Hunt W R
Aspen Crest Hospital, Pocatello, Idaho.
Psychiatr Clin North Am. 1990 Jun;13(2):323-31.
In the same practice setting a psychoanalyst does not practice psychiatry much differently than his colleague without analytic training. The impact of the economic environment can determine practice behavior more than differences in background. Subtle and not-so-subtle pressures, particularly from third-party payers, create a push to remove a symptom or resolve a crisis in the cheapest and fastest way possible. This pressure leads to a preference for the use of medication and supportive-directive types of psychotherapy in the absence of any evidence that they are truly more effective, as judged by a broad and long-range benefit to patient and society.
在相同的执业环境中,精神分析师的精神病学实践与未接受过精神分析培训的同事并无太大差异。经济环境的影响比背景差异更能决定执业行为。微妙和不那么微妙的压力,尤其是来自第三方支付方的压力,促使人们以尽可能便宜和快速的方式消除症状或解决危机。这种压力导致在没有任何证据表明药物治疗和支持性 - 指导性心理治疗从对患者和社会的广泛和长期益处来看真的更有效的情况下,人们更倾向于使用这些方法。