Understanding psychiatrists.

The relations between psychologists and psychiatrists especially in psychotherapy is discussed in the light of two premises (1) the medical responsibility of the psychiatrist, and (2) the inseparability of somatic and psychic illnesses. However, many problems fall into educational or social categories rather than illness. "… any attempt by psychologists to take over the diagnosis and treatment of… functional psychiatric disorders generally is bound to be regarded by the psychiatric speciality as a basic challenge to its function… and will surely lead to a major professional struggle between psychology and the whole of medicine." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationships between psychology and psychiatry: the hidden issues.

The "… underlying bases of friction between professions of psychology and psychiatry" are explored. Friction emanating from psychiatry stems from the medical pretense of omniscience, an elevated regard for the M.D. degree, and the psychiatrist's position as "… low man on the medical totem pole." Activities of psychologists entering private practice represent "… an economic threat to psychiatrists." The "psychiatrist's theoretical dogmatism… can be attributed to lack of training and sophistication in the content and methods of psychology." Friction emanating from psychology stems from a claim to omniscience, an elevated regard for the degree in psychology, and psychologists trained in areas other than clinical becoming clinical psychologists "… by fiat alone… ." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interprofessional relations or psychologists and psychiatrists are human too, only more so.

"Problems of interprofessional relations have been more productive of furor than fact." "Graduate students in psychology are expected to be skeptical and questioning; medical students begin their training with the absorption of static anatomical knowledge which has undergone little change in years." Psychiatry "… seems to represent the established order, and clinical psychology the force which seeks to change it." Conflicts stemming from differences in professional and social roles, from differences in professional training and potential roles, from differences in the preparation for and practice of pychotherapy, and from problems of collaborative research are discussed. Prospects for the future are considered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Putting self psychology to good use: When social and clinical psychologists unite.

The subareas of psychology often fail to share with one another their research and theorizing. This article attempts to redress this lack of communication as it pertains to social psychological theorizing and research on self-motives. The article starts with a review of the social psychological literature surrounding people's needs for positivity and verification, followed by a discussion of how to integrate these seemingly incompatible literatures. The article then highlights how these self-motives likely play a role in the psychotherapy enterprise and suggests ways in which therapists might use this information. By bridging the gap between the social and clinical literatures in this way, the authors anticipate that both fields will progress more productively toward their respective goals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychologist and Psychiatrist.

The recent renascence in print in the "American Psychologist" of the issues between psychologists and psychiatrists prompts me to vent my spleen on some of the topics so well brought out by Ausubel et al. in the February, 1956 issue. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Training in Psychotherapy for Psychologists: Recommendations of Clinical Psychologists.

This article discusses the current debate on the subject of psychotherapy training for psychologists and how it tends to concern itself with rather broad philosophical issues and matters of role definition. As part of a larger study, data not previously reported were derived from three questions which asked for opinions about ideal patterns of psychotherapy training for psychologists. This brief report suggests the desirability of careful stratification of the group of clinical psychologists in future opinion sampling and when policy recommendations are being developed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conflict of commitment in clinical research.

Some aspects of the problem of research in a psychological or psychiatric clinic are explored. "History leaves little doubt that, so far as we are scientific, we must push for further analysis of our data. At the same time the clinical commitment to the whole person is also irrevocable. The conflict of commitment appears to be an inevitable feature of clinical research. By making psychologists and psychiatrists aware of the inevitability and historical origins of the conflict, one may hope to avoid some of the more unfortunate of its possible manifestations." Major sections are: Research manifestations." Major sections are: Research commitment, Clinical commitment—whole childism, Darwin versus Lamarch—being versus becoming, Lamarckian philosophy in the clinic, Independence of errors, and Function versus ontology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social Workers and Psychotherapy.

The three papers, by Ausubel, Brody, and Kelly (February, 1956, American Psychologist) were both refreshing and illuminating. They brought to mind an incident of a number of years ago while I was taking graduate work in psychology. I was talking to one of my professors (a well-known and distinguished psychologist) about the American Orthopsychiatric Association. Toward the end of our discussion he commented more philosophically than bitterly, "Ortho is like a car with the psychiatrist in the driver's seat, the social worker next to him, and the poor psychologist in the back seat." Perhaps this may not have been a fair appraisal at that time (and I certainly do not believe that it applies today). However, I am inclined to think that outside of ortho, even among some of the more "mature" members of these disciplines, there may be considerable jockeying for position in the game known as, "Who Should Do Psychotherapy?" Although, as indicated by the authors, there are many indications of competitiveness between psychologists and psychiatrists, this phenomenon is further complicated by the feelings and attitudes of social workers, particularly those on clinic and hospital "teams" employing all three disciplines. It should be pointed out that in the usual mental hygiene clinic the bulk of the "treatment" is carried out by the social workers, probably for no more sinister reason than that there are more social workers than the total of both other disciplines in such clinics. One cannot help but wonder if in the next decade or two a plodding and less articulate dark horse called social work may not emerge as the leading contender in the scramble to corner the "psychotherapy market" while the more spirited fillies--psychology and psychiatry--knock themselves out in the race. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Understanding Psychiatrists": Comment.

Comments on the article by Richard Jenkins (see record 1955-03339-001), which discusses the relations between and the responsibilities of psychologists and psychiatrists in the light of two premises: (1) the medical responsibility of the psychiatrist, and (2) the inseparability of somatic and psychic illness. Because of a depth of concern for the welfare of his patient, the psychiatrist may at times feel that a more complete understanding of him would be facilitated by calling upon other individuals, such as psychologists, for their opinions. In such a case, the psychiatrist would retain final responsibility. Regarding the therapeutic competence of psychologists, it is our firm belief that this would best be determined by a board composed of psychologists of recognized standing, since they would be best qualified to judge the adequacy of psychological training. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comments on "Understanding Psychiatrists".

Comments on the article by Richard Jenkins (see record 1955-03339-001), which discusses the relations between and the responsibilities of psychologists and psychiatrists in the light of two premises: (1) the medical responsibility of the psychiatrist, and (2) the inseparability of somatic and psychic illness. Newton states that one difficulty between psychiatrists and psychologists is that neither is ideally prepared. What is needed is a degree of "Doctor of Psychology" to be awarded by the same institution that awards the "Doctor of Medicine" degree. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Frame of Reference.

Presents a letter speaking in support of the network television show The Eleventh Hour, which prominently features psychologist and psychiatrist characters. Regarding the portrayal of psychology in entertainment, the author argues that it would be wise to establish and expand beachheads, and to be alert to the possibility that the academic frame of reference may not be realistically imposed on the means of communication or the arts. Further, it is argued that it would be psychologically sounder to do what we could to actively assist any interpretive individuals or groups (on their terms if the psychological good is greater than the evil) and to work toward a goal of having art, entertainment, and other vehicles achieve as many of their objectives as we would wish them to allow us to achieve. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological services in relation to health insurance plans.

"Our preliminary investigations revealed that it is almost impossible to make any kind of general statement about the position of clinical psychologists in the insurance picture at the present time." The Board of Professional Affairs recommends that future efforts be directed at gaining general acceptance of provisions for covering psychological services when deemed necessary by those having medical responsibility for the treatment of the claimant. From Psyc Abstracts 36:02:2AK24W. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluating and overcoming barriers to taking abuse histories.

Psychologists are frequently faced with issues of whether, when, and how to ask clients if they have been abused. Despite the demonstrated relationship between child abuse and adult psychopathology, researchers report that many clinicians still do not routinely inquire about abuse. A questionnaire completed by 63 psychologists and 51 psychiatrists in New Zealand revealed that factors related to reluctance to ask about abuse include the following: more pressing issues, fear of disturbing clients, a diagnosis of schizophrenia, biological etiology beliefs, and fear of inducing "false memories." Significant differences were found between psychologists and psychiatrists on some of these factors. Practice guidelines for enhancing the frequency and efficacy of abuse inquiry are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reputable Psychologists and Rational Psychiatrists.

Discusses images and occupational stereotypes of psychologists and psychiatrists practicing in psychiatric hospitals, focusing on depictions in the book Psychiatric Nurse (1963) by Jane Converse. While the story is a romance, it is seen as disillusioning about the "status of psychiatry as the sole source of deliverance for the disturbed." Responses to such images of interprofessional relationships in mental hospitals are imagined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On "Treatment" in Student Training: Comment.

Comments on Leonard Small's article, "Toward Professional Clinical Psychology" (see record 1964-03434-001). This article has to do with students training to be psychologists and how unless they have been "treated", they cannot do effective therapy. The commentator discusses this issue and suggests that the research-based certainty of the value of psychotherapy is at too low a level of confidence to recommend treatment as a requisite of student training. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Quandary.

Although I applaud R. B. Cattell's (July 1983) recommendation/prognostication for the cessation of hostilities between the psychology and psychiatry professions, I am in a quandary as to how to convince my psychiatrist colleagues to give up their psychotherapy practices, change specialties, and disband the American Psychiatric Association. All of 10 physicians diagnosed me as delusional when I surveyed their attitudes toward Cattell's proposal. Three of 6 psychiatrists recommended medical psychotherapy, 2 suggested a trial on a phenothiazine, and 1 wanted to commit me to the local state psychiatric hospital. Four of 4 internists polled referred me back to psychiatrists for treatment. A change in the relationship between psychology and medicine will not evolve through natural selection. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reply to Dr. Rotgers' Letter.

Replies to the letter by Rotgers (see record 2005-09346-005) on the current author's original article (see record 1981-11085-001). Dr. Rotgers' letter is valuable, since it provides an excellent example of the fact that practice does not always conform to the "black letter" of the law. The current author is pleased to learn that New Jersey legislated their custom, for to rely on custom alone for the recognition of professional psychology is dangerous indeed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ten considerations in addressing cultural differences in psychotherapy.

As the United States population grows more culturally diverse, it is increasingly likely that psychologists will treat patients from dissimilar cultural backgrounds. Psychologists are often undecided about whether it is therapeutically appropriate to address cultural differences. Ten clinical considerations regarding the appropriateness of discussing cultural differences with patients are described. Examples are provided of how these suggested guidelines may apply to clinical practice. The literature that has supported addressing differences, including selected theoretical models, is cited in the context of these recommendations. All psychotherapy cases are distinct; therefore, these general guidelines should be adapted to the requirements of the individual patient. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A National Survey of Practicing Psychologists' Use and Attitudes Toward Homework in Psychotherapy.

Homework assignments have been studied extensively in psychotherapy research, but there is little data on the way in which homework is transferred to clinical practice. A survey was conducted of 827 practicing psychologists nationwide regarding their use and attitudes toward homework. Overall, 68% of the present sample indicated that they "often" or "almost always" used homework assignments. Factor analysis revealed that practitioners have a range of attitudes that can be classified as reflecting the notion that homework has (a) a negative impact on in-session therapeutic work and (b) a positive effect on therapy outcomes. More positive attitudes were reported among those with a cognitive-behavioral theoretical orientation. Nevertheless, the use of homework among psychodynamic/analytic practitioners reported in the present sample was unexpected and suggests that theoretical and empirical work is required to examine homework's effects in a range of psychotherapy approaches. (PsycINFO Database Record (c) 2010 APA, all rights reserved)