The practice of psychiatry has undergone great
changes in recent years. In this book, Joel Paris, MD, a
veteran psychiatrist, provides a fluently written and
accessible "state-of-the-field" assessment. Himself a
clinician, researcher, and teacher, Paris focuses on the
most striking change within the field - the diverging
roles of psychopharmacology and psychotherapy in
contemporary practice. Where once psychiatrists were
trained in Freudian psychoanalysis - which involved,
more than anything else, talking - current pressures in
mental health practice, including those imposed by
managed care, are leading psychiatrists to treat more
and more of their patients exclusively with medication,
which is cheaper and faster. At the same time,
psychotherapy is increasingly not being taught to new
psychiatrists-in-training, even though, as Paris
reveals, there is scientific evidence that both talk
therapies and medication can play an important role in
the treatment of mental illness. These developments are
occuring against a backdrop of exploding research in the
genetics and neurobiology of mental illness that will
continue to drive the field. Paris ends by contemplating
how going forward psychiatry can best respond to all
these forces and proposes a team-based approach to
mental health care. The book will appeal both to
specialists and nonspecialists, particularly psychiatric
residents and fellows, medical students considering
specialization in psychiatry, clinical psychologists,
social workers, and general readers, especially
consumers of mental health services.
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