Licensed psychologists in health care: A survey of their practices.

Dörken, Herbert; Webb, James T.

doi:10.1037/10070-003

Cited by 28 publications

(19 citation statements)

References 14 publications

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“…Back in 1977, before there was a law in any state specifically recognizing the hospital practice of psychology, a survey of licensed psychologists in 10 CHAMPUS reporting states (Dorken & Webb, 1979a) yielded some information on hospital practice (Dorken & Webb, 1979b). It showed that among psychologists in full-time fee-for-service practice (FT-FFS) there were some pioneers.…”

Section: Discussionmentioning

confidence: 99%

The hospital private practice of psychology: CHAMPUS 1981–1991.

Dörken¹

1993

Professional Psychology: Research and Practice

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This article reviews and analyzes CHAMPUS (Civilian Health and Medical Program of the Uniformed Service) inpatient data from 1981 to 1991. Utilization data are presented by state, year, and profession for inpatient visits. There has been a moderate but progressive growth in the proportion of inpatient visits provided by psychologists over these years, from 3.3% to 19.4%, nationally. In terms of beneficiaries receiving some psychological services, the proportion increased from 7.2% to 26.5%. Visit level in 1991 was highest in Texas at 30.5% and least in Georgia at 12.7% among the 9 states detailed. Psychiatry has seen a 20% drop in the proportion of inpatient visits it has rendered over these years, and fewer psychiatrists provided CHAMPUS services in 1991 than in 1981. These data reflect the fact that the private practice of psychology in hospitals has gained increasing recognition.The main purpose of this article is to document the gradual growth in the private practice of psychology in hospitals over the 1981 to 1991 period. The scope and volume of CHAMPUS mental health services provides a major window through which fee for service (FFS) psychological practice can be studied. The focus here is on the expansion of inpatient hospital practice by psychologists over an 11 -year period, in one of the single largest health programs in the country. To set the stage, pertinent state and then federal legislation are summarized, and a significant change in hospital accreditation standards is noted.The empirical utilization, provider, and cost data on hospital practice presented in this article were derived from the annual accounts of mental health services (claims paid data) under the Civilian Health and Medical Program of the Uniformed Service (CHAMPUS). These data are presented in tabular form, and their implications discussed. State LawPsychology state licensure laws are generally silent on "locus of care." Although freedom of choice legislation has been widely adopted, including 40 states covering 92% of the U.S.

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Section: Discussionmentioning

confidence: 99%

The hospital private practice of psychology: CHAMPUS 1981–1991.

Dörken¹

1993

Professional Psychology: Research and Practice

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“…This increasing demand for service can be contrasted to a national survey (National Register of Health Service Providers, 1977) which reported that less than one percent of psychologists have caseloads consisting primarily of the elderly. These and other data {e.g., Dorken & Webb, 1979;Ford & Sbordone, 1980;Levy et al, 1980;Lisdorfer & Stotsky, 1977) clearly indicate that psychology has failed to meet the service needs of the elderly. In searching for an explanation, many have placed this inequity (along with others which seem to characterize our contemporary consciousness) at the feet of Freud (e.g., Cohen 1981;Garfinkel, 1975); feet, we might add, whose ratio of clay to marble seems to fluctuate depending on the theoretical allegiance of the discussant.…”

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confidence: 82%

Responsibility and the elderly: Applications to psychotherapy.

Zevon¹,

Karuza²,

Brickman³

1982

Psychotherapy: Theory, Research & Practice

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Based on the analysis of four models of psychotherapy are proposed. It is argued that a key element in clinical interventions with the elderly is the extent to which the intervention affects the elderly clients' perceived responsibility for the cause of and solution to their presenting complaints. Empirical evidence is reviewed suggesting that psychotherapeutic models that foster enhanced personal responsibility for solutions to problems are beneficial for elderly clients. The dangers of a medical model psychotherapeutic orientation that strips clients' feelings of control are discussed.

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“…Both groups appear to share the same biases with regard to psychotherapy for elderly clients. Therefore, it should not be surprising that older adults, who in fact suffer disproportionately from psychological problems (Busse & Pfeiffer, 1977;Butler, 1975;Gate et al, 1980;Kay et al, 1964), receive psychotherapy so rarely (Butler, 1975;Cohen, 1980;Dorken & Webb, 1979;Dye, 1978;Goldstrom et al, 1987;Lebray, 1979;Marmor, 1975;Roybal, 1984Roybal, , 1988Storandt et al, 1978, preface;Turner & Turner, 1987;Zarit, 1980).…”

Section: Benefit Of Psychotherapymentioning

confidence: 99%

Psychotherapy for the elderly: Public opinion.

Zivian¹,

Larsen²,

Gekoski³

et al. 1994

Psychotherapy: Theory, Research, Practice, Training

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The ratings of 414 respondents aged 17-81 years revealed strong biases against psychotherapy for older adults. Ratings of the value of psychotherapy and the benefit that clients could derive from psychotherapy decreased steadily with increasing target age. The respondents' ratings in the present study are consistent with psychotherapists' lower preferences for treating older adults found in a previous study (see Zivian, Larsen, Knox, Gekoski, & Hatchette, 1992). Together, the results of the two studies reveal biases that may explain why so few older adults seek and receive psychological services. The present study examined the general public's knowledge, attitudes, and beliefs about psychotherapy for older adults. Two previous studies, Hochman, Storandt, & Rosenberg (1986) and Roy & Storandt (1989), investigated peoples' perceptions of the severity of psychopathology in older people, but, to the best of our knowledge, neither the general public's knowledge and beliefs This study is based on the second author's doctoral dissertation. A previous version of this article was presented at the 1986 meeting of the Canadian Association on Gerontology in Quebec City, Quebec, Canada. The authors wish to thank the staff and visitors of the Ontario Science Centre whose cooperation helped make this study possible.

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Licensed psychologists in health care: A survey of their practices.

Cited by 28 publications

References 14 publications

The hospital private practice of psychology: CHAMPUS 1981–1991.

The hospital private practice of psychology: CHAMPUS 1981–1991.

Responsibility and the elderly: Applications to psychotherapy.

Psychotherapy for the elderly: Public opinion.

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