Caucus on Psychotherapy Seeks to Grow in 2015
Abstract
The caucus is seeking to be a “big tent” providing a home-within-a-home for APA members concerned about the preservation of psychotherapy as part of the professional identity of a contemporary psychiatrist.
The APA Caucus on Psychotherapy has become a “beacon of hope” to APA members committed to the value of psychosocial treatment as part of the training, skill set, and identity of psychiatrists.
Caucus Chair Eric Plakun, M.D., says that psychotherapy is an evidence-based treatment that “changes the brain” and is even more important today because of epigenetic findings.
That’s what Caucus Chair Eric Plakun, M.D., said at a meeting of the group during APA’s 2015 annual meeting in Toronto. “The caucus has united therapists from multiple theoretical perspectives in common concern about the place of psychosocial treatment in psychiatry, especially in light of emerging evidence of the importance of environmental factors,” Plakun said. “We need a way to come together so we can speak to the field with a unified voice about the importance of psychotherapy and psychosocial treatment.”
The caucus had its origins in 2014 when Plakun and a dozen or so psychiatrists concerned about what they believe has been the increasingly biological emphasis of contemporary psychiatry and psychiatric training coalesced around a common interest in preserving psychotherapy by psychiatrists. Today, the caucus has more than 200 members, Plakun said.
“I think the field of psychiatry has been drifting in the direction of a focus on biology and sometimes a biologically reductionistic stance that has squeezed out room for psychosocial treatments like psychotherapy,” Plakun told Psychiatric News in an interview after the meeting. “A number of us have felt it is important, particularly because of the emerging evidence of the power of psychosocial factors—the importance of ‘epigenetics,’ for instance—that there be a place in American psychiatry to stand for and represent the value of psychosocial treatments and the importance of psychotherapy.
Caucus Members Share Concern for ‘Value of Meaning’ in Treating Patients
“The core identity of a psychiatrist needs to include the provision of psychotherapy and the valuing of meaning in the work with patients.”
That was the response of at least one psychiatrist member of the Caucus on Psychotherapy to a survey of caucus members. Another said, “We’ve lost sight of patient care, as psychiatrists, as has all of medicine and surgery, and spend too much time chasing paper, filling out forms, and struggling with administrative issues … and not enough time being able to do our work with helping people to heal and have productive lives.”
A third said, “Public awareness is lacking about psychiatrists doing psychotherapy. Most people assume we do ‘just medication management.’”
For APA members who share those sentiments, the caucus seeks to be a home within the larger APA home. The recent survey of over 100 caucus members offers an intriguing snapshot of the demographics, interests, and concerns of caucus members. These are among the survey findings:
Most caucus members identify as “late career,” followed by “established,” trainee or early career psychiatrist, and retired.
57.7 percent of respondents said they are in private practice. This was followed by academic medicine (20.4 percent), hospital-based psychiatry (7.1 percent), military (4.4 percent), residential treatment facility (3.5 percent), CMHC (2.7 percent), and “other” (4.4 percent).
Below is a breakdown of the type of psychotherapy provided by caucus members.
“It’s an evidence-based treatment that changes the brain, and we as psychiatrists should not neglect it,” he said. “We should include it in the way we think about training, about practice, and about our patients.”
Plakun said the caucus is a “big tent” for psychiatrists with an interest in therapy and psychosocial treatment from multiple schools—psychodynamic therapies and psychoanalysis; behavioral therapies such as cognitive-behavioral therapy and dialectical behavior therapy; supportive therapy; and family, group, and milieu therapy. At the meeting in Toronto, Plakun presented data from a survey of caucus members showing their demographics and identifying the concerns that are important to them (see sidebar).
A 12-member steering committee was formed to guide the mission and goals of the caucus. Plakun said the caucus is already producing real results and doing tangible things: at least four psychiatrists who had let their APA membership lapse rejoined the Association as a direct result of the caucus; and the American Psychoanalytic Association has rejoined the APA Assembly because of the caucus, he said.
Moreover, the caucus is creating networks with other like-minded groups, including the psychotherapy committees of the the Group for the Advancement of Psychiatry, American Association of Directors of Psychiatric Residency Training, Academy of Cognitive Therapy, American Psychoanalytic Association, Academy of Psychoanalysis and Dynamic Psychiatry, Association of Behavior and Cognitive Therapies, and state psychiatric society psychotherapy committees.
The caucus is also exploring the use of social media to network and extend its message.
As chair of the caucus, Plakun reported at the Toronto meeting that he was in communication with the Institute of Medicine’s Committee on Psychosocial Treatment for Mental Disorders and had met with former Rep. Patrick Kennedy—who was instrumental in the passage of the federal parity law and has continued to be a spokesperson for parity enforcement—about psychosocial treatment in psychiatry. Plakun said he was also holding conversations with a potential funding source for the caucus.
“I think we are succeeding at being the big tent model that we hope to be because we have medical students, residents, and early career psychiatrists as well as senior researchers and clinicians in psychiatry from all over the country and from various perspectives,” Plakun said.
Goals for the coming year include increasing membership and recognition of the caucus among APA members, developing a set of bylaws to support the continued existence of the caucus, finding sources of funding to support caucus activities, and creating a fact sheet about the efficacy of psychotherapy that can be used for advocacy and educational purposes.
Finally, Plakun said he sees hope in APA’s new logo, revealed for the first time during the annual meeting, which carries the tagline: “Medical leadership for mind, brain and body.”
“The ‘mind’ is back as a part of the professional identity of psychiatry,” Plakun said. ■
APA members interested in joining the caucus or learning more about it, or are interested in receiving the survey results, should contact Plakun at [email protected]. A video interview of Plakun can be viewed here. An audio interview can be accessed here.
