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As Psychiatrists Dispense with Offering Empathy and Advice, Marriage Education Becomes More Popular


Psychiatrists have discovered talk doesn’t pay, leading many to turn instead to drug therapy, Gardiner Harris reports in The New York Times. Low-cost, evidence-based marriage education and relationship skills training is becoming more popular as couples and singles reach out for practical skills to help them understand and talk to each other.

“The switch from talk therapy to medications has swept psychiatric practices and hospitals, leaving many older psychiatrists feeling unhappy and inadequate … just 11 percent of psychiatrists provided talk therapy to all patients … hospitals that once offered patients months of talk therapy now discharge them within days with only pills.”

~ New York Times
March 5, 2011

by Rachel Schindler

Psychiatrist Donald Levin in Doylestown, PA
“I had to train myself not to get too interested in their problems, and not to get sidetracked trying to be a semi-therapist,” says Psychiatrist Donald Levin.

Tom Cruise must be jumping on a couch somewhere after reading that “just 11 percent of psychiatrists provided talk therapy to all patients, a share that had been falling for years.”

“Psychiatric hospitals that once offered patients months of talk therapy now discharge them within days with only pills,” Gardiner Harris writes in the New York Times.

At the same time, many couples and singles are discovering they’re better off emotionally and financially learning to understand and talk to each other. Thousands are turning to popular low-cost marriage education and relationship skills training to learn how. Brief evidence-based skills building classes such as PAIRS Foundation’s nine-hour PAIRS Essentials program have shown promising, lasting benefits for singles and couples alike, including groups as diverse as combat veterans returning from deployment and the formerly homeless.

RELATED: Marriage Education Classes Help Singles Reduce Anxiety, Isolation

Harris writes about Dr. Donald Levin of Doylestown, Pennsylvania, a psychiatrist since 1972 who saw 50 to 60 patients a week before discovering he could treat 1,200 weekly by quickly dispensing medicine instead of empathy, understanding, and helpful advice.

“Like many of the nation’s 48,000 psychiatrists, Dr. Levin, in large part because of changes in how much insurance will pay, no longer provides talk therapy, the form of psychiatry popularized by Sigmund Freud that dominated the profession for decades. Instead, he prescribes medication, usually after a brief consultation with each patient,” Harris writes in “Talk Doesn’t Pay, So Psychiatry Turns Instead to Drug Therapy.”

Tom Cruise turned a lot of heads in 2005 when he told the Today Show’s Matt Lauer, “Psychiatry is a pseudoscience,” later saying: “You don’t know the history of psychiatry. I do.”

Tom Cruise jumps on Oprah's couch
Actor Tom Cruise jumps on Oprah's couch.

The famous actor raged against psychiatrists directing patients to begin daily regiments of Adderall and Ritalin, often prescribed to treat hyperactivity and attention-deficit disorder in children.

“Do you know what Adderall is? Do you know Ritalin? Do you know now that Ritalin is a street drug? Do you understand that?” Cruise asked on the live broadcast.

Psychiatrists who saw much of their personal fortunes washed away by Bernard Madoff and the nationwide housing and financial collapse discovered managed care and the traditional route to earning nearly $200,000 a year was becoming more difficult.

“At first, all of us held steadfast, saying we spent years learning the craft of psychotherapy and weren’t relinquishing it because of parsimonious policies by managed care,” Dr. Levin said. “But one by one, we accepted that that craft was no longer economically viable. Most of us had kids in college. And to have your income reduced that dramatically was a shock to all of us. It took me at least five years to emotionally accept that I was never going back to doing what I did before and what I loved.”

Harris reports there are “thousands of psychiatrists who still offer talk therapy to all their patients, but they care mostly for the worried wealthy who pay in cash. In New York City, for instance, a select group of psychiatrists charge $600 or more per hour to treat investment bankers, and top child psychiatrists charge $2,000 and more for initial evaluations,” he writes.

RELATED: Study Shows Skills Training Benefits Singles Too

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