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Cities where Psychotherapy is Popular?

Discussion in 'Psychiatry' started by prominence, Apr 21, 2007.

  1. prominence

    prominence Senior Member 10+ Year Member

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    Dec 19, 2001
    i have seen movies and tv dramas where seeing a psychiatrist for psychotherapy is depicted in a positive light among the affluent.

    i know certain places, like new york city, where psychiatrists who practice psychotherapy can have huge demand, such that some even have pure psychotherapy (out-of pocket) practices.

    are there other cities where psychotherapy is well respected, and not viewed with stigma?

    any thoughts? please share.
     
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  3. Tired Pigeon

    Tired Pigeon 7+ Year Member

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    Jan 27, 2007
    Seems like the more of a 'blue state' you're in, the less stigma.
     
  4. prominence

    prominence Senior Member 10+ Year Member

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    Dec 19, 2001
    what's a "blue state"? did u mean states that are predominantly democratic?
     
  5. Doc Samson

    Doc Samson gamma irradiated Physician 10+ Year Member

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    Not Boston anymore
    Boston
    Providence
    Chicago
    LA
    San Fran
    Seattle

    I'm sure that there are others, just not that I'm personally aware of.
     
  6. prominence

    prominence Senior Member 10+ Year Member

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    Dec 19, 2001
    thanks doc samson!
     
  7. Tired Pigeon

    Tired Pigeon 7+ Year Member

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    Jan 27, 2007
    Yes.:)
     
  8. billypilgrim37

    billypilgrim37 Unstuck in Time Physician Faculty 7+ Year Member

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    Apr 21, 2007
    Since when has there been any stigma against psychotherapy? There's lower reimbursement rates for psychotherapy, but that's not really stigma.
     
  9. toby jones

    toby jones 2+ Year Member

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    Jan 7, 2007
    > Boston
    Providence
    Chicago
    LA
    San Fran
    Seattle


    Yeah. I would have thought that cities (for the population) with psychoanalytic institutes. Typically analysts in training see people through an institute at a reduced fee / sliding scale. I am fairly sure (though could be wrong) that making the move from an institute (seeing patients on a reduced fee) to private practice (trying to obtain full fee paying patients) could be a bit tricky, however. I'd imagine that there would be quite a lot of competition between analysts to obtain full fee paying patients and the publics interest in psychoanalysis (and willingness to pay full fees for 3-5 sessions a week) is dwindling... That being said, I wonder if the psychoanalytic institutes keep track of where their graduates are now?

    I know a few people who do analysis and they consider it worthwhile. I'm fairly sure that most of them started seeing their analyst when their analyst was training and when they were themselves students. Now they are earning the money and so (of course) are their analysts. One way of setting oneself up might be to retain the sliding scale / reduced rate cients after their studies when they have jobs (assuming they stay in the area).

    I'd imagine it would help if one could offer 'brief psychodynamic' and be a reimbursed provider with insurance companies and / or for seeing patients for medication reviews.

    With respect to the stigma...

    Traditional Ego Psychology was only catered towards the 'neurotic' type patients who probably wouldn't count as being severely mentally disordered these days (though present with anxiety, depression etc I guess). More along the lines of 'problems in living' or something like that... Since then additional techniques have been added such that borderline conditions (such as borderline personality disorder and narcissistic personality) are suitable for analysis.

    I think part of the stigma comes from the notion that these people aren't REALLY severely mentally disordered and that while patients might subjectively report feeling happy with analysis that might be due to the analysts (unwittingly) fostering an unhealthy attachment such that patients don't obtain jobs in other regions and often move across country precisely so that they can continue seeing their analysts. There isn't much in the way of empirical support for long term analysis. It is hard to measure, to be fair. I find it a little hard to take when I hear professional women say that fairly much their entire salary goes to their analyst each year while they (and their dependents) live off their husbands salary.

    That being said... I'm thinking of becoming an analyst myself...

    ;-)
     
  10. toby jones

    toby jones 2+ Year Member

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    Jan 7, 2007
    (Because I'm interested in theory and it would be nice to have an illustrative case study or two)

    Sorry... I just realised you were wondering about reduced stigma for clients (rather than for analysts). And... You weren't talking about analysis in particular...

    I think the notion has something to do with functioning. If you are looking at clients paying full prices themselves (rather than dealing with insurance companies) then you are typically looking at fairly highly functioning clients. Or the children of fairly highly functioning clients. Or people with inherited wealth, of course, but fairly highly functioning. Analysis probably has less stigma associated primarily because it was originally catered towards high functioning clients. You can't be particularly mentally disordered if you are well enough for a course in analysis! Much like how self improvement is all the rage in some circles having enough money to spend on seeing an analyst for 'self development' is a socially accepted kind of conspicuous consumption in some circles...
     
  11. maranatha

    maranatha 5+ Year Member

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    Mar 12, 2006
    Off-centered
    Would also add the DC/Baltimore region.
     
  12. sasevan

    sasevan Senior Member 7+ Year Member

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    Aug 31, 2003
    Miami
    Hellooo,:D
    NYC South, i.e., South Florida :p (Miami, Ft. Lauderdale, Palm Beach):love:
     
  13. prominence

    prominence Senior Member 10+ Year Member

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    Dec 19, 2001
    i am specifically interested in the psychotherapy climates of cities such orlando, jacksonville, phoenix, atlanta, san diego, and dallas.

    if anyone has any first-hand info on any of these cities, i would love to hear about it.

    thanks for the great responses above!
     
  14. Doc Samson

    Doc Samson gamma irradiated Physician 10+ Year Member

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    Dec 2, 2005
    Not Boston anymore
    I'd rank them like this (most therapy friendly first):

    San Diego
    Dallas
    Atlanta
    ...
    gap
    ...
    Phoenix
    ...
    huge gap
    ...
    Jacksonvlle
    Orlando
     
  15. Caetano-MD

    Caetano-MD 2+ Year Member

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    Oct 31, 2006
    Do a little "industrial espionage".

    1. Do an internet search for "psychiatrists" in that city. Get 10-15 phone numbers.

    2. Call 10-15 psychiatrists. Generally you'll get a secretary.

    3. Say: "Hello. I am looking for a psychiatrist.

    a. How much is the initial visit? How much is the follow up visit?
    b. How long is the waiting list?
    c. How much does the Dr. charge for an hour of psychotherapy?"

    I did this in a couple cities when I was deciding on a place to set up practice--it gives you a good idea of what the market is like (especially long waiting lists mean a big need for psychiatrists).

    It's not foolproof--but it'll give you a general idea.

    Cheers!
     
  16. prominence

    prominence Senior Member 10+ Year Member

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    Dec 19, 2001

    thanks for the great tip!
     

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