scientists whereas the majority of physicians are not.
eric.malitz: I do cognitive-behavior therapy in my practice...I therefore have the pleasure of challenging irrational beliefs all day!
sabre_truth: my condolences on the cost issue. I sincerely hope that the States [I'm assuming that's where you are] eventually adopts universal health care.
Other Comments by oxytocin
8. Comment #67578 by BAEOZ on September 3, 2007 at 9:52 pm
Hey Oxytocin. I'm studying psych part time and was quite interested in cbt. How do you challenge irrational theistic beliefs? I think you have to put up with them, as they're not considered delusions like say, someone believing that a burning bush is talking to them.....oh wait, that's considered normal too. :) Other Comments by BAEOZ
9. Comment #67609 by chezzyd on September 4, 2007 at 2:23 am
Dr Benway on September 3, 2007 at 7:39 pm"I ask a person, what's your support system? Who do you call when you're feeling down? If a religious group is part of that, and if it's not driving the patient crazy, I'm glad it's there. It sucks to be depressed. Any source of human kindness is welcome"
Though personally I think that religious groups often prey on vulnerable people and have them blaming all kinds of things for their illness except the fact that it's an illness and needs treatment. If anything using religion as a crutch is more likely to drive you crazy. Human kindness from any source is one thing, convincing someone that believing in a Sky Fairy will solve all their problems is something else..
Other Comments by chezzyd
10. Comment #67615 by mdowe on September 4, 2007 at 2:57 am
Re: Comment #67578 by BAEOZ
How do you challenge irrational theistic beliefs?
I suggest going straight to electro-shock. Reason and rational argument rarely ever have any effect, and at least you'll get a bit of satisfaction >=)
Other Comments by mdowe
11. Comment #67622 by Richard Morgan on September 4, 2007 at 3:36 am
I wish the title of this article had been :Psychiatrists are the least religious of all physicians in the USAI live in France, a country where we have universal health care, and where medical practitioners refer their patients to medical practitioners.
Inasmuch as a religious belief is so obviously a neurotic construct, albeit a socially integrated one, I can't imagine (though I have no statistical proof) a French doctor sending a depressed patient to a professional neurotic (priest/pastor etc) rather than a specialist in psychological problems - a psychiatrist or a psychologist. Though curiously enough, in France, psychiatric treatment is covered by health insurance but NOT treatment by a psychologist.
On the negative side, we do have "homoeopathic" doctors, but I suspect that has more to do with bank accounts than beliefs.
Other Comments by Richard Morgan
12. Comment #67630 by Yorker on September 4, 2007 at 4:19 am
1. Comment #67554 by BAEOZ "So it's not just Tom Cruise and the his cadre of supernaturalists who dislike psychiatrists"
Correct. There are many people who dislike psychiatry because its basis is not scientifically sound. Richard Feynman was one of the first great scientists to point this out and felt insulted when he was forced to see a psychiatrist before working at Los Alamos, he told the guy what he thought and terminated the interview. They still wanted him though.
At a psychiatric conference a few years ago, several practitioners admitted in interview they'd never cured anyone of anything.
The article's conclusion is not surprising given the undeniable ability of Jewish people to make money; there's a lot of money in psychiatry, particulary in the USA. I make this comment based on years of experience working with Jewish people, indeed, some are among my best friends and most people I've admired throughout life have been Jews. The simple fact is I've never met a broke Jew, so it doesn't surprise me they find this job attractive.
Personally, I've never understood the need for psychiatry; like most, I've suffered tragedy and occasional depression but never even considered consulting a GP on such matters. If I was ever forced into psychiatric consultation it would inevitably become confrontational, I'd want a detailed explanation of how they could possibly help me overcome a mental problem I couldn't overcome myself. I don't think they could give me a satisfactory answer.
I well remember my father telling me the most important and kindest thing he could do for me was to make me independent and self-reliant as early as possible in life. It worked for me and I applied that philosophy to the upbringing of my own children, so far, it's worked for them also.
Other Comments by Yorker
13. Comment #67633 by Yorker on September 4, 2007 at 4:41 am
This is perhaps not the right place for this, but I wonder how many people try to get a doctor whose religiosity -- or lack thereof -- matches their own?I certainly did, how about you?
Other Comments by Yorker
14. Comment #67634 by scooternyc on September 4, 2007 at 4:41 am
So much of the recovery movement in AA and other such cults, are rooted in the idea of a "higher power". I find this completely irresponsible in its precepts and found it difficult to counsel people when I was in this profession for many years. The idea itself delegates responsibility and accountability to the "higher power" especially when it boasts, ""Came to believe that a power greater than ourselves could restore us to sanity" and most of the rest are just as inane.
This is so unbelievably absurd. It substitutes one addiction for another.
No form of counseling can support anyone if its foundation is not that of teaching the individual how to evaluate his/her life through the observation of action/reaction, that choice is relegated only to the individual and all choices are the responsibility of the individual.
Other Comments by scooternyc
15. Comment #67635 by Yorker on September 4, 2007 at 4:46 am
15. Comment #67634 by scooternyc "The idea itself delegates responsibility and accountability to the "higher power" especially when it boasts, ""Came to believe that a power greater than ourselves could restore us to sanity" and most of the rest are just as inane."
I didn't know that; it's enough to make one turn to booze!
Other Comments by Yorker
16. Comment #67642 by Prufrock on September 4, 2007 at 5:19 am
So how does a vicar cure someone of depression or treat the more severe symptoms of schizophrenia? I take it there must be a counselling component to curing mental illness in which case I can understand the sentiment of the final paragraph, though:"Patients probably seek out, to some extent, physicians who share their views on life's big questions"
sounds a bit strange as I don't even seek out my friends this way.
I have very little time for the counselling profession, though I daresay they do a good job for those who think they need them. I prefer practical, constructive and mutually beneficial relationships personally. I live by the win win motto.
Problems are for solving not for worrying about and wading in.
Other Comments by Prufrock
17. Comment #67645 by gibodean on September 4, 2007 at 5:28 am
Conmen are least likely to give money to someone based on trust.Magicians are least likely to be scammed by slight of hand.
Mentalists are least likely to be scammed by "psychics" doing cold reading.
Psychiatrists are least likely to fall for the mind games of religion.
This isn't really news.
Other Comments by gibodean
18. Comment #67651 by oxytocin on September 4, 2007 at 6:31 am
BAEOZ: I NEVER challenge patients' religious ideology. One of our highest ethical standards in psychology is respect for the dignity of all people and their beliefs. In a professional context, I cannot [as best as possible] let my bias against religion cloud my judgment. That's not to say we're supposed to respect the belief, but the person's right to have it. This is something I think anyway, therefore it's a happy coincidence. Richard Morgan: as embarrassed as I am to admit this, we have "Pastoral Care" in our hospital. They advertise their "ability" to treat all sorts of illnesses [despite their paucity of training], some of which I myself would steer clear of. Sadly, they're not competent to assume these duties, but do so anyway, because they're cheap labor. BTW, same thing here in Canada about coverage; Psychiatrists are covered, Psychologists are not, unless you see a Psychologist in the hospital system [where I am] and then we're covered.
Yorker: Yikes. You're coming dangerously close to reverse discrimination with your comments. "The undeniable ability of Jewish people to make money"? Huh? Second, it's your choice whether you ever seek mental health services [and I hope you never need to], but psychiatry and psychology are not [usually] there to help people with everyday problems, but with problems that most of us will never have to endure. Although we may have all experienced some transient sadness or worry, this is quite different in quality AND quantity from a diagnosable condition. Also, as a matter of professional conduct, I always explain to all of my patients how I propose to provide them with assistance. I am also quantitative in my practice, which means that I measure, pre-post, whether I was able to help someone or not. On the matter of whether psychiatry is effective: it is as effective as any other branch of medicine. Although it started in a very non-scientific way, anyone perusing a psychiatric journal today would quickly see the folly of assuming the reverse.
Other Comments by oxytocin
19. Comment #67671 by Yorker on September 4, 2007 at 9:51 am
19. Comment #67651 by oxytocinI don't think I've ever addressed you directly before oxytocin, so hello.
Actually your comment surprised me by its mildness, I expected that someone would probably attempt to label me racist over my Jewish comment but sensibly you avoided that.
I think I probably have more experience than most in interacting with Jews, I lived in Florida for a long time and it's undeniably true that many Jews live there! I can honestly say that of all the multi-cultured colleagues I had, my most pleasant memories are of the many conversations and technical discussions that took place with Jewish ones; their thoughts and advice proved to be mostly wise, fruitful and on occasion, financially rewarding. I learned quite a few anti-Jewish jokes in Florida, mostly from Jewish friends, one of whom told me that if he wasn't in the gemstone business then psychiatry would be a good choice and in fact his son was hoping to become a psychiatrist! So you see; my comment was based entirely upon personal experience and general observation, just look around you; many highly lucrative businesses such as jewels and finance are Jewish-controlled. The years of persecution they suffered taught them a valuable lesson: keep your assets portable in case you're forced to move, what could be better than jewels or money? RD has said that Jews have a disproportionate share of political power in the USA, he's right, but it's not because of their religion, it's because of the financial power they wield. Incidentally almost all the Jews I know are Jewish in name only, they're actually atheistic. I'm certain all my Jewish friends wouldn't consider me racist and that's all that matters to me, anyone else's opinion means naught.
On psychiatry, I suspect your knowledge of that field exceeds mine so I won't argue with you about it, I merely reiterate what I've read, what psychiatrists themselves say and what I've heard from those who've had dealings with them. As I said earlier, I have suffered tragedies like the death of those most dear to me, divorce, huge financial loss and personal illness; these are everyday problems you say psychiatry is not needed for but I can't think of anything worse that might happen to me! I certainly agree that psychiatry started off on a premise without scientific foundation and I don't know if it now has such a basis, your assertion that it has will make me conduct some research to verify what you say and to satisfy my own curiosity. I may be wrong, but it seems to me that psychiatry can only be a matter of opinion, i.e. not strictly clinical.
Other Comments by Yorker
20. Comment #67692 by oxytocin on September 4, 2007 at 11:42 am
Hello to you as well Yorker. Well, I'm happy to surprise you. I'm like gentle Jesus, meek and mild.
With regard to psychiatry, yes, please don't take my word for it. Research the issue yourself...nothing should be taken on faith, even from professionals. From my experience working on a daily basis with psychiatrists, I have found them to be just like any other physician. As I have suggested above, by and large, they are users of science, not generally producers of science. However, for an example of how scientific psychiatry has progressed, I would refer you to browse through an issue of the "American Journal of Psychiatry" [http://ajp.psychiatryonline.org/current.dtl]. Although you likely won't have access to its contents online, you can examine the titles of articles; if you like, you can read the journal in its entirety by visiting any university in your area. There are hundreds of other journals just like this, in both psychiatry and psychology.
I think you may have misunderstood me: although I have no doubt that you've experienced some very serious events in your life, it is your REACTION to them that is key. For example, although the majority of people have experienced what would be considered a "traumatic" event in their lives [approximately 86%], only a very small proportion of those people go on to develop "post-traumatic stress disorder" [prevalence depends on what type of event was experienced]. This is an abnormal response to an event that results in a diagnosable disorder; it is distinct from the way most of us would react. In other words, Yorker, you have demonstrated resilience through your life events.
I'll leave the Jewish issue alone.
Other Comments by oxytocin
21. Comment #67693 by Ewan D on September 4, 2007 at 11:49 am
Can psychiatrists actually distinguish between madness and sanity?http://video.google.co.uk/videoplay?docid=1132947090810101429
http://video.google.co.uk/videoplay?docid=5459494538449836108&total=46&start=0&num=10&so=0&type=search&plindex=5
http://video.google.co.uk/videoplay?docid=6367537325455544758&total=41&start=0&num=10&so=0&type=search&plindex=1
http://video.google.co.uk/videoplay?docid=-4207172971104626590&total=43&start=0&num=10&so=0&type=search&plindex=5
Other Comments by Ewan D
22. Comment #67696 by oxytocin on September 4, 2007 at 11:59 am
Ewan D,First "madness" and "sanity" have no meaning in mental health. "Sanity" is a legal word.
Second, this is a very old [but classic] study. The amount of work that has been done in the intervening years is immense. Not only have the diagnostic systems been dramatically overhauled, but the ethical guidelines have been revolutionized [for all professions working with patients, medical and non-medical], and the standards of care are qualitatively different. I work on an inpatient unit...I can say that our system works to get people back into their lives, not keep them incapacitated in bed in a hospital. The shorter the stay on our unit, the better.
This isn't to say that this scenario is impossible now, but the very nature of clinical methodology in modern times is to seek multiple measurements from different professionals [as a psychologist, I receive referrals from psychiatry to get a different take on tough cases], and, as a matter of course, collateral information from family and friends is routinely collected. This, coupled with systemic mandates to gets patients back into their lives, dramatically reduces the chances that people will be kept in hospital in a manner that is unwarranted.
Other Comments by oxytocin
23. Comment #67711 by Ewan D on September 4, 2007 at 1:29 pm
Hi Oxytocin,Thank you for responding. I'm particularly pleased to hear how much you bring to bear in terms of background information, when treating each patient.
By way of explanation, I found those video excerpts here...
http://www.existential-psychotherapy.com/index.html
That site (belonging to an existential psychotherapist friend of mine) has an interesting collection of resources which happen to be strongly anti CBT and anti psychiatric drugs. While finding much to think about regarding received notions of mental health and just what a 'diagnosis' comprises, (beyond a description of symptoms) I was uncomfortable at being asked to believe that mainstream psychotherapy is such a cynically profit-driven machine, interested only in making healthy people think they're unwell.
Other Comments by Ewan D
24. Comment #67716 by Bonzai on September 4, 2007 at 1:50 pm
Something about psychiatry, perhaps its historical ties to psychoanalysis and the anti-religious views of the early analysts such as Sigmund Freud, seems to dissuade religious medical students from choosing to specialize in this field," said study author Farr Curlin, MD, assistant professor of medicine at the University of Chicago. "It also seems to discourage religious physicians from referring their patients to psychiatrists.
Well there seems to be some mix up between psycho therapists and psychiatrists.Psychiatrists typically don't do counseling, they just pump their patients with pills.
P.S. Freud is not a part of medical school training. Many psychiatrists never read Freud (not that I think they miss much though)
Other Comments by Bonzai
25. Comment #67720 by oxytocin on September 4, 2007 at 1:56 pm
Hi Ewan D,I can see that your friend isn't a Psychologist; his methods are also very non-science based. Although we can certainly admit the holes in our methods [e.g., CBT], those amongst us who are scientifically driven believe in the value of knowing whether what we do actually works or not. The fact is that CBT [along with select other modes of treatment that have integrity] and psychotropic meds are evidence-based. I stopped paying attention to existential stuff in undergrad when I saw that they appeared to have no interest in double blind trials or any other type of empirical verification.
Bonzai, don't be so quick to dismiss Freud unless you've read his work. He was an extremely brilliant human who suggested many interesting ideas and prompted us to think about the human condition in new ways. Also, many psychiatrists do indeed do therapy.
Other Comments by oxytocin
26. Comment #67725 by Ewan D on September 4, 2007 at 2:22 pm
Hi Oxytocin,I'm with you entirely. Thanks for your answers.
Other Comments by Ewan D
27. Comment #67736 by oxytocin on September 4, 2007 at 3:02 pm
Ewan D, My pleasure, Sir. Other Comments by oxytocin
28. Comment #67769 by BAEOZ on September 4, 2007 at 5:21 pm
Interesting comments. Oxytocin, you're a font of knowledge. I once thought I could handle anything that came my way in life and shrinks were for weirdos, but in the end I kept doing destructive things in my relationships and stuff and sought help. I saw shrink for a year or so. He was brilliant, I think he did cbt. Therapy was nothing like on tv or movies, much more like working out stuff and trying different thoughts and behaviours. Very useful.
Anyway, that experience got me interested in psych and now I'm studying it part time. I can certainly attest to how scientific it is, and how much evidence is collected. Bloody experimental methods and statistics out my cloaca!
I believe that psychiatrists are doctors with psychological training but approach the problem as soluble with drug therapy as well as behavioural/mental approach. Is that basically correct?
Other Comments by BAEOZ
29. Comment #67774 by oxytocin on September 4, 2007 at 6:17 pm
BAEOZ, I'm happy to hear you had a good experience. And you're quite right: what therapy looks like in reality is entirely different from what it looks like on TV [I'm often enraged by what I see portrayed in the media]. As with most fields, I would imagine, Hollywood takes the worst stereotypes from about 100 years ago, amplifies them, and then dumbs them down for good measure. Psychiatrists are trained as general physicians, then they do their residency in psychiatry, which is [almost always] entirely practical. Clinical Psychologists generally do an undergraduate degree in general psychology [i.e.., abnormal, social, industrial/organizational, developmental, research methods/stats, physiological/neuro, etc.], followed by Masters and Doctoral work in the same field, but this time specialized. Graduate studies are composed of both practical [clinical] and research work. My university valued its research component very highly and so we did a lot of it. All this to say, yes, Psychiatrists can prescribe meds since they're physicians, while Psychologists cannot. There are some States in the US where psychologists are acquiring the right to prescribe, but this is a highly controversial and contentious idea.
Other Comments by oxytocin
30. Comment #67775 by BAEOZ on September 4, 2007 at 6:21 pm
Thanks for the info Oxytocin. I will probably finish my degree in a year or so. I don't think I'll do post-grad to become a therapist or such because I'd have to study full time at a uni and that would mean leaving my job which keeps me in beer and skittles of proportions I've become accustomed to. Also, I don't know that I have the ability to empathise and understand the client sufficiently to help them instead of telling them what I think they need to change, a la Dr. Phil. Other Comments by BAEOZ
31. Comment #67777 by oxytocin on September 4, 2007 at 6:26 pm
BAEOZ, well, if I can help you out in any way, please let me know. Good luck! Other Comments by oxytocin
32. Comment #67778 by BAEOZ on September 4, 2007 at 6:32 pm
Thanks for the offer. Can you finish my assignment that is due in a week? I'm up to the bit on Repeated Measures ANOVA and.....just kidding. Other Comments by BAEOZ
33. Comment #67787 by Dr Benway on September 4, 2007 at 7:26 pm
Bonzai:Psychiatrists typically don't do counseling, they just pump their patients with pills.Typical situation I see: someone says, "Mr. X has been getting a lot worse. He went off and five staff got hurt yesterday. Maybe his meds need to be changed?"
The expectation, then, is I will meet with Mr. X, change his meds, and all will be well. I sigh and wonder why things never change.
Mr. X likely will be non-verbal, or unable to tell me a coherent story about what happened yesterday.
I tell the behaviorist, the psychologist, and the nurse, we have to figure out what's causing this change in behavior before we do anything. Diagnosis before treatment, right? And before diagnosis, we need a clear description of the problem. So what does "getting worse" mean exactly? More aggressive? How are we tracking that? Incident reports? OK, looks like there were about 20 aggression-to-person events per month the past couple of months, and maybe 35 the past two weeks. Restraints are up, and time in restraint is up. Well, that does look like a change.
So why? Let's think this through per "bio-psycho-social."
Biology always comes first. Mental problems are diagnoses of exculsion. Bad form to treat cancer with antidepressants or CBT.
What's biology? It's sleeping, peeing, pooping, pain, illness symptoms. So I ask how that's going.
No change in sleep cycle; no daytime drowsiness. No change in continence. Why is that important? Because incontinence is a marker for cerebral disinhibition, which can be a marker for excess CNS sedation from meds or some other process.
Appetite OK? Change in weight? Last physical? Treated for otitis media about a month ago; resolved. Labs are fine. Last psychotropic med change was six months ago.
Nothing biological seems to be going on.
Psychological - strengths, weaknesses, fears, hopes. Friendship ups and downs? Disappointments? Change in behavioral protocol? No. This is an autistic boy who likes to play video games and that's about it; no real friendships. Has seemed stressed and anxious lately; caught masturbating in the hallway several times this past month.
Social/environmental - New female admission about a month ago; initially getting along ok, then some conflicts. Fairly high staff turnover. Family visiting about a month ago; visit ok.
Working hypothesis: Not acute mania, depression, or psychosis; new female admission a focus of fascination; more than this limited boy can handle.
Notably, the female peer will be moving to a group home in about a week.
Plan: See what happens after the peer moves, then re-assess.
In summary: I do "bio-psycho-social." I don't pump people full of pills, even though that sounds like it might be fun.
Other Comments by Dr Benway
34. Comment #67789 by oxytocin on September 4, 2007 at 8:04 pm
Dr Benway, are you a psychiatrist? Other Comments by oxytocin
35. Comment #67800 by BAEOZ on September 4, 2007 at 9:18 pm
Oxytocin:Dr Benway, are you a psychiatrist?
I believe the Dr. is some variety of avian, suffering from anal fixation, who's delusions, brought on by seeds dosed with LSD, lead him to believe that he's a psychiatrist and that he treats the mentally ill. I base this diagnosis on the good Dr's avatars, which were various sweet looking birds giving the viewer a good look at their respective cloacas. The current avatar is symptomatic of the pathological psychosis that one might expect of a small bird that's tripping so much that he thinks he's human. However, I'm yet to explain how a wee bird can access an interact with the internet via a computer. A conundrum indeed.....The alternate hypothesis the the Dr. is indeed a human, and a psychiatrist has been rejected due to lack humour it engenders in my mind.
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36. Comment #67812 by Richard Morgan on September 4, 2007 at 11:14 pm
BAEOZ:I don't think I'll do post-grad to become a therapist or suchGood.
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37. Comment #67814 by BAEOZ on September 4, 2007 at 11:26 pm
You don't want me to mess with peoples minds Richard? Other Comments by BAEOZ
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1. Comment #67554 by BAEOZ on September 3, 2007 at 7:29 pm
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