Reaction to psychiatrists doing therapy

[Nasrudin]

I have no idea why you need to pseudointellectualize "I should be able to prescribe what I want to whoever I want" but psychiatry isn't about meeting market demand to prescribe Adderall recreationally because people want to focus better.

It's dangerous practice and there's a reason there's a time and place for medical intervention. Pathologizing the human experience when there's no disorder of function is irresponsible medicine and there's no other way to spin it.

Diagnosing a mental illness in someone who doesn't have it is predatory and damaging, and pretending it's providing a service is like saying sex trafficking brings love and hedonism to markets that can't otherwise find it.

I don't know if I'm your pseudointellectual, but thanks if I am. I've never aspired to be an Intellectual. But I wouldn't disagree with the points you're making. If they were in fact, true. Or to what extent they are true. I have no idea what is happening in other people's practices. I know I've referred my clients to whoever wants to meet ADHD clients quarterly and rx from that high altitude and accept the risks of that and also the administrative burden of that 30 min meeting every 3 months paying for the admin burden to execute that rx in the current environment. Some of those I SUSPECT are practicing in the way you claim they are.

I am the John Snow of private market statistics and diagnostic fidelity and clinical responsibility. But I wonder if it's possible that we would be just so motivationally reasoned to overblow the clinical shenanigans of VC run pill mills. Could it be that they offer 80% of the value and safety and diagnostic accuracy. If so, what are the rights of those majority to access efficient if less quality of care?

Additionally, I've heard enough grumpy, stodgy clinical opinions from our ilk that thinks the neurocognitive traits of ADHD are a childhood phenomenon only that I don't know if we're as pure and as clinically objective or as thorough as you're implying either.

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[splik]

I'll do some more research but from what I have read, literature supports brainspotting as effective as EMDR.

brainspotting is getting very popular among master level therapists for some reason. I'd never heard of it before venturing out into private practice. It is an EMDR off-shoot but there isn't a single clinical study of brainspotting (i found one non-clinical one), let alone an RCT of efficacy. EMDR is also controversial because it is based on quackery. It does work for some indications, but it does not work how it was claimed it works and thus is a pseudoscientific therapy.

 

[psycho-matic]

brainspotting is getting very popular among master level therapists for some reason. I'd never heard of it before venturing out into private practice. It is an EMDR off-shoot but there isn't a single clinical study of brainspotting (i found one non-clinical one), let alone an RCT of efficacy. EMDR is also controversial because it is based on quackery. It does work for some indications, but it does not work how it was claimed it works and thus is a pseudoscientific therapy.

I worked with a very-well respected PhD level psychologist who told me about brainspotting and said it's more effective than EMDR.

 

[ObsequiousAplomb]

I worked with a very-well respected PhD level psychologist who told me about brainspotting and said it's more effective than EMDR.

And this is why expert opinion is considered one of the lower forms of evidence, despite the weight so many people put behind it.

Unfortunately, many well respected people are quacks and many otherwise non-quacks believe some quackery.

That expert very well may have a great intellectualization for why brainspotting and emdr are effective. Rationalization doesn't really change the external reality of the situation, though.

 

[R. Matey]

I do plan to pursue training this year for some specific MODALITIES, CBT-I (at UPenn) and brainspotting, because I want to be able to do more for my patients than push pills. There's almost no one in my metro area offering CBT-I and I think there's a need for it.

Both brainspotting and EMDR are questionable. You'd do more good with written exposure therapy.

 

[bGMx]

Therapeutic alliance is *all* it takes for some positive change. I'm sure a Ph.D with a need to prove something has plenty of that.

 

[AcronymAllergy]

I worked with a very-well respected PhD level psychologist who told me about brainspotting and said it's more effective than EMDR.

The fact that this psychologist mentioned both brainspotting AND EMDR, and spoke of the former positively, substantially erodes my confidence in their competence. At least EMDR has evidence supporting it (with PTSD), fluff notwithstanding.

 

[Fan_of_Meehl]

I am embarrassed that one of my fellow psychologists is that ignorant. I guess they probably don’t even know the difference between a psychiatrist and a PMHNP who in my experience are the ones who have almost zero training in therapy but want to pretend to do it the most.

As a psychologist who was trained 'back in the day,' unfortunately, I've been seeing a LOT more people getting a doctoral-level degree in the field who clearly shouldn't have.

 

[docksan]

The fact that this psychologist mentioned both brainspotting AND EMDR, and spoke of the former positively, substantially erodes my confidence in their competence. At least EMDR has evidence supporting it (with PTSD), fluff notwithstanding.

I've just only heard about this from reading the thread and within two sentences I'm insanely skeptical about "brain spotting".

 

[Stagg737]

I've just only heard about this from reading the thread and within two sentences I'm insanely skeptical about "brain spotting".

I also hate the name as it sounds more like a symptom or a radiologic finding, not a form of psychotherapy. It also sounds too much like Trainspotting, which was a great movie but an experience that I’d like my patients to avoid as much as possible…

 

[calvnandhobbs68]

I also hate the name as it sounds more like a symptom or a radiologic finding, not a form of psychotherapy. It also sounds too much like Trainspotting, which was a great movie but an experience that I’d like my patients to avoid as much as possible…

that's actually what I think of every time I hear it too 😆