News

Exposure-based therapies are highly effective for patients with anxiety disorders, to the extent that exposure should be considered a first-line, evidence-based treatment for such patients. In clinical practice, however, these treatments are underutilized, which highlights the need for additional dissemination and training.

In 2009, Maj Matthew P. Houseal, a psychiatrist, was in Iraq attempting to help suicidal soldiers when a fellow soldier killed him, a clinical social worker and 3 others at a combat stress center near Bagdad. Paradoxically, Houseal’s accused killer, US Army Sgt John Russell, had earlier threatened to take his own life, according to witnesses’ testimony during a recent investigative Article 32 hearing.

Describing herself as “strangled by debt” and “unable to deal with [the] school system” that had provided education for her special-needs son, psychiatrist Margaret Jensvold, MD, recently killed her 13-year-old son and then committed suicide.

For prescribing psychiatrists who want to offer treatment alternatives to patients who prefer to avoid medication, the evidence is clear that psychotherapy is an effective choice. Even in cases in which medication is accepted, the evidence suggests that psychotherapy may significantly improve patient outcomes.

A therapist forgets about a patient’s appointment. She becomes abnormally angry, unusually forgiving, atypically bored, or excessively voyeuristic. What is going on? The therapist’s countertransference is making itself known.

We are living in an evidence-based era in all fields of medicine, including psychiatry. For the most part, this represents progress because clinicians can start to base their interventions on treatments that have been supported by the results of research studies.

Psychotherapy outcomes and the mechanisms of change that are related to its effects have traditionally been investigated on the psychological and social levels, by measuring changes in symptoms, psychological abilities, personality, or social functioning.

The Intern

I was ready. In my mind I rehearsed agreeable sermons about diet, exercise, and MMR vaccines I’d use to shepherd my courteous new patients to wellness. It’s like I wanted to replace my memories of psychiatric patients with the most wholesome medical facts.