10.8%: A Look Behind the Report on Psychotherapy Trends

So is it true that only 10.8% of psychiatrists see all their patients for psychotherapy, as the media likes to tell us? I suppose that depends on whether a systematic random sample of an average of 19 visits submitted by an average of ~75 psychiatrists in a one-week period is a clear extrapolation of the practice of all office-based psychiatrists in the United States, and whether you believe that psychotherapy can take place in 30 minutes or less.  Why doesn’t the popular press mention that 70.2% of psychiatrists provide psychotherapy to all or some of their patients?  That would change the whole slant of the stories.  

“I really don’t think that the actual numbers – especially the 11% – should be taken literally. The strength of our study was to look at trends,” Ramin said.

The overall trends are more clear: whether or not they are providing psychotherapy, the surveyed psychiatrists are seeing their patients for shorter visits. In 1996, 44.4% of visits to these aggregate psychiatrists were psychotherapy sessions lasting over 30 minutes and by 2005 this number had decreased to 28.9%. The authors go on to identify specific factors including age, race, diagnosis, insurance type, and region of the country that are likely to be associated with psychotherapy sessions lasting over 30 minutes and their ideas about why this trend is occurring.

So lunch with Dr. Mojtabai was interesting and we had a lot to talk about. I asked him how he feels about the way the media uses his statistics and he replied, “I have to emotionally distance myself from that.”

As an aside, Ramin is the only person I’ve ever met who is both a psychologist and a psychiatrist, having completed a PhD in clinical psychology and a residency training program in psychiatry, as well as a master’s degree in public health. “I’ve spent my whole life in school,” he said. My response? “Obviously!”

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 --Dinah Miller, M.D.