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Some psychiatrists should continue to directly provide psychological therapies

Published online by Cambridge University Press:  02 January 2018

Mohsin Khan*
Affiliation:
Wycombe Hospital, email: mohsin.khan@doctors.net.uk
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Abstract

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Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists, 2013

Fitzgerald Reference Fitzgerald1 suggests that psychiatrists should not directly provide psychological therapies. There are a number of reasons why some of them should.

First, specialist experience in delivering psychological therapies may strengthen the skill of a psychiatrist in choosing when and how to use psychopharmacology. A psychiatrist’s experience in administering both psychotherapy and psychopharmacology may improve their ability to judge when to commence, combine or cease either treatment. 2 Indeed, the New Ways of Working for Psychiatrists report 3 predicted an increase in the need for support from consultant psychiatrists in psychotherapy for individuals with complex problems.

Second, some individuals may need difficult risk assessments while receiving psychotherapy. The different career path of a psychiatrist to that of a psychotherapist may make them better suited to make these assessments.

As for the financial cost of psychiatrists providing psychotherapy being ‘prohibitive’, Layard et al Reference Bell, Clark, Knapp, Layard, Meacher and Priebe4 have argued that the implementation of NICE guidelines requiring psychological therapies may be self-financing when the effect of depression and anxiety disorders on the wider economy is taken into account.

References

1 Fitzgerald, M. All future psychiatrists should be neuropsychiatrists. Psychiatrist 2013; 37: 309.Google Scholar
2 Royal College of Psychiatrists, Royal College of General Practitioners. Psychological Therapies in Psychiatry and Primary Care (College Report CR151). Royal College of Psychiatrists, 2008.Google Scholar
3 Department of Health. New Ways of Working for Psychiatrists: Enhancing Effective, Person-Centred Services through New Ways of Working in Multidisciplinary and Multi-Agency Contexts. Department of Health, 2005.Google Scholar
4 Bell, S, Clark, D, Knapp, M, Layard, R, Meacher, MC, Priebe, S, et al. The Depression Report: A New Deal for Depression and Anxiety Disorders . London School of Economics and Political Science, 2006.Google Scholar
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