Psychotherapy Finances

Therapists have a tough enough time marketing their practice, and managed care reimbursement rates have remained steady or fallen. But there may soon be more competition to contend with as a result of a computer game developed by researchers in New Zealand.

Called SPARX, the CD-ROM based game is available at sites around New Zealand to help young people deal with depression. In a study, the game was equally effective in treating depression as standard treatments comprised of mainly face-to-face therapy. Benefits include low cost and easy access.

According to the study, published in the British Medical Journal, SPARX was tested at 24 sites that included youth clinics, schools and general medical practices.

Half of the young people at the sites accessed standard treatment for depression through their physician, school counselor or other health care provider, and half used the SPARX game. SPARX was at least as good as the standard treatment, according to ScienceBlog.com.

“Using computer technology that young people are comfortable with is one way of making therapy more accessible, practical, and hopefully more fun,” says Sally Merry, associate professor of psychological medicine at the University of Auckland.

One in five New Zealanders experience depression before their 18th birthday, but 75% are never treated for it.

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Fewer graduating U.S. med school students are going into psychiatry this year. In 2010, 670 graduates opted for psychiatry residency programs, a number that dropped to 640 last year. This year, 616 are headed into the program, according to Psychiatric News.

That’s 3.9% of graduating seniors, the lowest percentage in six years.

There were 1,118 positions offered this year and 1,096 of them were filled. Those not filled by U.S. seniors go to international students, graduates of osteopathic schools and medical school graduates from past years.

In a separate article, Sandra DeJong, chair of the recruitment committee for the American Association of Directors of Psychiatric Residency Training (AADPRT), blamed several factors for the drop including stigma about mental illness and psychiatry, uncertainty about health care reform and reimbursement issues.

- John Nelander, Contributing Editor

UnitedHealth Group earnings were up 3% in the first quarter on 7% revenue growth, impressing Wall Street investors, the company announced Thursday. A major reason for the good showing: people are putting off major medical procedures and going instead for a quick fix, which is saving insurers money, analysts told the Minneapolis Star Tribune. The company is based in nearby Minnetonka.

Also, patients are avoiding emergency rooms and heading to urgent care centers.

Sheryl Skolnick, an analyst who follows UnitedHealth for CRT Capital Group in Stamford, Conn., told the paper that people are “being very cautious about how they spend their health care dollars. If a doctor gives them the choice of a fix or a painkiller, they’re taking the painkiller.”

Financial analysts say investors are worried, though, about the U.S. Supreme Court decision due in June. If the Affordable Health Care Act is struck down, and the insurance mandate dissolves, it will probably mean less revenue for UnitedHealth and other insurers in the long run.

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Social media websites are cracking down on material that promotes anorexia and other eating disorders, ABC News reported this week. Tumblr, Facebook and Pinterest said they would remove pro-eating disorder posts and links to websites that offer such information as how to cover up eating disorders.

A statement on Tumblr announced: “We aim to sustain Tumblr as a place that facilitates awareness, support and recovery, and to remove only those blogs that cross the line into active promotion or glorification of self-harm.”

Hospitalizations dropped 23% for eating disorders between 2007 and 2008, the first time they have decreased since tracking for the problem began in 1999. But skeptics say the real reason for the decline is a loss of health insurance coverage, not an actual drop in the number of people struggling with the condition.

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WELLNESS ON THE WEB: Aetna has hooked up with the online Mindbloom Life Game, making its services available to members and employees. The “Life Game,” according to Aetna “blends the principles of behavioral science with social gaming to offer a fun, simple and effective way for Aetna to inspire people to live healthy, productive and balanced lives.”

It’s an interactive service that encourages the user to set behavioral goals and keep track of their progress. The company’s move was announced April 11.

The website Mashable Business describes the Life Game this way: “Mindbloom’s Life Game is based on the central concept of a tree as the metaphor for a user’s life. By choosing a series of areas to focus on maintaining and improving — for example, health, creativity, relationships and so on — users see those facets of their lives represented as different parts of the tree.

“They can then in put a series of smaller benchmarks — such as completing a set of push-ups, practicing guitar scales or spending time with family — that aim toward larger goals. If they achieve their smaller tasks, then different areas of their tree grow. If not, then that growth remains stunted.”

Aetna claims the game is also way for members to manage stress and boost creativity.

What’s better than being a psychologist? Well, being a medical secretary, according to a new Best and Worst Jobs of 2012 published by CareerCast.com. Based on factors that included physical demands, work environment, income, stress and hiring outlook, psychologists came in at No. 41 out of a list of 200 occupations.

Right behind them were psychiatrists at No. 42. Medical secretary came in at No. 39 and physicians in general practice were 38th on the list. The top-ranked health care occupation, according to CareerCast, was a dental hygienist, ranked at No. 4.

Other medical professions ranked in the top 50 were: occupational therapist (7); speech pathologist (11); optometrist (12); physical therapist (13); pharmacist (14); dietician (17); chiropractor (19); orthodontist (23); podiatrist (24); dentist (32); registered nurse (38); optician (44); surgeon (45); respiratory therapist (46); and medical records technician (50).

Social Workers came in at No. 51.Marriage and family therapists were not ranked, nor were professional counselors.

The most undesirable health care occupation was a dental laboratory technician, listed at No. 134. The worst occupation overall, according to CareerCast, was a lumberjack, right behind dairy farmer and enlisted military soldier.

The best job was software engineer, only slightly better than an insurance actuary, which came in at No. 2.

Much of the survey, not surprisingly, is based on job demand and pay. Software engineers are commanding a median income of $88,142 per year, according to The Wall Street Journal. Lumberjacks start at between $12 and $13 per hour, the paper said.

- John Nelander, Contributing Editor

The National Alliance of Professional Psychology Providers (NAPPP) has a long history of blasting the trend toward physicians prescribing patients pharmaceuticals as a first-line of treatment for mental disorders. Last December, the organization contracted with a producer to make a pro-psychotherapy video to be aired on PBS, Fox News and CNN.

This month, NAPPP put a rough edit of the video on its website. “Keep in mind that this is a first edit,” John Caccavale, a member of the organization’s executive board, says in the new issue of The Clinical Practitioner. “The final will be available in a few weeks and in HD quality for TV broadcasting.”

Caccavale and other board members hope the video will reach 60 million viewers over the next year in a bid to confront the shift of mental health care to primary care physicians “head on. Psychologists must become ‘the adults in the room’ before it’s too late,” he says.

The video begins by setting up the argument: “The brain is the most complex organ in the human body, and perhaps the most remarkable,” a narrator says. “But one in five Americans will suffer at least one form of mental illness in his or her lifetime.”

It goes on to talk about the “over-prescribing of psychotropic drugs as a first line of treatment by primary care physicians who may be unqualified to treat mental disorders… [which] has been a concern of many mental health professionals.”

Drugs treat only the symptoms of problems like depression and anxiety, Nicholas Cummings, another executive board member and a former president of the American Psychological Association, says in the film. “If you give aspirin for a headache,” he says, “the person may get temporary relief from pain, but then may also die.”

In an article accompanying the release, Caccavale concludes: “Medications have their place in some treatment plans but not without an appropriate role for doctoral level psychologists.”

The watch the video, click here.

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Origins of the field of sports psychology were spotlighted–just in time for the opening of the 2012 baseball season–in the APA’s April issue of the Monitor on Psychology.

It tells the story of a Illinois psychologist Coleman Griffith, who was hired by Chicago Cubs owner Philip Wrigley to help bail out the 1938 season. The Cubs had tried everything that year, including bringing in a guy “in a checkered suit” to “put a whammy” on opposing teams.

But Griffith didn’t have any more success than the “unnamed voodoo expert,” according to the Monitor. In fact, manager Charlie Grimm was disgusted by the idea and ordered his players not to cooperate with the “headshrinkers.”

“Wrigley watched and did nothing,” says the Monitor. Griffith was kept on the payroll until 1940, after which he returned to the University of Illinois. Other managers looked at the experiment as a failure, but Griffith was declared “America’s first sport psychologist” in 1970.

- John Nelander, Contributing Editor