Patient suicide: Occupational hazard for psychologists and psychiatrists.

Using data from our earlier national surveys, we compared the frequency and impact of patient suicide among psychologists and psychiatrists. We also report data from a new survey designed to examine the influence of patient type, practice setting, and pattern of practice on risk of experiencing patient suicide and on its impact on the therapist. Twenty-two percent of psychologists and 51% of psychiatrists reported having experienced the loss of a patient to suicide. Both groups reported experiencing significant disruptions in their professional and personal lives after the patient's suicide. Work setting, kind of patient treated, and profession were most strongly associated with the occurrence in patient suicide. We argue that patient suicide is an occupational hazard for psychologists and psychiatrists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The psychologist's role in the emergency room: A comparative study.

Compared evaluations by psychologists, psychiatrists, a psychiatric team, and psychiatric residents of 258 16–76 yr old patients in an inner-city hospital emergency room. Both patient presentation and medical and psychiatric evaluations did not vary over time. Other than the finding that psychologists initiated evaluations sooner and hospitalized fewer patients than did psychiatrists, there were no significant temporal or dispositional differences in decisions made between psychologists and the other evaluators. Results are consistent with previous findings that more extensive evaluations lead to fewer recommended hospitalizations. Results also suggest disposition decisions are affected by training, and psychologists tend to place more responsibility on the patient and/or the patient's family than do psychiatrists. (38 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceptions of "counselors" and other help-givers: What's in a label?

Investigated the perceptions held by 240 undergraduates about counseling psychologists, college counselors, high school counselors, advisors, clinical psychologists, and psychiatrists. Ss completed a questionnaire containing 100 adjectives which they assigned to the various professions on the basis of how well each described the role. Greater differences were found within the counseling specialties than between counseling psychologists and either clinical psychologists or psychiatrists. Contrary to previous research, none of the counseling groups were viewed as "nice guys" in relation to psychiatrists or clinical psychologists. Implications for both research and public relations are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How the public perceives psychiatrists, psychologists, nonpsychiatric physicians, and members of the clergy.

Accompanying two decades of change in the mental health system have been a diffusion of the roles and practices of mental health professionals as well as shifts in the public's perceptions of the various specialties. In the present study, samples of patients and nonpatients used a 4-point Likert scale to rate (a) the competence of psychologists, psychiatrists, nonpsychiatric physicians, and the clergy to treat 10 different patient types, and (b) the personal qualities of the four practitioner groups along nine different dimensions. Psychiatrists and psychologists received significantly higher ratings than both nonpsychiatric physicians and the clergy on competence to treat most mental health problems. Intergroup differences on the ratings of personal qualities suggest a less uniformly favorable perception of psychiatrists and psychologists in comparison with the other two groups. Implications for the marketing and public relations efforts of mental health practitioners are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prescribing psychologists and patients' medical needs: Lessons from clinical psychiatry.

Psychologists who acquire prescribing privileges will assume an expanded obligation to address patients' medical (physical) conditions. Development of a training and practice model for prescribing psychologists may be informed by an awareness of how psychiatrists fulfill this obligation. Surveys of psychiatrists indicate that they rarely perform physical or neurological examinations. They typically participate only obliquely in the evaluation of patients presenting with acute behavioral or emotional symptoms suggesting organic illness, and they virtually never treat concomitant medical conditions of their patients. Other than in psychopharmacology, psychiatrists use their residual medical knowledge only indirectly. Findings imply that training for prescribing psychologists can be focused according to their expected clinical activities and that a model of practice emphasizing collaboration with nonpsychiatric physicians is feasible. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological test use in criminal forensic evaluations.

The authors surveyed forensic psychologists and psychiatrists (about 80% of whom were board certified) regarding their use of psychological testing in evaluations for competence to stand trial (CST; n?=?102) and criminal responsibility (CR; n?=?96), as well as their opinions about the importance of psychological testing for these evaluations. Psychological testing was perceived as either essential or recommended by approximately two thirds of the respondents for CR evaluations and by approximately one half for the CST evaluations, with no significant differences between psychologists and psychiatrists. Frequency of reported use of psychological tests was consistent with these opinions among forensic psychologists but was significantly lower for forensic psychiatrists. Data are also provided on the frequency with which respondents report using specific tests and categories of tests, including specialized forensic assessment instruments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Similarities of patients treated by private practice psychologists and psychiatrists.

Over 12,000 patients of psychologists and psychiatrists were compared regarding demographic data and MMPI 2-point codes (J. T. Webb, 1970). No professional contributed more than 30 cases to the total sample, and the sample represented every state in the continental US. Results indicate remarkable similarity in patient populations of psychiatrists and clinical psychologists regarding (a) demographic characteristics of patients and (b) type and severity of psychopathology as measured by MMPI 2-point codes. The few MMPI differences appeared attributable primarily to educational differences in the caseloads of the 2 professions. Such similarity in a nationwide sample contradicts the often expressed view that psychiatrists rather than psychologists see patients who are more seriously disturbed. (3 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychiatric versus psychological opinion regarding personality disturbances.

Results of a survey "designed to determine, at least to some extent, the degree of diversity and disunity of opinion between" psychiatrists and psychologists are presented. An objective questionnaire, consisting of 100 "declarative statements covering the nature, cause, and treatment of disturbances to the mental life and behavior of individuals, with chief emphasis on characteristics usually identified as psychotic and neurotic" which were representative of current opinion, was used. 75 psychiatrists (32 working in mental hospitals in Pennsylvania and New Jersey and 43 practicing psychiatrists in 21 states and the District of Columbia) and 60 psychologists (in 23 states and the District of Columbia) were the Ss. "Only 19 statements of opinion, out of the 100 explored in this study, reveal statistically significant differences of opinion between psychiatrists and psychologists." Psychiatrists show a higher degree of acceptance on 14 items, psychologists a higher degree of acceptance on the other 5. The specific items on which differences were indicated are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prototype of a profession: Psychology's public image.

Using a prototype approach to assessing concepts and persons, the present authors studied the attitudes of 128 undergraduate students (nonpsychology majors) and 46 of their parents toward psychologists, psychiatrists, physicians, counselors, teachers, and scientists. Results show a favorable attitude toward psychologists, who were seen as very similar to psychiatrists and dissimilar to scientists. However, the extent of the sample's familiarity with psychologists was doubtful. Findings support the need for an education campaign designed to inform the public about what psychologists do. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physicians' perceptions of the role of psychology in medicine.

Surveyed 80 physicians at the University of Kansas Medical Center on their perceptions of psychology's role in medicine. The sample included residents and staff physicians from 4 medical specialities: family practice, internal medicine, pediatrics, and psychiatry. It was found that the problems perceived as having the largest psychological component were depression, alcoholism, obesity, and headaches. Medical problems seen as having minimal psychological components were cancer, heart disease, and arthritis. Ss expressed an interest in treating the psychological components of medical illness themselves. They also reported that they would consult psychiatrists, psychologists, and social workers on an equal basis for treating these problems. (13 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Licensing and Professional Function.

It is shocking to summarize the ongoing debates on licensing of psychologists and on the relations between psychologists and psychiatrists. We psychologists seem chiefly to place the blame on the psychiatrists for the slow progress in gaining recognition of the professional function of psychologists. I offer a dissent which declares that a restrictive block must be removed from the thinking of psychologists before we are going to get anywhere on the problems of licensing and recognition of professional function. The block is manifested by the efforts of psychologists to imitate psychiatrists and beat them at their own game. This game is the diagnosis and treatment of mental and emotional disorders, illnesses, aberrations, etc. Such diagnosis and treatment involves a mechanistic and concretistic thinking which is proving itself powerless to deal with the behavioral functioning of human individuals in interactive contexts. I am tempted to say "has proven," but there is a sad lack of experimental evidence, for which psychologists must shoulder their share of the blame. For my part, I don't blame psychiatrists for opposing the licensing of psychologists to treat "mental and emotional illnesses." Without realizing it, the psychiatrists are doing us a big favor in warning us away from this fruitless endeavor in which they are themselves experiencing so much heartbreak. We are wasting our time in seeking to crowd with them into a theoretical structure which will not support intense scientific effort. No psychologist should discuss with any citizen the relief of symptoms which are now manifest in the citizen's organic functioning. The psychologist's function should be to teach his interested fellow human beings how to perceive an interpersonal world and interact within that social realm on a more efficient and harmonious basis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pertinent consumer issues in choosing a counseling professional.

In Study 1, 43 counselors (with MAs and PhDs), psychiatrists, clinical psychologists, and social workers completed a questionnaire evaluating issues in the literature as to their pertinence to the consumer in choosing a counseling professional. The most and the least pertinent issues are presented, as assessed by counseling professionals and clients. Counselors and psychiatrists were compared in their rankings. A significant positive correlation was found between the 2 groups. Study 2 utilized 39 17–61 yr old clients of counseling professionals in 4 categories: counselors (MA and PhD), psychiatrists, clinical psychologists, and social workers. Clients also completed the same questionnaire as in Study 1. Five items that differed significantly among clients' responses in the 4 professional counseling groups are presented. Results from both studies indicate the presence of general unifying concepts pertinent to consumer evaluation of potential counseling professionals. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of shame, guilt, and the negative reaction in brief dynamic psychotherapy.

Developed the Therapy Shame and Guilt Scale (TSGS) to test the hypothesis that patients' degree of shame and guilt would be significant predictors of therapy outcome. 35 patients (aged 20–80 yrs) with neurotic and/or character disorders received 16 weekly sessions of psychodynamically oriented psychotherapy. Two judges' ratings of Sessions 1, 5, 8, and 14 on the TSGS demonstrated that patient levels of shame and (especially) guilt were associated with therapeutic outcome. The TSGS was a better predictor of outcome than the Vanderbilt Negative Indicators Scale (VNIS), whose major point of overlap with the TSGS was the VNIS item of self-rejection. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The psychologist in the department of psychiatry.

Results of a US survey show that psychologists are well represented on psychiatry faculties but tend to hold lower academic rank and receive lesser salaries than psychiatrists in equivalent ranks. Results also indicate rigorous criteria for promotion in these departments. Positive aspects, including patient contact and clinical research opportunities, are noted. (7 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Beliefs about the helpfulness of interventions for mental disorders: a comparison of general practitioners, psychiatrists and clinical psychologists

OBJECTIVE: The aim of this study was to assess health professionals' beliefs about the helpfulness of a broad range of possible interventions for mental disorders. METHOD: The study involved a postal survey of 872 general practitioners (GPs), 1128 psychiatrists and 454 clinical psychologists. These health practitioners were presented with a vignette describing either a person with schizophrenia or one with depression. The vignettes were taken from an earlier survey of the general public. Respondents were asked to rate the likely helpfulness of various types of professional and non-professional help and of pharmacological and non-pharmacological interventions. RESULTS: Two-thirds or more of each profession agreed that the person with schizophrenia would be helped by GPs, psychiatrists, clinical psychologists, antipsychotic agents and admission to a psychiatric ward. Similarly, two-thirds agreed that the person with depression would be helped by GPs, psychiatrists, clinical psychologists, antidepressants, counselling and cognitive-behavioural therapy. However, there were also areas of disagreement. Psychiatrists were less likely than GPs and clinical psychologists to rate psychological and lifestyle interventions as helpful, while clinical psychologists were less likely to rate specifically medical interventions as helpful. Younger members of the professional groups and female members (who also tended to be younger) tended to rate a wider range of interventions for each disorder as likely to be helpful. CONCLUSIONS: Despite areas of broad agreement about treatment, health practitioners were more likely to endorse the interventions associated with their own profession. However, younger members of each profession tended take a broader view. If these age differences represent a cohort effect, health professionals may in the future show greater acceptance of the helpfulness of interventions offered outside their profession. These conclusions are limited by the methodology of the survey, which involved a questionnaire designed for the public rather than professionals.     

Patients of psychiatrists and psychologists in office-based practice: 1980.

Examined data from a national household survey of 17,900 people concerning medical care utilization and expenditures (G. S. Bonham, 1983) to compare psychiatrists' and psychologists' practices with respect to patient characteristics, length of treatment, regional patterns of use, charges, and sources of reimbursement. Differences between psychiatrists' and psychologists' patients were found in age, education, employment, health status, and insurance coverage and seemed to be associated with differential reimbursement of psychiatrists and psychologists. Psychiatrists and psychologists provide one-third of the mental health ambulatory visits in the US. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Agreement on patient diagnosis, treatment, and referral across provider groups.

Presented a national sample of 581 psychiatrists, clinical psychologists, and social workers with a questionnaire presenting 4 case vignettes taken almost verbatim from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-III) Case Book, to examine whether there would be differences in diagnosis both among providers within disciplines and between provider groups. Each vignette was prepared in order to ensure that all available information relevant to making diagnoses was included; however, the diagnoses were not presented to the Ss. Ss wrote their statement of the presenting problem and its severity and selected the best treatment plan and referral and the experts' diagnosis from lists of alternatives. Results suggest that as diagnosticians, these provider groups are essentially equivalent but that diagnostic findings are more reliable for the more severe mental disorders. Providers appear to alter their treatment plans depending on diagnosis; but for a particular diagnosis, they differ little as to the interventions deserving emphasis. Each provider group referred to itself the patients with less severe mental and emotional conditions. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Across the Secretary's Desk: Psychology, Psychiatry, and Legislation in New York.

Item discusses the opposition of psychologists in New York State against restrictive legislation. On February 8, a bill to revise the State Medical Practices Act to include "diagnosis and treatment of mental disorders" was introduced into the Senate of New York State. The bill, as psychologists will appreciate, springs from general social and sociological developments having differential effects on psychologists and psychiatrists and impinging differentially on the social philosophies of the medical and psychological professions. The bill also springs from other more intimately political processes. The column discusses responses to the bill and the legislative process involved. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How Canadian coordinators of graduate psychiatric education view psychologists.

Investigated the views toward psychologists as expressed by 16 Canadian coordinators of postgraduate education in psychiatry. The majority of Ss opposed psychologists holding senior administrative roles in departments of psychiatry and believed that psychologists should continue to be organized in divisions within departments of psychiatry. Considerable respect was evident for the clinical and academic skills that psychologists possess, and there was nearly unanimous support for psychologists holding academic appointments in departments of psychiatry. Most Ss approved of psychologists conducting psychotherapy as well as supervising psychiatric residents on psychotherapy cases and supported psychologists' involvement in the training of psychiatrists and vice versa. Views about eligibility of psychologists for senior administrative roles in psychiatry departments were related to views on other issues concerning psychologists. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The mental health arena.

If C. A. Kiesler's (1977) comparative analysis of the training of psychologists vs psychiatrists proves to be true after closer inspection, this analysis can document that doctoral-level psychologists have as much (or more) training as psychiatrists yet receive considerably less income. The reasons that psychiatrists dominate mental health settings are reviewed, and it is argued that the mythical nature of the public's collective approaches to physicians should be exposed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)