Extinction of Medical Psychotherapists

A message from one of the editors…

In the UK, with nearly half of the consultant posts gone in the last few years, Medical Psychotherapists face the possibility of becoming extinct like the dinosaurs. The reality of the situation might be approached through different scenarios. 1) This is just another cyclic crisis that will pass. Commissioners will realize our value and new posts will be created going back to how things were. I think that, at least in the short and medium term, this might be too optimistic a view. Training posts are being lost, impeding the recycling of the profession. Also, if the number of members of the community falls below a certain threshold, the culture might be damaged and the survivors might lose both support and grounding to go on doing their job. 2) Dinosaurs didn´t get extinct, they evolved into birds. Psychotherapists are coming out of their ivory tower (Psychotherapy services), ranging deep into the woods and fertilizing Liaison, Eating Disorders and other services. This hub and spoke model only works as long as there are strong hubs and links to support psychotherapists in the spoke positions. When the ivory towers fall, rangers get marooned, the dinosaurs lose their teeth and the culture gets diluted to a point where psychotherapists can not continue developing their specific function. 3) Like the warriors of Sibaris, psychotherapists have developed unprecedented skills and taste that should not be contaminated. Even if we die out, our memory will enlighten future generations... Very romantic and tempting, but I see this as just an approach to the dodo bird scenario (see below). 4) The dodo was a stupid bird, unable to compete and it deserved to go extinct. At least in the marketing department, psychotherapists have failed to keep up with the progress of the times. We are seen as clinically ineffective (or too expensive) and theoretically preposterous (being challenged for old psychoanalytic theories which are no longer mainstream). For decades, we failed to do effectiveness research and focused on deepening our understanding of the patient as if that ever mattered to the mental health systems (public or private) that support us. While it is clear that we have made mistakes, our extinction is far from certain. The future is gloomy indeed and we need to explore the different scenarios and act. Networking and lobbying might be key elements for our future. I understand the situation of Medical Psychotherapy in Australia and New Zealand is much brighter than in Europe, with prospects of the Psychotherapy section becoming a Faculty within the RANZCP. Communication and collaboration across frontiers might help to raise the profile of the discipline throughout the globe and enrich everyone involved. It is with this purpose that the newsletter of the UK Psychotherapy Faculty of the RCPsych is being offered to all members of RANZCP interested in receiving it and that the editors of the newsletters in the UK on one side and in Australia and New Zealand on the other, are communicating and starting to collaborate.