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. 2015 Jun;60(6):294-300.
doi: 10.1177/070674371506000609.

Psychotherapy in Contemporary Psychiatric Practice

George Hadjipavlou  1 , Carlos A Sierra Hernandez  2 , John S Ogrodniczuk  3
Affiliations

Psychotherapy in Contemporary Psychiatric Practice

George Hadjipavlou et al. Can J Psychiatry. 2015 Jun.

Abstract
in English, French

Objective: American data suggest a declining trend in the provision of psychotherapy by psychiatrists. Nevertheless, the extent to which such findings generalize to psychiatric practice in other countries is unclear. We surveyed psychiatrists in British Columbia to examine whether the reported decline in psychotherapy provision extends to the landscape of Canadian psychiatric practice.

Method: A survey was mailed to the entire population of fully licensed psychiatrists registered in British Columbia (n = 623). The survey consisted of 30 items. Descriptive statistics were used to characterize the sample and psychotherapy practice patterns. Associations between variables were evaluated using nonparametric tests.

Results: A total of 423 psychiatrists returned the survey, yielding a response rate of 68%. Overall, 80.9% of psychiatrists (n = 342) reported practicing psychotherapy. A decline in the provision of psychotherapy was not observed; in fact, there was an increase in psychotherapy provision among psychiatrists entering practice in the last 10 years. Individual therapy was the predominant format used by psychiatrists. The most common primary theoretical orientation was psychodynamic (29.9%). Regarding actual practice, supportive psychotherapy was practiced most frequently. Professional time constraints were perceived as the most significant barrier to providing psychotherapy. The majority (85%) of clinicians did not view remuneration as a significant barrier to treating patients with psychotherapy.

Conclusions: Our findings challenge the prevailing view that psychotherapy is in decline among psychiatrists. Psychiatrists in British Columbia continue to integrate psychotherapy and pharmacotherapy in clinical practice, thus preserving their unique place in the spectrum of mental health services.

Objectif :: Des données américaines suggèrent une tendance à la baisse de la prestation de psychothérapie par les psychiatres. Néanmoins, la mesure dans laquelle ces résultats se généralisent aux pratiques psychiatriques d’autres pays n’est pas claire. Nous avons interrogé des psychiatres de la Colombie-Britannique pour examiner si la baisse de la prestation de psychothérapie s’étend à l’ensemble de la pratique psychiatrique canadienne.

Méthode :: Un sondage a été posté à toute la population des psychiatres pleinement licenciés enregistrés en Colombie-Britannique (n = 623). Le sondage consistait en 30 items. Des statistiques descriptives ont servi à caractériser l’échantillon et les modèles de pratique de psychothérapie. Les associations entre variables ont été évaluées à l’aide de tests non paramétriques.

Résultats :: En tout, 423 psychiatres ont renvoyé le sondage, pour un taux de réponse de 68 %. Globalement, 80,9 % des psychiatres ont déclaré pratiquer la psychothérapie. Aucune baisse de la prestation de psychothérapie n’a été observée; en fait, il y a eu une augmentation de la prestation de psychothérapie chez les psychiatres qui ont commencé leur pratique dans les 10 dernières années. La thérapie individuelle était le format prédominant utilisé par les psychiatres. La principale orientation théorique la plus courante était psychodynamique (29,9 %). En ce qui concerne la pratique actuelle, la psychothérapie de soutien était la plus souvent pratiquée. Les contraintes de temps des professionnels étaient perçues comme étant l’obstacle le plus significatif à la prestation de psychothérapie. La majorité (85 %) des cliniciens ne voyaient pas la rémunération comme un obstacle significatif à traiter les patients par psychothérapie.

Conclusions :: Nos résultats remettent en question le point de vue dominant selon lequel la psychothérapie serait en baisse chez les psychiatres. Les psychiatres de la Colombie-Britannique continuent d’intégrer la psychothérapie et la pharmacothérapie dans la pratique clinique, préservant ainsi leur place unique dans le spectre des services de santé mentale.

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Figures

Figure 1
Figure 1
Percentage of psychiatrists practicing psychotherapy by years in practice, n = 420
Figure 2
Figure 2
Extent of practice of different therapy approaches, n = 342 ACT = acceptance and commitment therapy; CBT = cognitive-behavioural therapy; DBT = dialectical behaviour therapy; IPT = interpersonal psychotherapy; MBCT = mindfulness-based cognitive therapy
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